Executive Summary
I respectfully request that authorities open an investigation into an incident involving [Respondent Initials] and [Victim Initials] on or about [Date], where the victim was allegedly mentally incapacitated and unable to consent. This filing seeks an evidence-based review and appropriate legal action if warranted.
Allegation Overview
Key Claim
The interaction in question did not constitute valid consent. Witness observations and materials suggest the victim lacked capacity to understand or agree, consistent with criteria for incapacity under applicable consent laws.
Why This Matters
Consent requires capacity, voluntariness, and understanding. If a person is hallucinating, disoriented, or otherwise mentally unable to comprehend the situation, any sexual activity is not consensual.
Requested Actions
- Open a formal investigation.
- Preserve and review digital/video evidence.
- Interview witnesses and first responders.
- Provide survivor-centered support services.
Contact for Follow-Up
Name: [Your Full Name]
Email: [you@example.com]
Phone: [+1-xxx-xxx-xxxx]
Preferred Method: [Phone/Email]
Evidence List (to be provided to authorities)
- Video clip: [description, timestamp, source, chain of custody]
- Medical assessment notes: [facility, date, clinician, diagnosis/observations relevant to capacity]
- Witness statements: [initials, date, summary]
- Messages/Logs: [screenshots or exports with dates/times]
Statement (Affiant)
I make this statement in good faith and under penalty of perjury where applicable. I believe the evidence will show the conduct described herein occurred without valid consent due to incapacity, and I request a thorough, impartial investigation.
Signature
________________________________
[Your Full Legal Name]
Dated: [YYYY-MM-DD]
Submission Targets (examples)
- Local Police / Special Victims Unit
- County/Provincial Prosecutor
- Victim Services / Advocacy Clinic
- Hospital Forensic Nurse Examiner (if applicable)
Consult a licensed attorney on venue, statutes, and admissibility.
Public Sharing Notice
If you host this page publicly, keep placeholders or initials for private individuals, and avoid asserting unproven claims as facts. When in doubt, share privately with investigators and counsel instead.