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Forms

HOME » PDF Forms » Page 4

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Showing 31-40 of 96 results

PC 4900 Erroneously Convicted Person Claim Form (Rev 07/2025)

Material Request Form

American Dental Association (ADA) Dental Claim Form

Appeal Form – SPANISH

Request a CalVCB Presentation

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

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Statistics & Facts

In Fiscal Year 2025-26, CalVCB received 29,031 applications and paid $38 million in compensation. Download the CalVCB Annual Report for more information.

Mental Health: $7,638,557
Relocation: $4,240,604
Income/Support Loss: $8,324,163
Medical: $2,964,549
Funeral/Burial: $13,454,401
Dental: $801,687
Residential Security: $500,603
Crime Scene Cleanup: $35,901

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