Application for Benefits - Crime Victims

Application for Benefits - Crime Victims - (Forms/Publications)
Document Information
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Title Application for Benefits - Crime Victims (A fillable form - 870 KB PDF)
Description

Used by victims of a crime in Washington State to receive benefits for time lost from work, loss of financial support, medical or mental health treatment. The Spanish version of the instructions are online as F800-042-999.

Detail
Form number F800-042-000
Availability
Online only. See document above to download.
Keywords crime victims compensation, cvc, industrial insurance, worker's compensation, workers compensation, workers' compensation
Languages English , Spanish
Valid dates 12-2010
Contact information
Web pages Help for Crime Victims

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