PDF FILLABLE CLAIM FORMS

The Fund is providing PDF fillable claim forms to make it easier for you to file your claim. These forms are not intended to be used in place of the online claims system and are made available for those claimants who do not have easy and consistent access to the Internet and who prefer to submit a hardcopy claim form. These forms may be downloaded to a computer for easier data entry or printed and completed in writing. The completed forms must be printed and sent by mail to the VCF.

To help ensure the most efficient claims processing and to maximize the funds paid to Claimants, all Claimants are strongly encouraged to help lower administrative costs by submitting their claims electronically through the VCF's online claims system.

If you have any questions, or would like to request that a hardcopy claim form be mailed to you, please call our toll-free Helpline at 1-855-885-1555 (or 1-855-885-1558 for the hearing impaired).


Personal Injury Claimants

PDF Fillable Eligibility Claim Form
PDF Fillable Compensation Claim Form

Deceased Individuals

PDF Fillable Eligibility Claim Form
PDF Fillable Compensation Claim Form