Skip to main content

An official website of the State of Georgia.

Language icon English Organizations

The .gov means it’s official.

Local, state, and federal government websites often end in .gov. State of Georgia government websites and email systems use “georgia.gov” or “ga.gov” at the end of the address. Before sharing sensitive or personal information, make sure you’re on an official state website.

Still not sure?

Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia.

Georgia.gov logo Criminal Justice Coordinating CouncilGeorgia criminal justice coordinating council Criminal Justice
Coordinating Council

Main navigation

  • About CJCC
    • Staff Listing
    • Council Overview
    • Administrative Rules & Bylaws
    • Annual Report
    • Career Opportunities
    • Open Records Request
  • Grants
    • Grant Subject Areas
    • Funding Opportunities
    • Family Justice Center Initiative
    • Human Trafficking Victim Assistance Org.
    • LVAP (5%) Certification
    • Compliance Monitoring
    • Forms & Publications
    • Secure Communities and 287(g)
    • Georgia Victim Assistance Academy (GVAA)
    • Grant Writing Resources/Tips
  • Victims Compensation
    • Victims Compensation Forms
    • Victims Compensation Portal
  • The Statistical Analysis Center
    • Current Projects
    • Research Report Archive
    • Request Data
    • Georgia Criminal Justice Data Resources
  • Human Trafficking Task Force
    • Task Force Overview
    • Membership
    • Work Groups
    • Get Help
    • Task Force Meetings
    • Task Force FAQs
    • Statewide Screening Tool
    • Trainings and Resources
  • Press Releases
  • Events & Trainings
  • VINELink GA
Header Utility Narrow

Search this site

Popular searches

  • Mission Statement
  • Organization of the office
  • History
  • Meeting Requests
  • Key Staff
  • Duties of the Office
  • Event Requests
  • Contact

Breadcrumb

  • Home
  • Victims Compensation
  • Victims Compensation Forms

Victims Compensation

  • Victims Compensation Forms
  • Victims Compensation Portal

Victims Compensation Forms

  • Appeal Request  (PDF, 49.13 KB)
  • Billing Tab Guide for the Victims Comp Portal (PDF, 1.04 MB)
  • Certificate of Foreign Status of Beneficial Owner (W-8BEN) (PDF, 4.76 MB)
  • Civil Rights Requirements Form (PDF, 255.46 KB)
  • Claims Investigator Contact Roster (PDF, 170.8 KB)
  • CPT Code Description of Services Reference Sheet (PDF, 184.34 KB)
  • Crime Victims Compensation Application Spanish (PDF, 53.18 KB)
  • Crime Victims Compensation Application (PDF, 107.49 KB)
  • Deceased Victim Employment Verification Form (PDF, 236.18 KB)
  • District Attorney Release Form (PDF, 539.93 KB)
  • Employment Verification Form For Loss of Support (PDF, 193.02 KB)
  • Employment Verification Form for Lost Wages (PDF, 298.91 KB)
  • FI and FME Victims Compensation Division Designee Form (PDF, 533.47 KB)
  • Forensic Medical Exam CPT Code Reference Sheet (PDF, 208.03 KB)
  • Forensic Medical Examination Law Enforcement DFCS Verification Form (PDF, 580.83 KB)
  • Forensic Medical Examination Fee Schedule (PDF, 233.77 KB)
  • Forensic Medical Examination Law Enforcement- DFCS Verification Form (Fillable) (PDF, 176.65 KB)
  • Human Trafficking Reimbursement Form (PDF, 229.83 KB)
  • Itemized Bill Example (PDF, 260.07 KB)
  • Medical Release Form (PDF, 276.38 KB)
  • Minor Beneficiary Form in Spanish (PDF, 188.7 KB)
  • Minor Beneficiary Form  (PDF, 695.58 KB)
  • Prosecuting Attorney's Questionnaire (PDF, 299.56 KB)
  • Serious Mental and Emotional Trauma (SMET) Form (PDF, 117.71 KB)
  • Supplier Change Request Form (PDF, 903.3 KB)
  • Taxpayer Identification Number and Certification Form (W-9) (PDF, 45.82 KB)
  • Victims Comp FAQ for Restitution (PDF, 932.33 KB)
  • Victims Comp FAQ (PDF, 865.29 KB)
  • Victims Comp Portal Offender Restitution Feature (PDF, 496.49 KB)
  • Victims Comp Portal Rack Card (PDF, 602.55 KB)
  • Victims Comp Portal Resource Guide (PDF, 2.3 MB)
  • Work Release Form (PDF, 208.39 KB)
Georgia.gov logo Criminal Justice
Coordinating Council
  • Facebook page for Criminal Justice Coordinating Council
  • X (Twitter) page for Criminal Justice Coordinating Council
  • Linkedin page for Criminal Justice Coordinating Council
  • YouTube page for Criminal Justice Coordinating Council
  • Instagram page for Criminal Justice Coordinating Council

How can we help?

  • Call Us

    Primary: (404) 657-1956
    Toll Free: (877) 231-6590
    Fax: (404) 657-1957
  • Visit

    104 Marietta Street, NW
    Atlanta, GA 30303-2743 US
    Parking Information

Quick Links

  • Career Opportunities
  • Staff Listing
  • Open Records Request
  • Data Request
  • © Georgia.gov
  • Accessibility
  • Privacy/Security
  • Website powered by GovHub
  • Human Trafficking Notice
  • Georgia Web Analytics