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Tion 3. MIDDLE NAME: FIRST NAME: Preferred Spoken Language: Preferred Written Language: LAST NAME: GENDER: SOCIAL SECURITY # (No dashes): Does the claimant have a Social Security number? Relationship to victim: DATE OF BIRTH (MMDDYYYY): Mailing Address STREET NUMBER AND NAME OR P.O. BOX: Address 2 (Apartment or Unit #): From the date of the crime to the present, has the claimant been in prison, on probation, or on parole because of a felony? CITY: STATE: ZIP: HOME TELEPHONE: CA W.

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CalVCB is the payor of last resort and can only pay for treatment not covered by any other reimbursement source, including health insurance, civil suits, vehicle insurance, business insurance, home insurance, state disability insurance, and Worker's Compensation.

By law, CalVCB is a payor of last resort, which means applicants are compensated for covered expenses that have not been and will not be compensated from any other source. CalVCB provides compensation to victims of crimes who suffered injuries or threat of a physical injury that resulted in a covered pecuniary loss.

CalVCB funding comes from restitution paid by criminal offenders through fines, orders and penalty assessments, and federal grant funds.

Assistance is limited to the amount of out-of-pocket expenses or bills incurred by or on behalf of the victim or applicant. For applications filed on or after January 1, 2001, the maximum amount CalVCB can reimburse a victim is $63,000.

CalVCB typically issues payment within 30–90 days from receipt of a bill. Several things can cause a delay, including, other available sources of payment, a problem with the eligibility of the claim, or difficulty verifying some of the information.

CalVCB offers several ways to apply for compensation: CalVCB Online.... Open the application. Enter your information. Save a copy to your computer by selecting File > Save. Print a copy, print and sign it and date it. Send your application to: CalVCB. P.O. Box 3036. Sacramento, CA 95812-3036.

CalVCB is the payor of last resort and can only pay for treatment not covered by any other reimbursement source, including health insurance, civil suits, vehicle insurance, business insurance, home insurance, state disability insurance, and Worker's Compensation.

RELOCATION BENEFITS CalVCB may reimburse a claimant up to $3,418 per household for expenses incurred in relocating. Although your claim may have been found eligible, not all claimants qualify for relocation benefits.

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© Copyright 1997-2025
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3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232