This application form is intended for relatives or close friends of a person who died as the result of a criminal act. “Family and close friends” includes any person related to the deceased person by birth, by marriage or by some other very close relationship (such as a close friend or other significant person).
Priority will be given to immediate family members:
- spouse of the deceased victim
- child of the deceased victim
- father and mother of the deceased victim
- brother and sister of the deceased victim
- grandfather and grandmother of the deceased victim.
You are eligible for financial aid in the form of reimbursed expenses if all of the following statements apply to your case:
- The death of your loved one was caused by a criminal act (homicide, criminal negligence, impaired driving, dangerous driving, etc.).
- A legal proceeding in court or a hearing at the Review Board for Mental Disorder (Commission d’examen des troubles mentaux) has been set for a date later than January 28, 2019.
- The criminal act was committed in the province of Quebec.
Note that applicants under 18 years of age must have their legal guardian help them complete the form. The guardian must also sign in the space provided at the bottom of the form.
If you would like assistance in completing your form, please contact one of the following resources:
- Crime Victim Assistance Centres (CAVAC): 1-866-LE CAVAC (532-2822)
- Association des familles de personnes assassinées ou disparues (AFPAD) – association of families of homicide victims or missing persons: 1-877-484-0404
- MADD Canada – Mothers Against Drunk Driving: 1-877-392-6233
You must enter all the required information in the correct fields. Forms with incorrect or incomplete information may cause a delay in processing your application.
Acknowledgement of receipt
You will receive a printable version of the form by email once you have completed and submitted it.
After you have submitted your form
Based on available information and applications received, the Program will determine which two of the victim’s family or close friends will be accepted. In order to give those close to the victim sufficient time to submit their request, we can wait up to six months following the accused’s first court appearance or two weeks before the date of an important step in the legal proceedings (such as a preliminary inquiry, trial or entering of a guilty plea) before making a final decision on the choice of applicants.
If any additional information is needed to process your application, a Program representation will contact you.
If your application is accepted, you will be informed in writing. You will then be required to complete the reimbursement forms in order to be compensated for your expenses (and those of your companion[s], as applicable): up to a maximum of $2,000 for a legal proceeding, including appeals. In the event of a new legal proceeding or if there are several accused with different trials, additional amounts will be added to the initial allowance.
Travel, meals, accommodation and parking expenses are all eligible for reimbursement. The Program does not provide compensation for loss of income or childcare expenses, however.
If your application is not accepted, you will be informed in writing.
If you are not satisfied with the decision in your case, you may request a decision review in writing within five business days of the decision date, clearly stating the reason for your request. You will be notified of the results of your request within 30 days. All review decisions are final.
Notice of collection of personal information
The information contained in this form is being collected for the sole purpose of administering and evaluating the Program. Access to the information you send us is reserved for authorized persons only. In accordance with the Act respecting the protection of personal information in the private sector (chapter P‑39.1), your information will not be shared with any third-party organizations.
Please do not hesitate to contact us if you have any questions or require more information. Write to us at email@example.com or call 514-277-9860, ext. 2234.