Associated Forms & Documents | ITVERP | Office for Victims of Crime

ITVERP Documents

These materials describe the International Terrorism Victim Expense Reimbursement Program (ITVERP), general program requirements, program implementation efforts, and the steps to apply for this reimbursement.

ITVERP Brochure
ITVERP Fact Sheet

Forms & Checklists

You will need the following forms and instructions to prepare your application.

ITVERP Application (OMB Number 1121-0309; form expires 12/31/2026.)
Supplemental Sheet (OMB Number 1121-0309; form expires 12/31/2026.)
ITVERP Application Checklist
ITVERP HIPAA Release
Sample Property Loss Affidavit
Automated Clearinghouse Form (For direct deposit of payment of a claim.)
Authorization for Legal Representative Affidavit
Third Party Payer Authorization

Regulations

ITVERP Final Regulations (Federal Register Volume 71, Issue 172; September 6, 2006).
ITVERP Final Rule (Federal Register Volume 76, Issue 69; April 11, 2011).

Reports to Congress

View ITVERP annual reports to Congress

Resource List

These resources and programs from OVC and partner agencies may be of assistance to you.

Office of Overseas Citizens Services

The Office of Overseas Citizens Services, Bureau of Consular Affairs, U.S. Department of State assists American citizens who become victims of crime while traveling, working, or residing abroad. Consular duty personnel are available for emergency assistance 24 hours a day, 7 days a week, at embassies, consulates, and consular agencies overseas and in Washington, D.C.

View contact information for U.S. Embassies and Consulates overseas.

Federal Bureau of Investigation: Victim Services Division

The Victim Services Division, Federal Bureau of Investigation, U.S. Department of Justice, manages the FBI’s operational victim assistance response to terrorist attacks outside the United States, criminal transportation disasters, and other mass casualty crimes.

Office of Justice for Victims of Overseas Terrorism (DOJ/OVT)

The mission of the Office of Justice for Victims of Overseas Terrorism, National Security Division, U.S. Department of Justice is to support U.S. victims of terrorism overseas by helping them navigate foreign criminal justice systems and by advocating for their voices to be heard around the world. They advocate for U.S. victims and their families to obtain information, be present during foreign terrorism prosecutions, and have a voice during the proceedings, as permitted by foreign law. They further provide policy advocacy on overseas terrorism victims’ issues both within the U.S. Government and throughout the world.

More information on the office, responsibilities, and assistance to victims can be found on the DOJ/OVT website and Resources page.

Disaster Distress Helpline

The Substance Abuse and Mental Health Services Administration's Disaster Distress Helpline provides 24/7, 365 days a year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters.

Call or text 800-985-5990 to connect with a trained crisis counselor.

United Nations Victims of Terrorism Support Portal

The Support Portal is dedicated to and highlights the importance of those individuals across the globe who have been attacked, injured, traumatized, or lost their lives during terrorist attacks.

National Mass Violence Victimization Resource Center

The National Mass Violence Victimization Resource Center serves to achieve a social understanding of mass violence upon which civic leaders, mental health professionals, journalists, policymakers, and victim assistance professionals can rely. The vision of the Center is to provide communities access to evidence-based information and resources needed to prepare for and respond to mass violence incidents successfully.

National Organization of Parents Of Murdered Children

The National Organization of Parents Of Murdered Children (POMC) is a national self-help organization for the families and friends of children who have been murdered. POMC provide the ongoing emotional support and promotes healthy grief resolution that parents and other survivors need to build a "new life" after experiencing a child’s murder.

Call the POMC hotline at 888-818-POMC (888-818-7662).

The Dougy Center

The Dougy Center focuses on grief support groups for children and teens, from 3 to 18 years old, and their families who are grieving the death of a parent, sibling, or friend. Through the Center’s website, you can access a database of centers throughout the country that provide grief support and services. The Center also provides educational materials about children and grief.

VictimConnect

This OVC-funded service offers confidential assistance to victims of crime. Trained specialists are available to help you locate services in your area, including mental health counseling, legal services, and more. VictimConnect employs both English and Spanish-speaking victim assistance specialists.

Call or text VictimConnect at 855-4VICTIM (855-484-2846) or chat online.