Application adba1f66_admin December 26, 2023
COMPENSATION

Application

Filling out an application is the first step to receiving financial assistance. You can apply even if you don’t yet know all your expenses—submitting an application ensures your eligibility moving forward.

Applying as soon as possible after the crime increases your chances of being eligible for assistance. Delays in submitting an application could affect your eligibility.

computer showing VCCB application on the screen

How to Apply

Innocent victims of crime, certain relatives, dependents, legal guardians and individuals that incurred an expense as the direct result of a crime may be eligible. Whether applying online, by email, fax or through a printed application, please ensure the Release of Information on the final page is signed and included.

We encourage applicants to work with advocates to complete the application process. After submitting your application, our office may request additional information. A representative will contact you to update the status of your claim.

To strengthen your application, include copies of any supporting documents, such as bills or insurance information. If you need help with the application, contact our office—we’re here to assist.

Additional Forms

Additional information may be required based on the request being made. If you have the information already, you can send all supplemental documents at the time of the application; if not, information can be added at a later date. Use this form if your provider requests an updated release of information.

If you paid directly for any of these services, please save your receipts to send in as verification.