The Application for Crime Victim Compensation form is available in Portable Document Format (PDF). To view this fillable PDF form, we recommend using the latest version of Adobe Reader which is freely available for download. This form can be saved locally and printed when completed.
NOTE: An application must be completed and filed for each victim. If victim is a minor or is mentally incompetent, the applicant (person filing for victim) must be an adult who is responsble for victim's welfare. Please fill out this application as completely and accurately as possible. Claims will be thoroughly investigated and verified. Unsigned or not witnessed applications may be returned unprocessed.