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This guide provides clear instructions on completing the T4 Application for Compensation Form for a Personal Injury. Following these steps will help ensure your application is filled out accurately and comprehensively, facilitating a smoother process for your compensation claim.

Follow the steps to complete your application effectively:

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by reading the attached guidance notes carefully, as they contain crucial information regarding the application process. It is important to understand the guidelines before filling in your details.
3. Fill in all sections using block capitals with a black pen. Start with your details, ensuring that you provide accurate information including your title, last name, first names, date of birth, and contact information.
4. If you are applying on behalf of someone who is under 18 or unable to handle their own affairs, complete the relevant section with the necessary information about your relationship to the victim, along with your contact details.
5. Provide details of any representative or organization assisting with the claim. If you have someone representing you, include their full name, address, and contact details. This section is optional if you are managing the application independently.
6. Describe the incident in detail, including the date, time, and location of the injury. Use clear and specific language, and provide the names of individuals involved, if known.
7. Document how you reported the incident to the police, including any relevant dates and the names of officers you spoke with. Explain thoroughly if the report was not made immediately.
8. Detail any injuries sustained as a result of the incident. Be specific about your physical and mental injuries and the treatment you have received.
9. If applicable, provide information on any loss of earnings or special expenses incurred as a result of the injury, ensuring that you understand the conditions under which you can claim for these losses.
10. Review your application thoroughly before submitting. Make sure all sections are completed accurately. Check for any necessary proof of supporting documents if you are applying on behalf of someone and ensure you have their consent to disclose information.
11. Once completed, save any changes and download or print the form as needed. Return the filled-out form to the address provided in the application instructions.

Complete your T4 Application for Compensation Form online today to ensure you receive the support you need.