ଓଡିଶା ମାନବ ଅଧିକାର ଆୟୋଗ
Odisha Human Rights Commission
Guideline to fill form
ONLINE COMPLAINT FILING
COMPLAINANT DETAILS(ଅଭିଯୋଗ ଯାଞ୍ଚ)
Name(ନାମ)
*
Email(ଇମେଲ୍)
Mobile No.(ମୋବାଇଲ୍ ନଂ)
*
Gender(ଲିଙ୍ଗ):
*
Select
Male(ପୁରୁଷ)
Female(ମହିଳା)
Transgender(ଟ୍ରାନ୍ସଜେଣ୍ଡର)
State(ରାଜ୍ୟ):
*
Select State
JAMMU AND KASHMIR
HIMACHAL PRADESH
PUNJAB
CHANDIGARH
UTTARAKHAND
HARYANA
DELHI
RAJASTHAN
UTTAR PRADESH
BIHAR
SIKKIM
ARUNACHAL PRADESH
NAGALAND
MANIPUR
MIZORAM
TRIPURA
MEGHALAYA
ASSAM
WEST BENGAL
JHARKHAND
ODISHA
CHHATTISGARH
MADHYA PRADESH
GUJARAT
DAMAN AND DIU
DADRA AND NAGAR HAVELI
MAHARASHTRA
ANDHRA PRADESH
KARNATAKA
GOA
LAKSHADWEEP
KERALA
TAMIL NADU
PUDUCHERRY
ANDAMAN AND NICOBAR ISLANDS
TELANGANA
District(ଜିଲ୍ଲା):
*
Police Station(ଥାନା):
*
Full Address(ପୂର୍ଣ୍ଣ ଠିକଣା):
*
Pin Code(ପିନ୍ କୋଡ୍):
*
INCIDENT DETAILS(ଘଟଣାର ବିବରଣୀ)
Incident Head Name(ଘଟଣା ନାମ):
*
Select Incident Code
CHILDREN
HEALTH
JAIL
JUDICIARY
MAFIAS/GOONS
LABOUR
POLICE
POLLUTION/ECOLOGY/ENVIRONMENT
RELIGION/COMMUNAL VOILENCE
SERVICE MATTERS
WOMEN
MISCELLENOUS
SC/ST/OBC
OTHERS
Minorities/SC/ST
Juvenile/Beggers Home
Defence Forces
Incident Name(ଘଟଣା ନାମ):
*
Other Subject Matter(ଅନ୍ୟାନ୍ୟ ବିଷୟ):
*
Incident Place(Village/Town/City)(ଘଟଣା ସ୍ଥାନ (ଗ୍ରାମ / ଟାଉନ୍ / ସହର)):
*
State(ରାଜ୍ୟ):
*
Select State
JAMMU AND KASHMIR
HIMACHAL PRADESH
PUNJAB
CHANDIGARH
UTTARAKHAND
HARYANA
DELHI
RAJASTHAN
UTTAR PRADESH
BIHAR
SIKKIM
ARUNACHAL PRADESH
NAGALAND
MANIPUR
MIZORAM
TRIPURA
MEGHALAYA
ASSAM
WEST BENGAL
JHARKHAND
ODISHA
CHHATTISGARH
MADHYA PRADESH
GUJARAT
DAMAN AND DIU
DADRA AND NAGAR HAVELI
MAHARASHTRA
ANDHRA PRADESH
KARNATAKA
GOA
LAKSHADWEEP
KERALA
TAMIL NADU
PUDUCHERRY
ANDAMAN AND NICOBAR ISLANDS
TELANGANA
District(ଜିଲ୍ଲା):
*
Date of Incident(ଘଟଣାର ତାରିଖ):
*
Brief summary of facts/allegations of human rights involved(ସମ୍ପୃକ୍ତ ମାନବିକ ଅଧିକାରର ଅଭିଯୋଗ / ଅଭିଯୋଗର ସଂକ୍ଷିପ୍ତ ସାରାଂଶ ):
*
VICTIM’S DETAILS(ପୀଡିତାଙ୍କ ବିବରଣୀ)
Whether victim details is same as complainant's details(ପୀଡିତାର ବିବରଣୀ ଅଭିଯୋଗକାରୀଙ୍କ ବିବରଣୀ ସହିତ ସମାନ କି |)
Name of the victim(ପୀଡିତାଙ୍କ ନାମ):
*
No. of victims(ପୀଡିତଙ୍କ ସଂଖ୍ୟା):
*
Full Address(ପୂର୍ଣ୍ଣ ଠିକଣା):
*
State(ରାଜ୍ୟ):
*
Select State
JAMMU AND KASHMIR
HIMACHAL PRADESH
PUNJAB
CHANDIGARH
UTTARAKHAND
HARYANA
DELHI
RAJASTHAN
UTTAR PRADESH
BIHAR
SIKKIM
ARUNACHAL PRADESH
NAGALAND
MANIPUR
MIZORAM
TRIPURA
MEGHALAYA
ASSAM
WEST BENGAL
JHARKHAND
ODISHA
CHHATTISGARH
MADHYA PRADESH
GUJARAT
DAMAN AND DIU
DADRA AND NAGAR HAVELI
MAHARASHTRA
ANDHRA PRADESH
KARNATAKA
GOA
LAKSHADWEEP
KERALA
TAMIL NADU
PUDUCHERRY
ANDAMAN AND NICOBAR ISLANDS
TELANGANA
District(ଜିଲ୍ଲା):
*
Pincode(ପିନ୍ କୋଡ୍):
*
Police Station(ଥାନା):
*
Gender(ଲିଙ୍ଗ):
*
Select
Male(ପୁରୁଷ)
Female(ମହିଳା)
Transgender(ଟ୍ରାନ୍ସଜେଣ୍ଡର)
Both
Age(ବୟସ):
*
Whether Disabled Person(ଅକ୍ଷମ ବ୍ୟକ୍ତି କି ):
*
Select
Yes(ହଁ)
No(ନା)
Other Details(ଅନ୍ୟାନ୍ୟ ବିବରଣୀ)
Whether similar complaint has been filed before any Court/tribunal/ Other Commission(କୌଣସି କୋର୍ଟ / ଟ୍ରିବ୍ୟୁନାଲ / ଅନ୍ୟ କମିଶନଙ୍କ ନିକଟରେ ସମାନ ଅଭିଯୋଗ ଦାଖଲ ହୋଇଛି କି):
Select
Yes(ହଁ)
No(ନା)
Name of the Court/State Human Rights(କୋର୍ଟ / ରାଜ୍ୟ ମାନବ ଅଧିକାର):
Name, designation of public servant against whom Complaint is being made:(ସରକାରୀ କର୍ମଚାରୀଙ୍କ ନାମ,ପଦବୀ ଯାହାଙ୍କ ବିରୁଦ୍ଧରେ ଅଭିଯୋଗ କରାଯାଉଛି )
Address of the public servant against whom Complaint is being made(ସରକାରୀ କର୍ମଚାରୀଙ୍କ ଠିକଣା ଯାହାଙ୍କ ବିରୋଧରେ ଅଭିଯୋଗ କରାଯାଉଛି):
Prayer/ Relief if any, sought(ପ୍ରାର୍ଥନା / ରିଲିଫ୍ ଯଦି ଅଛି) :
Supporting Document(ଡକ୍ୟୁମେଣ୍ଟ୍ )
Choose file
Only pdf(Max size 10MB)
Captcha
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Verify All Details Carefully!
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COMPLAINANT VERIFICATION(ଅଭିଯୋଗ ଯାଞ୍ଚ)
Name
*
Email
Mobile No.
*
Gender:
*
Full Address:
*
State:
*
District:
*
Police Station:
*
Pin Code:
*
INCIDENT DETAILS
Incident Head Name:
*
Incident Name:
*
Other Subject Matter:
*
Incident Place(Village/Town/City):
*
State:
*
District:
*
Date of Incident:
*
Brief summary of facts/allegations of human rights involved:
*
VICTIM’S DETAILS
Whether victim details is same as complainant's details
Name of the victim:
*
No. of victims:
*
Full Address:
*
State:
*
District:
*
Pincode:
*
Police Station:
*
Gender:
*
Age:
*
Whether Disabled Person:
*
Other Details
Whether similar complaint has been filed before any Court/tribunal/ Other Commission:
Name of the Court/State Human Rights(କୋର୍ଟ / ରାଜ୍ୟ ମାନବ ଅଧିକାର):
Name, designation of public servant against whom Complaint is being made:
Address of the public servant against whom Complaint is being made:
Prayer/ Relief if any, sought :
Supporting Document
