Forms and Publications

The following forms and publications are formatted as PDF files (unless otherwise noted) -- you need Adobe Acrobat version 3 or later to view the files. If you don't already have a PDF Viewer, you can download Adobe's Acrobat reader here.

Form names followed by an asterisk (*) can be filled out on-line.

General Forms and Publications
Victim Compensation Forms and Publications
Revenue Recovery and Appeals Division Forms and Publications
Government Claims Forms and Publications

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General

• Annual Report 2003-2004
• Annual Report 2002-2003
• Annual Report 1999-2002
• Latest Board Meeting Agenda
• Legislation 2003-2004
• Legislation 2000-1998
• Reports to the Legislature

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Victim Compensation

Materials Request Form (Revised September 2004)

• Applications for Victim Compensation
  • English
    • Victim Application for Crime Victim Compensation*  (Revised April 2004)
      
    • Family Member Application*  (July 2002)
      
  • Español:
    • Solicitud Para Recibir Compensación por un Delito (Para la Víctima) (May 2002)
      
    
    
• Brochures
  • Help for Crime Victims
    
  • Ayuda para Victimas de Crimenes
  
  
• En Español:
  
  • Ayuda para Victimas de Crimenes
  • Solicitud Para Recibir Compensación por un Delito (Para la Víctima)
    
  • El Programa para Ayudar a Victimas de Crimen por Causa de Desprecio y Prejuicios Raciales (Planilla de datos)
    
  • La Publicación para el uso por la aplicación de la ley
    
  
  
• Forms
  • General
    • Relative Caregiver Affidavit
  • Provider Treatment and Billing Forms
    • Additional Treatment Plan*
    • CMS 1500 Form
    • CMS 1500 Sample with instructions
    • CMS (HCFA) Form 1500 Questions and Answers
    • CMS 1450 Form
    • CMS 1450 Sample with instructions
    • Treatment Plan (TP)*
    • Treatment Progress Report*
  • Relocation Benefit Forms
    • Law Enforcement Relocation Benefit Verification*
    • Mental Health Provider Relocation Benefit Verification*
    • Relocation Estimate/Worksheet*
    • W9 Form
    • Rental Agreement
  
  
• Statistical Data
  • July 1, 2005 through August 31, 2005
  • July 1, 2004 through June 30, 2005
  
  
• Victim Compensation Connection Newsletter
  • Victim Compensation Connection - August 2005
  • Victim Compensation Connection - June 2005
  • Victim Compensation Connection - April 2005
  • Victim Compensation Connection - February 2005
  • Victim Compensation Connection - December 2004
  • Victim Compensation Connection - October 2004
  • Victim Compensation Connection - August 2004
  
  
• Other Publications
  • Law Enforcement
    • Law Enforcement Bilingual Card
      
  • Mental Health Care
    • Child Crime Victims: Standards of Care Task Force Guidelines (2001)
      
    • Providers Guide to the New VCP Mental Health Session Limits
    • Provider Flow Chart
  • Posters
    • Posters
  • Standards of Care Guidelines
    
    • Mental Health Care for Child Crime Victims: Standards of Care Task Force Guidelines (2001)
      Publisher: California Victim Compensation and Government Claims Board (CVCGCB), Victim Compensation Program
      Task Force Chairperson: David Chadwick, M.D., Assistant Task Force Chairperson: Michele Winterstein, Ph.D.
      
      This 300-page volume is the result of the efforts of a group of mental health providers and organization representatives who specialize in the treatment of child trauma victims in the State of California. The goal of this group was to produce a set of guidelines that reflect a consensus of the most effective practices for remediating the effects of emotional trauma in child victims of crime. The task force was convened by the CVCGCB; the work of the task force was to address the needs of all victims of child maltreatment.
  • Victims of Hate Crime
    • Arabic
      
    • Farsi
      
    • Gujarati
      
    • Punjabi
      
    • Urdu
      
    • El Programa para Ayudar a Victimas de Crimen por Causa de Desprecio y Prejuicios Raciales (Planilla de datos)
      
  • Victim Witness Centers
    • List of Victim/Witness Assistance Centers

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Revenue Recovery

• California Judges Benchguide
  
• Adult Restitution Fines (Revised January 2004)
  
• Adult Restitution Orders (Revised January 2004)
  
• Juvenile Restitution Fines (Revised January 2004)
  
• Juvenile Restitution Orders  (Revised January 2004)
  
• Revenue Recovery Materials Request (Revised June 2004)

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Government Claims

• Government Claims Claim Form* (Revised August 2004)
  
• Fee Waiver Request (August 2004)
  
• Government Claims Materials Request* (Revised June 2004)
• Erroneously Convicted Felon (Penal Code § 4900) Claim Form

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