Application for Benefits - Crime Victims

Document Information
  How to complete a fillable form.
Title Application for Benefits - Crime Victims

This application is used by victims of crime in Washington State to apply for benefits such as compensation for time lost from work; loss of financial support; and medical or mental health treatment.

The application for Homicide Claims is available online by searching for form number F800-120-000.

Document number F800-042-000
How to get this document
Alt Language(s) Español
Valid dates 11/2015
Contact information
Websites Help for Crime Victims

End of main content, page footer follows.

Access Washington official state portal

  © Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.