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Victims Access Line 1800 633 063 Aboriginal Contact Line 1800 019 123 (Monday-Friday, 9am-5pm)

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Victim Support Scheme

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Application form for Primary Victims (online)

Application form for Counselling (online)

Application form for Support for a Family Member of a Homicide Victim (online)

Application form for funeral expenses by a funeral director (online)

Application form for forensic cleaning expenses (online)

Application forms - PDF versions

Funeral expenses by a funeral director – fillable (PDF, 100kb)

Forensic cleaning expenses – fillable (PDF, 101kb

Immediate needs support package

Immediate needs support package - Fact sheet & form (PDF, 222Kb)

Use this form to apply for a grant to help pay for costs needed urgently following domestic violence.

You need to attach this to your online Application for support for primary victims, or send it as a hardcopy along with the PDF version of the Application for support for primary victims.

Templates for collecting information to support your application

How to collect information to support your application (PDF, 70kb)

Use this guide to find out how you can use the templates below to collect information to support your application for victims support.

Certificate of injury – fillable (PDF, 105kb)

Use this template to collect information about how the violent crime has affected you physically or psychologically/emotionally. Ask your medical practitioner or other health practitioner to fill out this template.

Certificate of earnings - fillable (PDF, 107kb)

Use this template to collect information about how you were unable to work because of the violent crime. Ask your employer to fill out this template.

Expense Form - fillable (PDF, 439kb)

Use this form to claim new costs related to the violent crime, only if you have already submitted an application form. The Expense Form should only be used for new costs on existing applications.

If you have not already submitted an application for victims support, you can do this online at: 

Government-funded organisation report - fillable (PDF, 95kb)

Use this template to collect information about the violent crime if you reported it to a government or government-funded organisation instead of the police. Ask the government or government-funded organisation to fill out this template. This template may be used to support victim claims made after 14 January 2019.

Family victims

Family victims - a fact sheet about supporting documents (PDF, 45kb)

Use this fact sheet to find out how you can use the templates to collect information to support your application for family victims support.

Family victims travel expenses declaration form - fillable (PDF, 94kb)

Use this form to declare travel expenses incurred as a family victim as a direct result of the act of violence.

Family Victims – A fact sheet about support available to families of homicide victims in NSW

Use this fact sheet to find out more on available support for family members of homicide victims.


Charter of Victims Rights complaints form - fillable (PDF, 2772kb)

Information about making a complaint under the Charter of Victims Rights (PDF, 122kb)

The Charter of Victims Rights sets out 18 rights which outline how government departments should treat and assist you if you are a victim of crime. Victims Services has a responsibility to receive complaints and to try to resolve th em. The Charter Complaints webpage explains what you can do if you feel that your rights have not been met.

Service Complaint Form (Complaints about Victims Services and Approved Counsellors)

Client consent for representative to make a complaint on their behalf.

Information on applying for an internal review

Application for an internal review - fillable (PDF, 97Kb)

Use this form to apply for an internal review if you disagree with a decision from Victims Services about an application for victims support.

Authorising a person to enquire or act on your behalf

Authorising a person to enquire or act on your behalf - fillable (PDF, 70Kb)

Use this form to authorise someone to act on your behalf, to make enquiries and to receive written communication in relation to an application.


Have you been convicted of an offence? You may have to pay restitution (PDF 190KB)

If you have difficulty downloading any forms please contact Victims Services.

All our forms require Adobe Reader (8.01 or above) to be installed on your computer. The free Adobe Reader software can be downloaded from the Adobe website.