Manitoba Victim Impact Statement Form Page 3

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Manitoba Victim Impact Statement Form Printable pdf

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3. Financial Impact:

Please describe any financial or property losses that resulted from the crime.

For example:

• the value of any property that was lost or destroyed and the cost of repairs or

replacement

• insurance coverage and the amount of the deductible you paid

• financial loss due to missed time from work

• the cost of medical expenses, therapy or counselling

• any costs not covered by insurance

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This is not an application for financial compensation or restitution. If you wish to inquire

about compensation, contact the Compensation for Victims of Crime Program at

204-945-0899 (Winnipeg) or toll free: 1-800-262-9344.

4. Other Comments or Concerns:

Please describe any other concerns that have arisen as a result of the crime.

For example:

• other ways your life has changed because of the crime

• how you feel about contact with the offender

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