Restitution payment: Fill out & sign online

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Click ‘Get Form’ to open the restitution payment form in the editor.
Begin by entering your name and the date at the top of the form. This personal information is essential for processing your submission.
Indicate whether this is unclaimed restitution by selecting 'YES' or 'NO'. This helps clarify the nature of your claim.
Fill in the CICF Claim number, if applicable, along with the county where the crime occurred. This information assists in tracking your case.
Enter the amount of check enclosed and any unpaid balance. Accurate financial details are crucial for proper processing.
Provide names for both the offender and victim, ensuring that all parties involved are correctly identified.
If there is an intended recipient of restitution other than the victim, please specify their name clearly.
Complete additional fields such as date of crime, your role (victim, witness, probation), case number, and court details as required.
To receive a receipt, print your name and address in the designated area before submitting.

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