(1)  An application for an award is to be made to a Commissioner by lodging it with the VAU and including the following particulars:

(a) the applicant’s full name, address and date of birth;

(b) a statement as to whether the application is for an interim or final award;

(c) details of the criminal conduct giving rise to the application, including –

(i) the date of the offence; and

(ii) the nature of the offence; and

(iii) details of the offence; and

(iv) the name of the offender, if known;

(d) a statement as to whether the application arises from –

(i) a single offence; or

(ii) a series of offences committed by the same offender; or

(iii) a series of offences committed simultaneously or consecutively by multiple offenders acting in concert;

(e) details of any criminal proceedings taken against the offender, including –

(i) whether the offender was charged; and

(ii) whether those proceedings have been completed; and

(iii) the outcome of those proceedings; and

(iv) details of any penalty imposed on the offender;

(f) details of any claim for damages made against the offender by the applicant, including –

(i) whether a claim for damages has been made against the offender and, if so, the current status or result of that claim; and

(ii) whether a claim for compensation was made in any criminal proceedings taken against the offender and, if so, the current status or result of that claim;

(g) details of the injuries suffered which form the basis of the application, including –

(i) physical injuries; and

(ii) psychiatric or psychological injuries; and

(iii) the impact of these injuries on the applicant, including details of any pain and suffering;

(h) details of expenses incurred by the applicant, or by another person on the applicant’s behalf, as a result of any relevant injury, including –

(i) details of any medical, pharmaceutical, counselling or other treatment expenses not recoverable; and

(ii) the cost of purchase and installation of any therapeutic devices; and

(iii) the cost of travel undertaken for the applicant’s medical or other treatment –

(A) by the applicant; and

(B) if applicable, by a person accompanying the applicant; and

(iv) any other costs incurred as a result of the injury;

(i) details of any loss of income arising from any total or partial incapacity to work arising from a relevant injury to the applicant or to a primary victim for whom the applicant provides care;

(j) details of the costs incurred by the applicant, or by another person on the applicant’s behalf, in making the application, including –

(i) costs of legal representation; and

(ii) costs of medical or other reports obtained to support the application; and

(iii) any other costs incurred in making the application;

(k) a statement as to whether the applicant wishes to have the matter dealt with –

(i) as part of a hearing; or

(ii) as part of a hearing in respect of a matter other than the amount of the award; or

(iii) on the basis of the materials lodged with the application and without a hearing.

(2)  If an application for an award is made by a person for funeral expenses for a primary victim, the application is also to include details of the funeral expenses that the person actually and reasonably incurred, or is reasonably likely to incur, in relation to the death of the primary victim.

(3)  If an application for an award is made by an applicant on behalf of another person, the application is also to include the following information:

(a) the full name, address and date of birth of the person on behalf of whom the application is made (the claimant );

(b) the relationship of the applicant to the claimant;

(c) the reason the application is made by the applicant rather than the claimant;

(d) if requested by the Commissioner, evidence of the claimant’s consent to the applicant making the application on the claimant’s behalf.

(4)  If an application for an award is made by a related victim or a secondary victim, the application is also to include the following information about the primary victim of the offence in respect of which the application is made:

(a) the primary victim’s full name, address and date of birth;

(b) the relationship of the applicant to the primary victim (if any);

(c) details, if known, of any claim for damages made against the offender by the primary victim including the details specified in subregulation (1)(f)(i) and (ii) ;

(d) details, if known, of the injuries suffered by the primary victim including the details specified in subregulation (1)(g)(i) , (ii) and (iii) .

(5)  If an application for an award is made by a person who suffered injury as a result of witnessing an offence, the application is also to include a statement of the circumstances in which the applicant witnessed the relevant offence.

(6)  If an application for an award is made by an applicant as a result of the death of a person, the application is also to include the following information:

(a) the full name and date of birth of the deceased;

(b) the relationship of the applicant to the deceased;

(c) details of expenses incurred as a result of the death, including –

(i) details of any medical, pharmaceutical or other treatment expenses not recoverable; and

(ii) details of funeral expenses; and

(iii) any costs of travel arising from the death; and

(iv) any other costs incurred as a result of the death;

(d) if the applicant was a dependant of the deceased, details of any other financial loss suffered by the applicant as a result of the death.

(7)  If an application for an award is made as a result of an injury incurred in the provision of assistance to a police officer, the application is also to include the following information:

(a) the name and rank of the police officer to whom assistance was provided;

(b) details of the circumstances giving rise to the provision of assistance;

(c) details of the assistance provided.

(8)  An application for an award is to be accompanied by a statutory declaration made by the applicant or the person applying on the claimant’s behalf.

(9)  The statutory declaration is to –

(a) set out the particulars of the application as specified in this regulation; and

(b) be in accordance with the form in Schedule 1 .

(10)  An applicant for an award may adduce evidence in support of an application by –

(a) filing a statutory declaration by any other person; or

(b) filing a document, or a copy of a document, relevant to the application, including an invoice, account, medical report or similar document; or

(c) lodging any exhibit or other thing, other than a document, with the VAU –

(i) at the time of lodging the application; or

(ii) at any time before the application is determined.