Application & Forms

Here you will find the application and all necessary documents to apply for victims compensation.

If you have questions, please call 800-750-1213 (Vermont only) or 802-241-1250. Our Compensation Claims Specialists are available Monday through Friday from 8:30am to 4:30pm.

If you have difficulties printing any of the documents, please call us.

When applying for Victims Compensation you do not have to provide a police report. The claims specialist assigned to your application will gather the information needed for eligibility.

View a short video about how to fill out an application for the Victims Compensation Program.  This video provides ASL interpretation.

To access the Victims Compensation Program’s Online Application, click here. 

You will be asked to Create an Account to start the application process, or to sign in if you have an active application.

Victims Compensation Application Documents:

• Victims Compensation Application English

• Victims Compensation Application Arabic - طلب تعويض الضحايا_اللغة العربية

• Victims Compensation Application Bosnian - Zahtjev za kompenzaciju žrtvama bosanski

• Victims Compensation Application Dari - د قربانیانو د جبران غوښتنلیک دری

• Victims Compensation Application French - Demande d’indemnisation des victimes_Français

• Victims Compensation Application Maay Maay - Edsigy Maghdhowky Dhibiniyaalky_Maay Maay

• Victims Compensation Application Nepali - पीडितहरूका क्षतिपूर्ति आवेदन_नेपाली

• Victims Compensation Application Pashto - د قربانیانو د جبران غوښتنلیک دری

• Victims Compensation Application Simplified Chinese - 受害者赔偿申请书_简体中文

• Victims Compensation Application Somali - Codsiga Magdhowga Dhibanayaasha _Soomaali

• Victims Compensation Application Spanish - Solicitud de indemnización a las víctimas_español

• Victims Compensation Application Swahili - Ombi la Fidia ya Waathiriwa_Kiswahili

• Victims Compensation Application Vietnamese - Đơn Yêu Cầu Bồi Thường Cho Nạn Nhân_Tiếng Việt

Victims Compensation Forms Documents:

• Gas Mileage Form

Victims Compensation Other Documents

• Individual Victim Notice Package Dari - د انفرادي قرباني د خبرتیا بسته دري

• Your Rights as a Victim of Crime in Vermont

• Choosing A Mental Health Provider

• Discrimination Procedures

• Public Records Statute

• Victims Compensation Statute

• Individual Rights Notice Package Pashto - د انفرادي حقونو د خبرتیا بسته پښتو

• Individual Victim Notice Package Bosnian - Individualni paket obavijesti o žrtvama bosanski

• Your Rights as a Victim of Crime in Vermont Bosnian - Vaša prava kao žrtva zločina u Vermontu bosanski

• Your Rights as a Victim of Crime in Vermont Dari - په ورمونټ دري کې د جرم د قرباني په توګه ستاسو حقونه

• Your Rights as a Victim of Crime in Vermont Pashto - په ورمونټ پښتو کې د جرم د قرباني په توګه ستاسو حقوق

• Your Rights as a Victim of Crime in VT Arabic - احتفظ بھذه النشرة في سجلاتك

• Your Rights as a Victim of Crime in VT Nepalese - यो ह्यान्डआउटलाई आफ्नो रेकडर्का ला􀍬ग राख्नुहोस

• Your Rights as a Victim of Crime in VT Somali - KU HAYSO QORMADAN DIIWAANADAADA

• Your Rights as a Victim of Crime in VT Spanish - CONSERVE ESTE FOLLETO PARA SUS REGISTROS

• Your Rights as a Victim of Crime in VT Simplified Chinese - 请保留本宣传单以作记录

• Your Rights as a Victim of Crime in VT Swahili - HIFADHI KITINI HIKI KWA REKODI ZAKO

• Your Rights as a Victim of Crime in VT Vietnamese - HÃY GIỮ LẠI TÀI LIỆU NÀY ĐỂ LƯU HỒ SƠ.

• Your Rights as a Victim of Crime in VT French - CONSERVEZ CE DOCUMENT DANS VOS DOSSIERS.

• Your Rights as a Victim of Crime in VT Maay Maay - ING HAAYSOOY ASHARKUNG DIIWAANGKAA.