Kindly fill all details in the form below to give an accurate account of the violation being reported.

Name Of Reporter *

Reporter's Phone

Name Of Victim *

Victim's Phone

Date of Violation *

What Case Type(s) does the Violation fall under? [ choose at least (one) 1, or at most (three) 3 ] *

• Battery & Assault
• Arbitrary Arrest
• Mob Attack
• Invasion Of Privacy
• Conversion Therapy
• Wrongful Dismissal
• Threat To Life
• Harassment
• Blackmail
• Discrimination
• Rape
• Theft
• Extortion
• Forceful Eviction
• Kidnapping
• Defamation
• Sexual Assault
• Kito

Case Summary *

Kindly provide an account of the violation being reported

Perpetrators of Reported Violation

• State Actors ( Police, Government Officials, etc)
• Non-State Actors ( Friends, Family, Neighbors, etc )
• State & Non-State Actors

What is(are) the Victim(s)'s Gender identity?

• Transgender Man (you were born female, but identify as male)
• Transgender Woman (you were born male, but identify as female)
• Cisgender Man (If you were born male, and still identify as male)
• Cisgender Woman (you were born female, and still identify as female)
• Gender Non-Binary (You do not identify as strictly a man or a woman)
• Intersex (you were born with sexual or reproductive anatomy that doesn't seem to fit the typical definitions of female or male)

What is(are) the Victim(s)'s Sexual Orientation?? *

• Gay
• Lesbian
• Bisexual
• Pansexual
• Asexual
• Queer

Location Of The Violation *

What is the status of the violation *

• Ongoing
• Already Happened

How would you like TIERs to come in?

Submit