START UP SAMPLE PARALEGAL CASE RECORD FORM Ensure this is the same name used on official applications, to facilitate follow-up. Remember to check whether it is legal to collect data on ethnicity in your country Do you want to record multiple contact details for an individual? How about a back-up in case of displacement/detention/ theft of phone/moving house? Ask about birth registration of children. This could be an opportunity to talk about the importance of registration and inform clients about the process A simple numbering system that assigns a unique number to each case will allow forms to be easily retrieved in a filing cabinet and on a database. Here, the form uses paralegal code–dd/mm/yy — case count (i.e., case number 001, 002 for that date) Are there other gender options that figure among your target population? PARALEGAL CASE RECORD CASE NUMBER: INTAKE DATE: PARALEGAL NAME: Client name: Physical Address/Phone: Place of Birth: Next of Kin/Assisting with Case (Name): Age: Ethnic Group: # of Children: # of Other Household Dependents: m Male m Female | Marital Status: m Single m Married m Widowed m Divorced Client Occupation: m Employed m Unemployed m Student m Retired m N/A (client is child) m N/A (client is deceased) m Other: C L I ENT I NTAK E S E C TI O N Gender: Case Status q Case Opened/Pending q Case Resolved (Successful) q Case Closed (Unsuccessful) How Clients Learned of Paralegals q Door to door outreach q Community meeting q Observed by paralegal at government office q From former client q Is a former client q Other “word of mouth” q Radio q School q Health Clinic q Place of Worship q Other ( __________________________________ ) Does client have birth certificate? m Yes m No Does client have an ID Card? m Yes m No Reason Client Didn’t Apply Before Now q Not eligible until now q No need for document until now q Felt document was not important q Didn’t know details of how to apply q Afraid to interact with govt officials q Didn’t have supporting docs needed q Family members lacked docs needed q Felt distance to reg. center too far q Lacked financial means q Not applicable (has applied before) q Other ( __________________________________ ) Case Type: NATIONAL IDENTITY CARD m Application under normal conditions m Late Application m Update to newer version of document m Replacement (card lost/stolen) m Citizenship by Registration BIRTH CERTIFICATE m Application m Late Application m Replacement PASSPORT Reason Client Seeking Document q Open a bank account q School enrollment/sit for exams q Access to healthcare services q Register to vote q To seek employment q Due to fear of police/criminal penalty q To travel, study, work abroad q To use to apply for another doc. q To support family member’s doc. q Inheritance process q Feel doc important/no urgent reason q Other ( __________________________________ ) Previous Action Taken m None (first attempt to apply) m ook some steps but hasn’t applied m Applied formally, in process m Applied, accepted m Applied, denied m Purchased counterfeit ID m Other ( _________________________________ ) Summary of Issue and Previous Action: m Application m Renewal m Replacement DEATH CERTIFICATE m Application m Late Application m Replacement See the ‘Types of cases paralegals may face’ and ‘Categorizing your caseload’ sections to help think through these options in your context 62 | What other documents (beyond birth certificate) might a client need in your context, to access nationality or other rights and services? E.g. passport, consular card. Refer back to your needs assessment for an idea of the most important documents in your setting that you may want to track for each client. Remember, you cannot search easily for data that is stored in a free text format. Make sure a form also has a typology of cases that can be selected, to facilitate data analysis. A C O M M U N I T Y- B A S E D P R A C T I T I O N E R ’ S G U I D E : D O C U M E N T I N G C I T I Z E N S H I P A N D OT H E R F O R M S O F L E G A L I D E N T I T Y