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TEXAS CRIME VICTIMS’ COMPENSATION PROGRAM …

10/15 Page 1 of 9 TEXAS CRIME victims COMPENSATION PROGRAM APPLICATION Nota: Si tiene alguna pregunta sobre esta solicitud o si la desea en espanol, favor de llamar al Programa de Compensaci n para las Victimas de Crimen al (512) 936-1200 o (800) 983-9933. Please read the directions on this page before completing the application. Reading these instructions will help youcomplete each section correctly. Include all the documentation you can. If you have a copy of the police report, protective order with affidavit, hospital ordoctor bills, health insurance card, or auto insurance declaration page (if the CRIME is auto-related), be sure to sendthem with the application. If you require additional space on any section of the application, please attach a separate sheet of paper and include allthe required information.

Crime Victims' Compensation Program (011) P.O. Box 12198 . Austin, Texas 78711-2198 If your address or phone number changes, it is important that you let us know. The toll-free number for victims, claimants and service providers is (800) 983-9933. Austin callers should use (512) 936-1200. For security reasons,

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