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er rNEW YORK STATE Office of Victim Services Claim Application and Instructions How to Apply for Compensation Who can apply for compensation? Innocent victims of crime, certain relatives, dependents, legal guardians and eligible Good Samaritans can apply to the Office of Victim Services (OVS) for compensation of out-of-pocket expenses not covered by insurance or other resources. What kind of expenses can I get compensated for? OVS offers compensation related to personal injury, death and loss of essential personal property. The specific expenses OVS may cover include: • Medical, pharmacy and counseling expenses • Loss of Essential Personal Property (up to $500, including $100 for cash) • Burial or Funeral Expenses (up to $6.000) • Lost Wages or Lost Support (up to $30.000) (Parents or guardians of hospitalized minor children may be eligible for this benefit) • Transportation (court/medical) • Occupational/Vocational Rehabilitation • Security Devices and DV Shelter Costs • Crime scene clean-up (up to $2.500) • Good Samaritan property losses (up to $5,000) • Moving expenses (up to $2,500) How do I ask for compensation? Send us your completed OVS application along with copies of: • Police reports • Medical bills • Correspondence with insurance companies or benefits plan saying if they will cover your loss • Insurance cards • Receipts for essential personal property • Death certificate and funeral contract • Victim's birth certificate • Proof of age (driver's license, birth certificate etc.) • Legal guardianship papers What if I don't have some of the papers OVS needs? Send your application in right away. You can send the other documents later. What if my property was lost, damaged or destroyed because of the crime? If you are under 18, 60 or over, disabled or were injured, you may apply for benefits to replace your essential personal property or cash that was not covered by any other resource.

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