Download the file below, read the instructions carefully and fill out the claim application. Also include copies of as much related information (i.e. copies of itemized receipts, bills, insurance statements) as you have.
The more information we have now, the sooner your application can be processed. You can send more itemized bills later as you receive them.
The VCCO will send you a letter when your application is received. If you have not received a letter after four weeks, please call the VCCO. Keep in touch. If you move or if your phone number changes, please let us know.
- The crime must have occurred in New Jersey or a New Jersey resident victimized outside of the State.
- The victim must have reported the crime to police within 9 months*
- The victim must cooperate with reasonable request of the investigation and prosecution of the crime
- The claim must be filed within 5 years of the date of the crime*
* Consideration will be taken if good cause exists for delayed filing
Application and Instructions (PDF)
Help with completing this form can be found through law enforcement agencies, your County Office of Victim/Witness Advocacy or by contacting us at 1-877-658-2221.
Claims Processing System
Below you will find forms useful for Victims, Providers. Some of the following resources are of use to both Victims and Providers.
Third Party Disclosure - Agency
Third Party Disclosure Consent Form
Yearly Evaluation of Mental Health
Psychological Assessment Authorization
Mental Health Providers List
Mental Health Counseling Fee Schedule