1.      Source(s) of Information (journalist/media outlet, 3rd party, field, news article, etc.):

• Journalist Name, if applicable:

Address:

(Can journalist receive mail from Help Line at this address?)

Email:

(Can journalist receive mail from Help Line at this address?)

Telephone:

(Can journalist receive phone calls from Help Line at this number?)

Press ID:

• Media Outlet of Complainant:

Address:

(Can journalist receive mail from Help Line at this address?)

Email:

(Can journalist receive mail from Help Line at this address?)

Telephone:

(Can journalist receive phone calls from Help Line at this number?)

2.      Date Incident Reported:  

3.      Date Incident(s) Occurred:

(Was it over a period of time?)

4.      Location of Incident:

(As specific as possible) 

5.      Description of Incident:

(Including all parties involved, possible supporting documentation, other people Help Line should speak to (optional for Help Line follow-up), and other appropriate follow-up questions as per definitions.)

6.      Possible Motives for Incident:

7.      Any Prior or Subsequent Action Taken by Journalist/Media Outlet (Authorities Contacted, press statement released, etc.):

8.      Help Line Action Sought by Journalist:

9.      Court Involved, if any (Including Address):

10.  Level of Confidentiality Requested:

a)      Name can be used in public statements

b)      Name can be used in private fact-finding by FMHL

c)      Name and description of incident can be –used internally by OHR offices in the field

d)      Name not to be used at all

• To document actual instances of threats to media freedom and journalists’ rights, and to determine the scope and magnitude of the problem in BiH;
• To provide direct assistance to journalists and media outlets which have experienced threat or interference, to the extent possible within the mandate and resources of the OHR;
• To co-ordinate appropriate follow-up by other agencies.

This project is funded by the European Union, the Swiss Agency for Development and Cooperation and the Office of the High Representative