How To Apply
To apply for ITVERP, you must submit a completed application.
The application is generally time-consuming and requires supporting documentation to be considered complete. Carefully review the ITVERP Application Checklist before you apply. Simply answering the questions on the application is not sufficient and such applications will be considered incomplete.
Please contact an ITVERP case manager at 1–800–363–0441 for assistance with completing your application. ITVERP case managers will answer your questions and assist you with completing all application steps.
OVC strongly encourages you to use the ITVERP online application, which contains instructions to guide you through the process. You may attach supporting document directly into the online application and track your claim’s progress throughout the lifecycle of their claim.
If you prefer to fill out a paper application, you may find all necessary application and instructions below:
- ITVERP Paper Application (PDF 983 kb)
- Supplemental Paper Application Sheet (PDF 170 kb)
- ITVERP Application Checklist (PDF 81 kb)
- ACH Form (Fillable PDF 140 kb)
- Authorization for Legal Representative Affidavit (2018) (PDF 118 kb)
- Third Party Payer Authorization (2018) (PDF 946 kb)
This application can be used for three different situations:
An Itemized Application—For applicants who have not already submitted an ITVERP claim.
A Supplemental Application—For applicants who have already submitted an ITVERP claim and are requesting additional reimbursement for out-of-pocket expenses not previously claimed or expenses that have changed since the first application (e.g., bills received late or newly required services).
An Interim Emergency—For applicants seeking funds for an immediate need, such as medical treatment, short-term lodging, or emergency transportation. Emergency applications are designed to avoid the substantial financial hardship likely to arise from delayed reimbursements. This type of application is processed at the discretion of the OVC Director.
Generally, the deadline to submit an ITVERP application is 3 years from the date the incident occurred. However, at the discretion of the Director, the deadline for filing a claim may be extended if there is good cause to make an exception.
Details are available in the ITVERP Final Rule (Federal Register Volume 76, Issue 69; April 11, 2011).