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Forms

HOME » PDF Forms » Page 9

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

Language Access Complaint Form – ENGLISH

Language Access Complaint Form – SPANISH

Language Access Complaint Form – VIETNAMESE

Language Access Complaint Form – KOREAN

Language Access Complaint Form – CHINESE

Language Access Complaint Form – ARMENIAN

Telehealth Therapy Verification Form

Attorney Fee Service Reply Form – Legal Services Provided to Applicants

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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

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