Follow the steps to complete your application online.

1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by providing your personal information in Section 1. Include your full name, any other names you have used, your social insurance number, and your birthdate. Make sure to indicate your marital status and provide your contact information.
3. In Section 2, describe the crime you experienced. You will need to indicate the type of crime, the date it occurred, and the location. If you are filing later than one year after the incident, provide a brief explanation.
4. Section 3 requires you to provide details about any medical or dental treatment received due to the crime. Include the names of any healthcare providers, the treatment dates, and confirm your coverage set-ups.
5. In Section 4, detail the expenses and losses you are claiming as a result of the crime. Check all applicable boxes and keep original receipts for submission.
6. If you are claiming lost income, complete Section 5, providing your employer's details, the days missed from work, and whether you have applied for Workers’ Compensation Benefits.
7. If you are completing the application on behalf of the victim, fill out Section 6 with your relationship to the victim and your contact information.
8. Sign and date both the Declaration (Section 7) and Authorization (Section 8) sections. This is crucial, as applications without signatures will be returned.
9. Finalize your application by reviewing all entries for completeness and accuracy. Then, save your changes, download the completed form, print it, and prepare it for mailing.
10. Mail the original application and any necessary attachments to the Crime Victim Assistance Program using the provided address.

Complete your Canada Victim Application online today to access the support you need.