Criminal
CRIMINAL INJURIES COMPENSATION ACT
CHAPTER 5:31
Current Authorised Pages
Pages Authorised
(inclusive) by L.R.O.
1–6 ..
7–16 ..
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Act
21 of 1999
Amended by
12 of 2011
*14 of 2011
*See Note on page 2
LAWS OF TRINIDAD AND TOBAGO
L.R.O. UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
MINISTRY OF LEGAL AFFAIRS www.legalaffairs.gov.tt
Note on Subsidiary Legislation
This Chapter contains no subsidiary legislation.
Note on Amendment—No. 14 of 2011
The First Schedule to this Act was amended by the Trafficking in Persons Act (No. 14 of 2011)
to include offences under that Act.
2 Chap. 5:31 Criminal Injuries Compensation
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Criminal Injuries Compensation Chap. 5:31 3
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CHAPTER 5:31
CRIMINAL INJURIES COMPENSATION ACT
ARRANGEMENT OF SECTIONS
SECTION
PART I
PRELIMINARY
1. Short title.
2. Commencement.
3. Interpretation.
4. Application of Act.
PART II
ESTABLISHMENT, COMPOSITION AND PROCEDURE OF
BOARD
5. Establishment of the Board.
6. Composition of the Board.
7. Tenure of office of Board members.
8. Remuneration and allowance.
9. Functions of the Board.
10. Meetings and procedure of the Board.
11. Policy directions.
12. Seal.
13. Execution of documents.
PART III
STAFF
14. Appointment and functions of Secretary.
15. Tenure of office of Secretary.
16. Remuneration.
17. Appointment on transfer.
18. Transfer on secondment.
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
MINISTRY OF LEGAL AFFAIRS www.legalaffairs.gov.tt
ARRANGEMENT OF SECTIONS—Continued
SECTION
PART IV
FINANCIAL PROVISIONS
19. Appropriation of moneys for meeting the operating expenses of the
Board.
20. Appropriation of moneys for the payment of compensation to victims.
21. Estimates of expenditure.
22. Account and audit.
23. Financial year.
PART V
APPLICATION FOR COMPENSATION
24. Application for compensation.
25. Procedure for determining applications.
26. Board not bound by legal procedure.
27. Sittings and hearings by the Board.
28. Determination of the Board.
PART VI
PAYMENT OF COMPENSATION
29. Persons entitled to compensation.
30. Compensation may be paid notwithstanding prosecution or conviction.
31. Criminal intent notwithstanding incapacity.
32. Limitation of application.
33. Grounds for denial.
34. Maximum payment.
35. Method of payment.
36. Duty to refund compensation.
37. Failure to disclose.
38. Court’s discretion.
39. Subrogation of Board.
40. Regulations.
FIRST SCHEDULE.
SECOND SCHEDULE.
4 Chap. 5:31 Criminal Injuries Compensation
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Criminal Injuries Compensation Chap. 5:31 5
LAWS OF TRINIDAD AND TOBAGO
L.R.O.
*See section 2 for date of Commencement of this Act.
21 of 1999.
Short title.
Commencement.
257/2000.
Interpretation.
[12 of 2011].
First Schedule.
CHAPTER 5:31
CRIMINAL INJURIES COMPENSATION ACT
An Act to establish the Criminal Injuries Compensation Board,
to make provision for the payment of compensation to
victims of criminal injuries and for matters relating thereto.
*[ASSENTED TO 29TH SEPTEMBER 1999]
PART I
PRELIMINARY
1. This Act may be cited as the Criminal Injuries
Compensation Act.
2. This Act came into operation on 1st November 2000.
3. In this Act—
“application” means an application made under section 24;
“Board” means the Criminal Injuries Compensation Board
established by section 5 of this Act;
“child” includes a step-child, an adopted child and a child of the
victim born after his death;
“criminal injury” or “injury” includes any harm or damage done
to a person’s physical or mental condition as a result of a
crime listed in the First Schedule, any disease deliberately,
recklessly or negligently inflicted on another person and
pregnancy arising out of a rape;
“dependant” means—
(a) a spouse or former spouse who was being maintained
by the victim at the time of the victim’s death;
(b) a person who was living in a cohabitational
relationship with the victim for not less than
three years before his death;
(c) a child under the age of eighteen; or
(d) a person who at the time of the victim’s death
was financially dependant on him;
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First Schedule.
Application of
Act.
First Schedule.
Establishment
of the Board.
Composition of
the Board.
“GAAP” means Generally Accepted Accounting Practice which
includes the International Accounting Standards adopted
by the Institute of Chartered Accountants of Trinidad and
Tobago (I.C.A.T.T.);
“member” means a member of the Board;
“Minister” means the Minister to whom responsibility for the
Criminal Injuries Compensation Board is assigned and
“Ministry” has the corresponding meaning;
“Secretary” means the Secretary to the Board;
“victim” means a person who suffers criminal injury or is killed
by any act or omission of another person which act or
omission is a crime listed in the First Schedule.
4. (1) This Act applies to a—
(a) person who suffers injury; and
(b) dependant of a person who dies, as a result of a
crime listed in the First Schedule.
(2) The Minister may by Order amend the First Schedule.
PART II
ESTABLISHMENT, COMPOSITION AND
PROCEDURE OF BOARD
5. There is hereby established a body corporate to be known
as the “Criminal Injuries Compensation Board” (hereinafter
referred to as “the Board”).
6. (1) The Board shall consist of a Chairman and six other
members, all of whom shall be appointed by the Minister.
(2) The Chairman shall be an attorney-at-law with no
less than ten years experience in the practice of criminal law.
(3) The other members of the Board shall comprise the
following persons:
(a) a medical practitioner of no less than ten years
experience;
(b) an Attorney-at-law of no less than seven years
experience in the practice of civil law;
6 Chap. 5:31 Criminal Injuries Compensation
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Criminal Injuries Compensation Chap. 5:31 7
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Tenure of office
of Board
members.
Remuneration
and allowance.
(c) an attorney-at-law of no less than seven years
experience in the practice of criminal law;
(d) a psychologist;
(e) a representative from the Ministry with
responsibility for social services; and
(f) a duly appointed representative of the Tobago
House of Assembly.
7. (1) Subject to subsections (2) to (6), an appointment to
the Board shall be for a period not exceeding three years and the
members shall be eligible for reappointment.
(2) The Chairman may resign at any time, by letter
addressed to the Minister.
(3) Other members may resign at any time by letter
addressed to the Chairman who shall forward it to the Minister.
(4) An appointment to the Board and the termination
thereof whether by death, resignation, revocation, effluxion of
time or otherwise shall be notified in the Gazette.
(5) Where a member is unable to perform the functions
of office owing to his absence from Trinidad and Tobago, illness
or otherwise, the Minister may appoint another person to act as a
temporary member during that period.
(6) Where the absent member is the Chairman, the
Minister shall appoint a member, not being a temporary member,
to act in his place.
(7) Where a member is absent without leave for three
consecutive meetings of the Board he is deemed to have vacated
his seat.
8. (1) The Board shall pay its Chairman and other
members such remuneration as the Minister approves.
(2) For the purpose of defraying reasonable travelling
and out-of-pocket expenses incidental to their office, members of
the Board shall be paid such allowances as may be approved by
the Minister.
UNOFFICIAL VERSION
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Functions of the
Board.
Meetings and
procedure of the
Board.
Policy
directions.
9. The Board shall be responsible for receiving and
considering applications for compensation and deciding what
compensation, if any, shall be paid.
10. (1) The Board shall meet at least twice a month and at
such other times as may be necessary or expedient for the
transaction of its business.
(2) Meetings of the Board shall be held at such place
and time and on such day as the Board determines.
(3) The Chairman, or in his absence, a member elected
by the Board, shall preside at all meetings of the Board.
(4) Four members of the Board shall form a quorum.
(5) The Chairman shall have a casting vote only.
(6) The decisions of the Board shall be by a majority of
votes of the members present and voting.
(7) The Secretary shall keep, in proper form, the
minutes of each meeting and the minutes shall be confirmed by
the Board and signed by the Chairman at a subsequent meeting.
(8) All decisions made by the Board shall be recorded in
the minutes.
(9) The Board may co-opt any person to attend a particular
meeting of the Board for the purpose of assisting or advising the
Board, but no such co-opted person shall have a right to vote.
(10) Subject to this section, the Board may, by standing
orders, regulate its own procedure at meetings.
(11) The Chairman shall cause notices to be issued to all
members, for a special meeting of the Board, within seven days
of receiving a request in writing signed by any three members, so
to do.
(12) A request for a special meeting shall include
sufficient indication of the purpose of the requested meeting.
11. In the performance of its administrative functions the
Board shall act in accordance with any general policy directions
of the Minister.
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Criminal Injuries Compensation Chap. 5:31 9
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Seal.
Execution of
documents.
Appointment
and functions of
Secretary.
Ch. 69:01.
Tenure of office
of Secretary.
Remuneration.
Appointment on
transfer.
Transfer on
secondment.
12. The Board shall have an official seal that shall be kept in
the custody of the Chairman or otherwise as the Board determines.
13. The seal of the Board shall be affixed to any document
required to be executed by it and such document shall be deemed
to be duly executed if signed by the Chairman or the Secretary.
PART III
STAFF
14. (1) The Board shall appoint a suitably qualified person
to be the Secretary.
(2) In addition to performing the duties of Secretary, as
determined by the Board, the Secretary shall be the Accounting
Officer for the purposes of the Exchequer and Audit Act and for
that purpose shall be a qualified Accounting Technician.
15. (1) The Secretary to the Board shall hold office for not
more than five years and shall be eligible for reappointment.
(2) The Secretary may resign by giving notice in writing
addressed to the Chairman.
(3) The Board may terminate the Secretary’s appointment
by giving one month’s notice or salary in lieu thereof.
16. The Board shall pay the Secretary such remuneration as
the Minister approves.
17. (1) An officer in the Public Service or in the service of
a Statutory Authority may, with the approval of the appropriate
Service Commission and the Board, consent to be appointed on
transfer to the service of the Board.
(2) The officer shall, upon transfer, have preserved this
superannuation and pension rights accruing at the time of transfer.
18. (1) An officer in the Public Service or in the service of
a Statutory Authority may, with the consent of the appropriate
Service Commission and the Board, consent to be transferred on
secondment to the service of the Board.
UNOFFICIAL VERSION
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Appropriation
of moneys for
meeting the
operating
expenses of the
Board.
Appropriation
of moneys for
the payment of
compensation to
victims.
Estimates of
expenditure.
(2) Where a transfer on secondment is effected, such
arrangements as may be necessary shall be made to preserve the
rights of the officer transferred, to any pension, grant or other
allowance for which he would have been eligible had he not
transferred.
PART IV
FINANCIAL PROVISIONS
19. (1) The Board shall establish a fund consisting of such
sums as are appropriated by Parliament from the Consolidated
Fund for the purpose of meeting its operating expenses.
(2) The moneys of the fund, in any financial year, shall
be applied in defraying the following expenditure:
(a) the remuneration and allowances of the Chairman
and other members of the Board;
(b) the remuneration and allowances of the Secretary
and other members of staff;
(c) other operating expenses of the Board.
(3) All moneys appropriated by Parliament to meet the
operating expenses of the Board shall be paid into a bank account
opened with the approval of the Minister of Finance.
20. (1) Parliament shall also appropriate moneys from the
Consolidated Fund for the payment of compensation to victims
or their dependants, as the case may be.
(2) Moneys appropriated under subsection (1) shall be a
separate item of expenditure of the Ministry from which the
Ministry shall pay compensation to a victim on the written
authority of the Board.
21. (1) The Board shall, at least seven months before the
commencement of each financial year, submit to the Minister, for
his approval, an estimate of expenditure in relation to its
operating expenses and the payment of compensation for such
year, in such form as the Minister may prescribe.
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LAWS OF TRINIDAD AND TOBAGO
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
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Criminal Injuries Compensation Chap. 5:31 11
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L.R.O.
Account and
audit.
Ch. 1:01.
Financial year.
Application for
compensation.
(2) The Board shall, at such time as the Minister directs,
furnish him with any further information in relation to the
estimate of expenditure as he may require.
(3) The estimate of expenditure as approved by the
Minister shall be the expenditure budget of the Board for the
financial year to which it relates and is subject to the approval of
the Minister of Finance.
22. (1) The Board shall keep proper books of accounts and
records of all moneys received and expended by the Board and
shall record the matters in respect of which such sums were
received and expended.
(2) Within three months after the end of each financial
year the Board shall cause to be prepared, in respect of that year—
(a) a report setting out the activities of the Board;
and
(b) financial statements prepared in accordance
with GAAP.
(3) In instances where the standards included in GAAP
are inappropriate or inadequate the Treasury shall provide
instructions.
(4) The Accounts of the Board are public accounts of
Trinidad and Tobago for the purposes of section 116 of the
Constitution.
(5) As soon as the accounts of the Board have been
audited, the Auditor General shall send a copy of the Financial
Statements and Report to the Chairman of the Board, the Minister
and the Minister of Finance and shall forward the report to
Parliament in accordance with section 116 of the Constitution.
23. The Financial year of the Board shall be the period of
twelve months beginning the first day of October in any year.
PART V
APPLICATION FOR COMPENSATION
24. (1) A victim or his dependant may apply to the Board
for compensation in accordance with the provisions of this Act.
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
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Second
Schedule.
Ch. 28:02.
Procedure for
determining
applications.
(2) Every application shall be made to the Board in the
manner prescribed in the Second Schedule.
(3) An applicant shall submit the following documents
with the application:
(a) a medical certificate, evidencing the injury
sustained, where the application is being made
by the victim; or
(b) the death certificate of the victim, where the
application is being made by a dependant.
(4) The applicant shall also submit other relevant
documents and other information as requested by the Board.
(5) Where a dependant is—
(a) an infant, the application may be made on his
behalf by a parent, guardian or person acting
in loco parentis;
(b) a mentally and ill person within the meaning of
the Mental Health Act, the application may be
made by the person with whom he normally
resides or a duly authorised medical officer.
25. (1) The Board shall conduct its own inquiries with
reference to an application and may consider any statement,
document or other information that may assist it in making its
decision.
(2) The Board shall obtain a copy of the report of the
police complainant in respect of the crime to which the
application refers and may require the applicant or any other
person to furnish it, within a specified period, with such other
information it may require.
(3) In determining whether or not to pay compensation,
consideration shall be given to—
(a) the nature of the injuries suffered;
(b) whether there was any provocation by the
victim; and
(c) whether the victim or dependant co-operated with
the police and prosecutors in the investigation
and prosecution of the case.
12 Chap. 5:31 Criminal Injuries Compensation
LAWS OF TRINIDAD AND TOBAGO
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MINISTRY OF LEGAL AFFAIRS www.legalaffairs.gov.tt
Criminal Injuries Compensation Chap. 5:31 13
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L.R.O.
Ch. 15:02.
Board not
bound by legal
procedure.
(4) In determining the amount of compensation,
consideration shall be given to—
(a) the amount received or receivable from any
other source by the victim or his dependant, as a
result of the criminal injury;
(b) the conduct of the victim which contributed to
the injury.
(5) For the purposes of subsection (4)(a) all amounts
received or receivable shall be disclosed to the Board by the
victim or his dependant, in writing, at the time of the making of
the application or as soon thereafter as it comes to his knowledge.
(6) For the purpose of subsection (4)(b) and subject to
subsection (7) where the infliction of injury to the victim was
attributable to the conduct of the victim, the application for
compensation may be rejected or the amount of compensation
reduced, having regard to the contribution of the victim to the
criminal injury.
(7) Where injury to the victim was due to his effort to
prevent a crime or to apprehend a person who had committed a
crime or to aid or attempt to aid a member of the security forces
so to do, the amount of compensation shall not be reduced.
(8) For the purposes of subsection (7) “member of the
security forces” means a member of the—
(a) Police Service;
(b) Prison Service;
(c) Fire Service;
(d) Defence Force to the extent that such member
has been assigned to act in aid of the Police;
(e) Supplemental Police established under the
Supplemental Police Act.
(9) Where the application is rejected by the Board, the
Board shall inform the applicant in writing.
26. The Board, in considering an application, shall not be
bound to entertain submissions from legal or other
representatives of a victim or dependant and shall not be bound
by the rules of evidence or legal procedure.
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
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Sittings and
hearings by the
Board.
Determination
of the Board.
Persons entitled
to
compensation.
27. (1) The Board shall hear claims for compensation in
Port-of-Spain, San Fernando and Tobago at such times and in
such places as the Board may determine.
(2) The Board shall notify the applicant of the time and
place of the hearing of the relevant application.
(3) Where the Board makes a decision to hear the
applicant it shall be entitled to call and examine any other person.
(4) The Board shall reach its decision on the basis of
evidence and other information available to it at the hearing.
(5) Subject to section 26 the applicant shall be entitled
to be assisted in presenting his case by a legal adviser or by any
other person of his choice.
(6) The Board shall not be liable to the applicant for the
cost of assistance by a legal adviser but may pay the expenses of
other persons required to attend the hearing.
(7) All hearings shall be in private.
28. (1) Subject to section 30(2), the Board shall make its
determination regarding an application within thirty days of
acknowledgment of receipt of the application and all other
supporting documents and information.
(2) The decision of the Board shall be final.
PART VI
PAYMENT OF COMPENSATION
29. (1) Subject to an application being submitted to the
Board, the Board may pay compensation under this Act to—
(a) the victim;
(b) a dependant of the deceased victim; or
(c) the person responsible for the care and
maintenance of the victim or dependant, where
that person has suffered pecuniary loss or has
incurred expense in the care of the injured
victim or dependant, as the case may be.
14 Chap. 5:31 Criminal Injuries Compensation
LAWS OF TRINIDAD AND TOBAGO
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
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Criminal Injuries Compensation Chap. 5:31 15
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L.R.O.
Compensation
may be paid
notwithstanding
prosecution or
conviction.
Criminal intent
notwithstanding
incapacity.
Limitation of
application.
Grounds for
denial.
(2) Compensation may be paid in respect of—
(a) expenses reasonably incurred as a result of the
injury or death of the victim;
(b) loss of earning power as a result of total or
partial incapacity of such victim;
(c) pecuniary loss to the dependant of the deceased
victim;
(d) other pecuniary loss or expenses incurred
resulting from the personal injury or death of the
victim which the Board determines to be
reasonable.
30. (1) Compensation may be paid whether or not a person
is prosecuted or convicted of the crime on account of which the
application was made.
(2) The Board may suspend consideration of any
application for such period as it thinks appropriate on the ground
that the prosecution for the crime, out of which the injury
occurred, has commenced or is imminent.
31. Notwithstanding the incapacity of the person responsible
for the injury or death by reason of age, insanity, or otherwise,
compensation may be payable under this Act.
32. No compensation shall be paid unless the application is
made within one year after the date of the injury or death or after
that date, upon determination by the Board, that good cause
exists for the delayed application.
33. No compensation shall be paid where the victim—
(a) was guilty of a contravention of, or failed to
comply with, any law which caused or
contributed to his injuries;
(b) was injured as a result of the operation of a
motor vehicle, boat or airplane unless the same
was used as a weapon in a deliberate attempt to
do the victim harm or to cause bodily injury.
UNOFFICIAL VERSION
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Maximum
payment.
Method of
payment.
Duty to refund
compensation.
Failure to
disclose.
Court’s
discretion.
34. (1) Subject to subsection (2), the amount of
compensation payable, under this Act, in respect of the death or
injury of any victim shall be within the absolute discretion of the
Board and shall be in the nature of an ex gratia payment.
(2) No compensation shall be paid, in an amount in
excess of twenty-five thousand dollars.
(3) The Minister may, by Order, increase the amount
payable generally up to a maximum of fifty thousand dollars.
(4) Subject to the provisions of this Act, as to the
payment of compensation to dependants, no compensation is
payable for the benefit of the estate of a deceased victim.
35. Compensation shall be paid in lump sum, except that in the
case of death or protracted disability compensation may provide for
periodic payments to compensate for loss of earnings or support.
36. Where a victim or dependant to whom compensation is
paid subsequently receives a settlement by way of damages or an
award, he shall repay to the Board an amount equal to the
compensation paid to him by the Board.
37. A victim or dependant who—
(a) provides false information to the Board;
(b) fails to disclose the amount received from any
other source in respect of the injury; or
(c) fails to refund the compensation in accordance
with section 36,
commits an offence and is liable on summary conviction to a fine
equal to that of the compensation received or the amount
received from other sources whichever is less and to
imprisonment for six months.
38. Where the victim or a dependant fails to comply with the
requirements of section 36, the Court may in its discretion,
having regard to all the circumstances of the victim or dependant,
decide whether or not the amount of compensation paid to such
victim or dependant shall be refunded to the Board.
16 Chap. 5:31 Criminal Injuries Compensation
LAWS OF TRINIDAD AND TOBAGO
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
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Criminal Injuries Compensation Chap. 5:31 17
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FIRST SCHEDULE
CRIMES TO WHICH THIS ACT APPLIES
(a) Murder;
(b) Manslaughter;
(c) Wounding with intent;
(d) Inflicting injury with or without a weapon;
(e) Using a drug with intent to commit an offence;
(f) Administering poison or other destructive or noxious substance
so as to endanger life or inflict grievous bodily harm;
(g) Administering poison with intent to injure or annoy;
(h) Offences under the Sexual Offences Act;
*(i) Offences under the Trafficking in Persons Act.
Subrogation of
Board.
Regulations.
Section 4(1).
[14 of 2011].
Ch. 11:28.
[14 of 2011].
39. (1) The Board is subrogated to all the rights of the person
to whom payment is made under this Act to recover damages by
civil proceedings in respect of the injury or death and may maintain
an action in the name of such person against whom action lies.
(2) Where the Board pursues an action under subsection (1),
any amount recovered shall be applied—
(a) first to the payment of costs actually incurred in
the action;
(b) second, to the reimbursement to the Board of the
value of the compensation awarded; and
(c) finally, in respect of the balance, if any, to the
payment of the person whose rights were
subrogated.
40. (1) The Minister may make Regulations to give effect to
the provisions of this Act including prescribing any procedures to
be followed in the making and determination of applications.
(2) The Regulations made under this section shall be
subject to negative resolution of Parliament.
*See Note on page 2.
UNOFFICIAL VERSION
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MINISTRY OF LEGAL AFFAIRS www.legalaffairs.gov.tt
Section 24(2). SECOND SCHEDULE
APPLICATION FOR COMPENSATION UNDER THE
CRIMINAL INJURIES COMPENSATION ACT (CHAP. 5:31)
To: The Chairman
Criminal Injuries Compensation Board
I ...................................................... of ..............................................................
(Address)
............................................................................................................................
being a victim of a crime or a dependant person entitled to compensation, hereby
apply for compensation under the above Act and furnish the following particulars:
Name of Victim ..................................................................................................
(Print in block letters)
Name of Applicant (if different from above) ....................................................
Capacity in which application made ........................................... As Victim
........................... As Dependant
Age ................... Date of Birth .................................. Sex ................................
Occupation ........................................................................................................
Place of Employment ........................................................................................
Earnings (Monthly) .................................. Other ..............................................
NIS #...................................
Identification: Passport ...................... ID Card ................................
Driver’s Permit ......................
Crime committed ........................................................ Date ............................
Nature of injuries or loss sustained ..................................................................
Circumstances of injuries or loss sustained ......................................................
18 Chap. 5:31 Criminal Injuries Compensation
LAWS OF TRINIDAD AND TOBAGO
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
MINISTRY OF LEGAL AFFAIRS www.legalaffairs.gov.tt
Criminal Injuries Compensation Chap. 5:31 19
LAWS OF TRINIDAD AND TOBAGO
L.R.O.
No. of dependants and dates of birth—
Name Date of Birth Relationship
1. ................................ .................................. ....................................
2. ................................ .................................. ....................................
3. ................................ .................................. ....................................
4. ................................ .................................. ....................................
Police Station where complaint was made ........................................................
Date on which complaint was made ................................................................
Status of Police Investigation ............................................................................
(State whether police investigations have begun, are in progress or are completed)
............................................................................................................................
............................................................................................................................
............................................................................................................................
Court Proceedings ............................................................................................
(State whether these are civil or criminal)
Status of Court Proceedings ..............................................................................
............................................................................................................................
(State whether these have begun and if they have been completed state the result)
Medical Treatment Received ............................................................................
(Please attach medical certificate)
............................................................................................................................
Whether Insured Yes No
Name of Company ............................................................................................
Type of Insurance ..............................................................................................
Do you waive your right to pursue the cause of action which arises as a result
of the crime? ....................... Yes No
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
MINISTRY OF LEGAL AFFAIRS www.legalaffairs.gov.tt
20 Chap. 5:31 Criminal Injuries Compensation
LAWS OF TRINIDAD AND TOBAGO
SECOND SCHEDULE—Continued
Declaration ........................................................................................................
(State whether you have received or expect to receive amounts from
another source or sources)
............................................................................................................................
............................................................................................................................
Undertaking (to repay any amounts received from other sources)
............................................................................................................................
............................................................................................................................
............................................................................................................................
List all documents accompanying application
............................................................................................................................
............................................................................................................................
............................................................................................................................
............................................................................................................................
...................................................... ......................................................
Signature Date
UNOFFICIAL VERSION
UPDATED TO DECEMBER 31ST 2014
MINISTRY OF LEGAL AFFAIRS www.legalaffairs.gov.tt
