Application Form
ADVERTISEMENT
1
2
3Criminal Justice Coordinating Council
georgia crime victims
compensation program application
The Crime Victims Compensation Program (CVCP) was established for two
primary purposes, to assist victims with debt incurred as a result of violent crime,
YOU SHOULD APPLY IF:
and to encourage victims to participate in the criminal justice system. Eligible
• You are an innocent victim of
program applicants can receive compensation for up to $25,000 to help with
a violent crime and suffered
personal injury and/or serious
medical and dental care, mental health counseling, economic support, crime
mental or emotional trauma as
scene clean-up, and funeral expenses when the costs are not covered by other
a result
sources (see category caps below).
• You went to the aid of another
Categorical Caps (For covered expenses)
and suffered personal injury
and/or serious mental or
Medical and Dental Expenses - up to $15,000
emotional trauma as a result
Mental Health Counseling Expenses - up to$3,000
• You witnessed or were
Funeral Expenses - up to $3,000
threatened with a crime and
Economic Support - up to $10,000
suffered serious mental or
emotional trauma as a result
Crime Scene Clean-Up - up to $1,500
• You are the parent or legal
*Benefits received are based on actual eligible expenses.
guardian of a minor victim
General Instructions
• You are the parent or legal
guardian of a minor victim and
Please print clearly and remember to sign your application (an original
you lost wages or support due
signature is required to process your application).
to the victimization
Provide at least two telephone numbers where you can be reached, or
• You are the surviving spouse,
where we can leave a message, during business hours.
parent, grandparent, sibling or
child of a homicide victim
Provide the completed and signed application, one itemized bill, and a
• You were legally dependent
copy of the police report, incident report, TPO, or warrant when you
on support from a deceased
submit your application.
crime victim
If you would like assistance filing your claim, or if you have questions,
• You are a domestic violence
please call the Criminal Justice Coordinating Council at 404-657-2222 or
victim who is dependent on
800-547-0060.
support from your abuser
Please send your completed application to:
• You are not the victim, but you
Georgia Crime Victims Compensation Program
have been paying bills related
104 Marietta Street NW, Suite 440
to the crime
Atlanta, GA 30303
YOU SHOULD NOT APPLY IF:
Please Note
• You were committing a crime
You may submit an application even if there is no known offender.
or you were incarcerated
Prosecution is not a program requirement.
when the crime occurred
• You participated in or were
It is important that you inform the Program if you change your address or
telephone number. Also, be sure to provide a secondary contact who has
involved in the events leading
an address or telephone number that we can send information about your
to the crime
claim, or leave messages for you regarding your claim.
• You were on probation or
CVCP is the payor of last resort, this means your benefits will be reduced
parole for a felony conviction
when the crime occurred
by the monies you receive from any other source as a result of the crime,
• You are filing the application
such as insurance, restitution, and civil suit settlements.
more than 3 years from the
CVCP is not an entitlement program; we only award compensation to
date of the crime
those who meet all of the programs eligibility requirements.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial