§ 1-40-107 — Application for compensation; required information

Wyoming § 1-40-107

• Jurisdiction: Wyoming
• Title 01: Civil Procedure
• Ch. 40: CRIME VICTIMS COMPENSATION
• Art. 1: IN GENERAL

Text

(a) The application for compensation shall be on a form
furnished by the division, setting forth:
(i) The victim's name and address;
(ii) If the victim is deceased, the claimant's name
and address and his relationship to the victim, the names and
addresses of the victim's dependents and the extent to which
each is dependent;
(iii) The date and nature of the criminal act on
which claim for compensation is based;
(iv) The date and place where and the law enforcement
officials to whom notification of the criminal act was given;
(v) The nature and extent of the injuries the victim
sustained and the names and addresses of those giving medical
and hospitalization treatment to the victim;
(vi) The economic loss to the applicant and to all
other persons as specified under paragraph (a)(ii) of this
section resulting from the injury or death;
(vii) The amount and source of benefits, payments or
awards, if any, payable to the applicant and dependents;
(viii) Releases authorizing the surrender to the
division of all reports, medical records and other information
relating to the claim and crime; and
(ix) Any other information the division reasonably
requires.
(b) The division may require that materials substantiating
the facts stated in the application be submitted with the
application. If the division finds that an application does not
contain the required information or that the facts stated
therein have not been substantiated, it shall notify the
applicant in writing of the specific additional items or
information or materials required and that the applicant has
thirty (30) days from the date of the notice in which to furnish
those items to the division. The division shall reject the
application of an applicant who although notified fails to file
the requested information or substantiating materials within the
time specified unless he requests, and the division grants, an
extension of time in which to furnish that information.
(c) An applicant may file an amended application or
additional substantiating materials to correct inadvertent
errors or omissions at any time before the division disposes of
the original application. In either case, the filing of
additional information or of an amended application shall be
considered to have been filed at the same time as the original
application.
(d) Information contained in the claim files and records
of victims, which are subject to any privilege of
confidentiality under Wyoming law, shall remain confidential and
shall not be open to public inspection. The information shall be
immune from legal process and shall not, without the consent of
the person furnishing the information, be admitted as evidence
or used for any purpose in any action, suit or other judicial,
legislative or administrative proceeding.