State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_15B > GS_15B-7

§15B‑7.  Filing of application for compensation award; contents.

(a)        A claim for anaward of compensation is commenced by filing an application for an award withthe Director.  The application shall be in a form prescribed by the Commissionand shall contain the following information:

(1)        The name and addressof the victim of the criminally injurious conduct, the name and address of theclaimant, and the relationship of the claimant to the victim;

(2)        If the victim isdeceased, the name and address of each dependent of the victim and the extentto which each is dependent upon the victim for care and support;

(3)        The nature of thecriminally injurious conduct that is the basis for the claim and the date onwhich the conduct occurred;

(4)        The law‑enforcementagency or officer to whom the criminally injurious conduct was reported and thedate on which it was reported;

(5)        The nature andextent of the injuries that the victim sustained from the criminally injuriousconduct for which compensation is sought, the name and address of any personwho gave medical treatment to the victim for the injuries, the name and addressof any hospital or similar institution where the victim received medicaltreatment for the injuries, and whether the victim died as a result of theinjuries;

(6)        The total amount ofthe economic loss that the victim, a dependent, or the claimant sustained as aresult of the criminally injurious conduct, without regard to the financiallimitations set forth in G.S. 15B‑11(f) and (g).

(7)        The amount ofbenefits or advantages that the victim, a dependent, or other claimant hasreceived or is entitled to receive from any collateral source for economic lossthat resulted from the criminally injurious conduct, and the name of eachcollateral source;

(8)        Whether the claimantis the spouse, parent, child, brother, or sister of the offender, or issimilarly related to an accomplice of the offender who committed the criminallyinjurious conduct;

(9)        A releaseauthorizing the Commission and the Commission's staff to obtain any report,document, or information that relates to the determination of the claim for anaward of compensation;

(10)      Any additionalrelevant information that the Commission may require.  The Commission mayrequire the claimant to submit, with the application, materials to substantiatethe facts that are stated in the application.

(b)        A person whoknowingly and willfully presents or attempts to present a false or fraudulentapplication, or a State officer or employee who knowingly and willfullyparticipates or assists in the preparation or presentation of a false orfraudulent application is guilty of a Class 1 misdemeanor if the application isfor a claim of not more than four hundred dollars ($400.00).  If theapplication is for a claim of more than four hundred dollars ($400.00), theperson is guilty of a Class I felony. (1983, c. 832, s. 1; 1987, c.819, s. 13; 1991, c. 301; 1993, c. 539, s. 303; 1994, Ex. Sess., c. 24, s.14(c).)