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This form is to be completed by the applicant’s employer, or their accountant if they’re self-employed. This form is to assess an applicant’s claim for loss of earnings under the Victims Support Scheme as a result of the violent crime or modern slavery.

Patients who have been injured during or following a violent crime may apply for support through the NSW Government as part of the Victims Support Scheme. In most cases they must present documents to verify that they were injured due to a violent crime. This certificate is intended to be used for such verification.

Learn about supporting documents required for a victims support application and access optional templates to help you collect this information.

We understand that losing a family member to homicide is a traumatic and painful experience. If you are a family member of someone who has died as a result of a homicide in NSW, we're here to help during this difficult time.

Recognition payments are payments to acknowledge that a violent crime has been committed against you.

Financial assistance for economic loss to help pay for loss of earnings and other costs that assist with your recovery.

Financial assistance for immediate needs of up to $5000 can help you pay for urgent things you need after experiencing a violent crime.

Immediate Needs Support Package (INSP) helps victims of domestic violence pay for urgent needs such as security, relocation, household items or clothing and toiletries.

If you are a family member of someone who has died as a result of a road crime in NSW, you can use this form to apply for counselling through the Victims Support Scheme.

This fact sheet provides information about the support available to people who have been affected by a homicide that happened in NSW. If you have been affected by another type of crime, visit the Victims Services website for information about the support available. The Victims Support Scheme can provide certain family members with counselling, financial assistance for immediate needs, financial assistance for funeral expenses, financial assistance for justice-related expenses, a recognition payment.