Links to Forms and Publications

Service Provider Forms

Mental Health Service Report (fill-in form for service providers)

Mental Health Service Report (non fill-in form to print - for service providers)

Employer's Certificate (Word)

Funeral Director's Report (Word)

Physicians Report (to be completed by attending physician)

Law Enforcement Victims Rights Notification Pamphlet (eff. 2019)

Sexual Assault Examination Fund Application (Effective November 1, 2023) 

Sexual Assault Examination Fund INVOICE (Effective November 1, 2023)(non fill-in version) 

 

         Crime Victims Compensation Claim Forms

Claim Form (print and write-in) English

Claim Form (type-in and print) English

Aplicar para Compensación para Víctimas de Delitos (July 2019)  

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Brochures / Pamphlets

Victims Rights

Crime Victim Compensation in Indian Country Brochure

25 Suggestions to a Witness

Law Enforcement Victims Rights Notification Pamphlet (eff. 2019) 

2018 Victims Compensation Annual Report Final

 

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Laws and Rules

Public Notice Regarding Personally Identifiable Data

Victims Compensation Board & Sexual Assault Exam Fund Rules/Regs

 Victims Compensation Act

Victims Legislation Manual

Crime Scene Clean up Guidelines for Payment

Native American Traditional Services Guidelines

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Forms for Use by Victim-Witness Services Personnel Only 

2019 Victims Compensation Annual Report Final

Victim Witness Coordinator List (January 2019)

Additional Consideration Transmittal Form (Word fill-in form)  

Appeal Transmittal Form (Word fill-in form)

Claim Form (Word fill-in form)  

Claim Form (non fill-in form)  

Claim Summary Template (Word fill-in form)  NEW

Collateral Source Information Form (Word fill-in form)

Continued Claim Transmittal Form (Word fill-in form)

Eligibility Transmittal Form (Word fill-in form)

Employer's Certificate (Word)

Funeral Director's Report (Word)

Mental Health Service Report (fill-in form for service providers)

Law Enforcement Certificate

Native American Traditional Services Guidelines

Request for Traditional American Indian Services Form

Physicians Report (to be completed by attending physician) 

 Request for Restitution Form

Sexual Assault Examination Fund Application (4/1/2010)

Victim Notification Request Form

Victim Impact Statement

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VOCA Information, Tools, Forms and Training

  Link to VOCA Page  (Click here to redirect you to the VOCA Page)