Application Forms

Application Forms
The following application forms are available to enable you to apply for compensation for criminal injuries sustained in Northern Ireland on or after 1 May 2002:

Personal Injury (PDF)
Use this form to claim compensation for a personal injury, whether mental or physical

Fatal Injury  (PDF)
Use this form to claim compensation if your parent, child, husband, wife, or partner has died as a result of a criminal injury

Supplementary Compensation
Use this form, in relation to claims were the victim has died, other than in consequence of the injury sustained, to claim compensation for loss of earnings or special expenses between the date of injury and subsequent date of death. Please note that if the time period between date of injury and date of unrelated death is less than 28 weeks you will not qualify for a supplementary compensation award.