Report the case Does the trafficking case you want to report concern you or someone else? Yes, the case I am reporting concerns meNo, the case concerns another person(s) What kind of exploitation have you been exposed to? sexual exploitationforced labour / labour exploitationcoercion to begcoercion to commit crimesforced marriageorgan traffickingother When did the case you are reporting happen? Case durationThe case is still ongoing From: Until: Where did the case you are reporting take place? Is there anyone besides you in the same or similar situation? YesNo If you are able and have time, please describe in a few sentences what happened to you If you want, write down your name or surname, one of the two or a nickname (optional information): Name: Surname: Nickname: 8. How old are you? (optional) Gender? MaleFemale Please write down (if known) the address you are currently at (optional) Please write down the address of your official residence / as in the ID card (optional) Have you reported this case before? YesNo Whom to? Do you know the person who exploited you (or is exploiting you)? YesNo If you know his or her personal details, please enter them below (optional) Name: Surname: Nickname: Gender: Age (approximately): Address: Contact (phone or e-mail): Would you like us to contact you regarding this report? YesNo Contact phone or e-mail Convenient time for us to contact you How did you find out about ASTRA? Who provided you with the job? a companyan agencyan intermediary If you know, list the data of the company / agency / employment intermediary: Name (and surname): address: phone number: e-mail: website (in case of a company or agency): Describe briefly how it happened 5. Have you signed a contract with the employer? YesNo Was the content of the contract clear to you before signing? YesNo Is the work you do in accordance with the contract you signed? YesNo Are you adequately paid for the work you do? YesNo Do you have health insurance? YesNo Working hours are: Part-time (less than 8 hours)regular (8 hours)overtime (over 8 hours) If you work overtime, are you paid extra for that work? YesNo 9. Does any of the following describe your workplace? (check all the points you recognize in your case) irregular payment of salariesunpaid overtime workconfiscated personal documentsdenied the ability to movethreats to you or your loved onesphysical violenceverbal violenceunsafe or no work equipmentpoor hygienic conditions in the accommodation (if the employer provides accommodation)unregulated employment statusunregulated residence status (if you are employed in a foreign country)inability to leave the job of one's own free will 10. If you want, write down your name or surname, one of the two or a nickname (optional information) Name: Surname: Nickname: How old are you? (optional) Gender? MaleFemale Please write down (if known) the address you are currently at (optional) Please write down the address of your official residence / as in the ID card (optional) Have you reported this case before? YesNo Whom to? Do you know the person who exploited you (or is exploiting you)? YesNo U17. If you know his or her personal details, please enter them below (optional) Name: Surname: Nickname: Gender: Age (approximately): Address: Contact (phone or e-mail): Would you like us to contact you regarding this report? YesNo Contact phone or e-mail Convenient time for us to contact you How did you find out about ASTRA? What kind of exploitation has the person(s) been exposed to? sexual exploitationforced labour / labour exploitationcoercion to begcoercion to commit crimesforced marriageorgan traffickingother When did the case you are reporting happen? Case durationThe case is still ongoing From: Until: Where did the case you are reporting take place? Number of persons / potential victims in the case you are reporting? If you are able and have time, please describe in a few sentences the case you are reporting Have you known the potential victim before? Please, write down where you have met Have you ever reported this case? YesNo Whom to? Do you know the person who is exploiting potential victims in the case you are reporting? YesNo If you know his or her personal details, please enter them below (optional) Name: Surname: Nickname: Gender: Age (approximately): Address: Contact (phone or e-mail): Can we contact you related to this report? YesNo Contact phone or e-mail Convenient time for us to contact you Name and surname (optional) How did you find out about ASTRA? Who provided the person(s) with the job? a companyan agencyan intermediary If you know, list the data of the company / agency / employment intermediary: Name (and surname): Address: Phone number: E-mail: website (in case of a company or agency): Describe briefly how it happened Has the person signed a contract with the employer? YesNo Was the content of the contract clear to them before signing? YesNo Is the work they do in accordance with the contract they signed? YesNo Is the person(s) adequately paid for the work they do? YesNo Does the person(s) have health insurance? YesNo Working hours of the person(s) whose case you report are? Part-time (less than 8 hours)regular (8 hours)overtime (over 8 hours) If they work overtime, are they paid extra for that work? YesNo Does any of the following describe the person(s)’ workplace? (check all the points you recognize in the case) irregular payment of salariesunpaid overtime workconfiscated personal documentsdenied the ability to movethreats to them or their loved onesphysical violenceverbal violenceunsafe or no work equipmentpoor hygienic conditions in the accommodation (if the employer provides accommodation)unregulated employment statusunregulated residence status (if you are employed in a foreign country)inability to leave the job of one's own free will Have you known the potential victim before? YesNo Please, write down where you have met Have you ever reported this case? YesNo Whom to? Do you know the person / employer who is exploiting potential victims in the case you are reporting? YesNo If you know his or her personal details, please enter them below (optional) Name: Surnemae: Nickname: Gender: Age (approximately): Address: Contact (phone or e-mail): Can we contact you related to this report? YesNo Contact phone or e-mail Convenient time for us to contact you Name and surname (optional) How did you find out about ASTRA? Δ
