Get Victim Compensation Application Form - Larimer County - Larimer

Filling out the Victim Compensation Application Form is an important step for individuals seeking compensation for injuries or losses resulting from a crime. This guide offers a clear and supportive approach to help you accurately complete the form online.

Follow the steps to successfully fill out the application form.

1. Click the ‘Get Form’ button to access the Victim Compensation Application Form and open it in the online editor.
2. Begin with Section I, providing your name, date of birth, and contact information including your mailing address and phone numbers. Ensure to fill out your sex and provide your email address for communication, if applicable.
3. If you are not the victim but are submitting the application on their behalf, complete Section II with the claimant's information, including their relationship to the victim.
4. Move to Section III to provide detailed information about the crime, including type, date, law enforcement agency involved, and any relevant incident or case numbers.
5. In Section IV, indicate your insurance information. Specify if you have health, automobile, or homeowner's insurance and provide details about your coverage.
6. If applicable, complete Section V to disclose any civil lawsuits you plan to file related to the injury and provide your attorney's contact information if you have one.
7. Proceed to Section VI to specify the types of claims you are seeking compensation for. Include any necessary documentation, such as itemized bills, where required.
8. If you are applying for relocation or shelter assistance, complete the necessary details in Section VI, ensuring to provide information regarding any protective orders in place.
9. Read and initial each statement in Section VII regarding the release of information and your rights and responsibilities as an applicant.
10. Finally, review your completed application for accuracy, then save your changes. You can download, print, or share the form as needed when you are finished.

Complete your Victim Compensation Application online to begin the process of receiving support.