Get Restitution Claim Form - County Of Lake

Filing a restitution claim is an important step in seeking compensation for losses incurred due to a crime. This guide provides straightforward instructions for completing the Restitution Claim Form for the County of Lake online, ensuring that users can effectively navigate each section of the form.

Follow the steps to accurately complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Complete the top section by filling in the details of the case including 'State V.', 'In the interest of:', 'Case No.', 'Charge(s)', 'Date of incident', and 'Victim'.
3. Provide your address, ensuring it is where restitution should be sent, and include your home, cell, and work phone numbers.
4. Indicate if no restitution is requested by checking the blank provided and returning the form.
5. Detail specific items lost or damages suffered. Attach copies of all receipts, bills, and repair/replacement cost estimates to support your claim.
6. For lost wages, specify your net wages and attach documentation from your employer if applicable. Make sure to clarify any sick or vacation time taken.
7. List mileage incurred, providing dates, reasons for the mileage, and total miles for each entry at the rate of .20 per mile.
8. Itemize medical expenses by listing the dates of treatment and the facilities used. Attach all relevant bills showing itemized services and any payments made.
9. For property stolen or damaged, list each item separately with its replacement cost or repair cost alongside supporting documentation.
10. Include any miscellaneous expenses such as funeral costs as applicable.
11. Calculate and enter the total costs incurred due to the incident at the designated area.
12. Fill out the insurance information, providing the insurer's details, reimbursement status, and any necessary claim documentation.
13. Affirm the accuracy of the information by printing your name, signing the form, and adding the date.
14. Once all fields are completed, save your changes to retain a copy of your claim. You can also download, print, or share the form as needed.

Complete your Restitution Claim Form online today to pursue your rightful compensation.