Documents tagged "Compensation"
Found 3 documents with this tag
DOJ-OGR-00026113.jpg
The image is a photograph of an official document titled "CRIMINAL INJURY COMPENSATION APPLICATION FORM" from the Criminal Injuries Compensation Authority (CICA) in the UK. The form includes fields for personal details, such as name, date of birth, address, and contact information. There is also space to provide details about the incident leading to the claim, including the date, time, location, and description of the crime committed. The document features a table with columns that are partially filled out, indicating sections for injuries sustained, treatment received, and any loss of earnings or support required as a result of the injury. Additionally, there is space designated for providing evidence to support the application.
DOJ-OGR-00026073.jpg
The image shows a document with various texts and signatures, indicating it is an official form or letter of some sort. The text includes a reference to the "U.S. Department of Health and Human Services" and a section titled "Statement in Support of Claim for Compensation Under the National Vaccine Injury Compensation Program." There's also a date mentioned as "12/05/2008," suggesting when the form was signed or filled out. The document appears to be certified or acknowledged by a person whose name is partially visible at the bottom right corner, though it is redacted for privacy reasons.
DOJ-OGR-00005903.jpg
The image shows a document with text that appears to be structured into paragraphs and sections. The visible text includes headings such as "Re: RE: Re: 12/04 - C&P Examination" and "Reference(s):" followed by an acronym "DIC," which is commonly used in veterans affairs contexts to refer to the Department of Veterans Affairs' Disability Compensation system. The document has a formal layout with lines for addressing recipients at the top, as well as sender information at the bottom. The text itself discusses medical exam procedures and seems to be related to a claim or examination process within the context of veterans benefits.