Forms

W-9 Request for Taxpayer Identification Number and Certification – SPANISH

W-9 Request for Taxpayer Identification Number and Certification – ENGLISH

Relocation Mental Health Verification Form – ENGLISH

Treatment Plan – ENGLISH

Additional Treatment Plan – ENGLISH

Relocation Packet Instructions – SPANISH

Relocation Packet Instructions – ENGLISH

Appeal Form – SPANISH

Appeal Form – ENGLISH

Statistics & Facts

In Fiscal Year 2021-22, CalVCB received 39,015 applications and paid $40.3 million in compensation. Download the CalVCB Annual Report for more information.

Mental Health: $9,991,555.63
Relocation: $2,473,834.25
Income/Support Loss: $5,497,697.41
Medical: $6,251,578.05
Funeral/Burial: $13,464,930.00
Dental: $1,775,836.55
Residential Security: $703,713.51
Crime Scene Cleanup: $20,029.89

© 2024 State of California

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