Get Ct Jd-vs-35 2021-2025

The CT JD-VS-35 is an important form used by individuals seeking to provide information related to crime disclosure in Connecticut. This guide offers comprehensive, step-by-step instructions to help you correctly complete the form online.

Follow the steps to successfully fill out the CT JD-VS-35.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering the date of birth in the format mm/dd/yyyy. This is essential for identifying the victim.
3. Fill in the name of the victim, providing their first, middle, and last names in the respective fields.
4. Enter the claim number associated with the case, ensuring accuracy as this links the form to the victim's information.
5. Input the name of the claimant or the person who is filing on behalf of the claimant, followed by specifying the claims examiner’s name.
6. Answer whether the victim disclosed that they were a victim of a crime in Connecticut by selecting 'Yes' or 'No.' If 'Yes,' provide the date the incident was disclosed.
7. Check the appropriate types of crime that apply to the incident. You may select more than one type, including options such as sexual assault and domestic violence.
8. Indicate whether the victim suffered a physical injury by selecting 'Yes,' 'No,' or 'Don't know.'
9. Specify if the victim suffered an emotional injury and received treatment by selecting 'Yes,' 'No,' or 'Don't know.'
10. Provide a detailed description of the incident, including any physical or emotional injuries disclosed by the victim.
11. State the date or date span of the incident(s) accurately.
12. Select the relevant profession from the options provided, indicating your role in relation to the victim.
13. Fill in the city or town where the incident(s) occurred.
14. Complete the section regarding the person filling out the form, including their name, title, provider license number (if applicable), agency name, address, phone number, and signature.
15. Review all entered information for accuracy before finalizing your form.
16. After completing the form, you may save changes, download, print, or share the completed form as necessary.

For more efficient and effective documentation, complete the CT JD-VS-35 form online today.