The Socioeconomic Impact of Pretrial Detention in Guinea Conakry

Page 55

FAMILY MEMBER DETAILS

F00

Name of the family member?

_________________________________

F01

Name of the Head of Family?

_________________________________

F02

Location of the family member?

Town:

Verification – To be filled after the interview V00

Date of the Interview

/___/___//___/___//___/___/

V01

Name of Enumerator(s)

______________________

V02

Name of Supervisor

______________________

V03

Name of Data Clerk [Not filled by the Enumerator]

______________________

V04

Result of the Interview

District: Village: House Number:

1. Finished 2. Not finished

F03

Reference Point / Description of the place?

F04

Telephone number of the family member?

F05

Other information on how family members can be reached?

F06

Is your family member likely to visit you in these coming days?

Yes……………1 No…………….2

F07

When are they coming?

Yes No Monday………………..1 0 Tuesday……………….1 0 Wednesday…………...1 0 Thursday………………1 0 Friday………………….1 0 Saturday……………….1 0 Sunday………………....1 0

GENERAL COMMENTS/OBSERVATIONS Please note in particular: x Any costs or losses the interviewee (the detainee) has incurred as a result of his arrest and detention which have not been recorded in the above survey instrument. x Any costs or losses the interviewee claims his family / household members have incurred as a result of the interviewee’s arrest and detention which have not been recorded in the above survey instrument. x The conditions of the prison where the interviewee is held and that of the cell the interviewee generally occupies. x Whether pretrial detainees at the prison where the interview took place are kept separately from sentenced prisoners.

1. ______________________ 2. ______________________

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-------------------------------------------------------------------------------------------------------------------------------------------------------Study on the Socioeconomic Consequences of Pretrial Detention

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-------------------------------------------------------------------------------------------------------------------------------------------------------Study on the Socioeconomic Consequences of Pretrial Detention

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