Victims Register Application Form

Support and further information

For assistance completing this form please call the Victims of Crime Helpline on 1800 819 817 and ask to speak with the Victims Register (9am-5pm, Monday-Friday), or email  victimsregister@justice.vic.gov.au

To learn more about the Victims Register, please click on the below link: 

Victorian Victims Register – offender information | Victims of Crime Victoria

To learn more about available supports including the Victim Assistance Program (VAP), please click on the below link:

Get help | Victims of Crime Victoria

Printable application form

If you would prefer to complete a printable form please click on the below link:

Victims Register Application Form | Victims of Crime Victoria

Prefer to have a nominee receive information on your behalf?

You can choose to have another person (nominee) receive information from the Victims Register on your behalf. Your nominee can be someone you trust and remain in regular contact with, for example: a close friend, family member or case worker.

If you would prefer to use a nominee, please complete the printable application form. 

If you have any questions or require support with the nominee process please contact the Victims Register.

The Victims Register is committed to providing an inclusive, safe and accessible service. Some of the questions below are optional and are asked to assist in providing the best service to our clients. If you would prefer not to disclose certain information please skip the question or choose 'Prefer Not to Say'. 

The Victims Register will generally communicate with you in writing via email and follow-up SMS

If you require practical or emotional support when completing this application, please call the Victims of Crime Helpline on 1800 819 817 and speak with trained Helpline staff or ask to speak with the Victims Register.

Applicants have the option to ' save and complete later ', which will allow you to come back to your application at a later date without losing the information you have already entered. To save your application please click on the link at the bottom of the page.

Section 1 of 5

We value diversity, inclusion and social justice. We are committed to treating people of all cultures, ethnicities, gender identities, bodily diversities, sexual orientations, ages, abilities, and religions with dignity and respect.

Please note that applicants who are family members, other than next of kin or primary caregivers, are only eligible to register to provide a written submission to the Adult Parole Board. Please contact the Victims Register if you have any questions regarding eligibility.

You must select 'Yes' to both questions to be eligible to apply under this category, otherwise please complete Category D

If you selected 'No' to either question for Category C, please proceed to Category D

If you apply only under Category D, extra documents may be required. 

To discuss what additional information is required for your application, please contact the Victims Register  on 1800 819 817 or email victimsregister@justice.vic.gov.au.

Can you demonstrate a substantial connection to the offence?

You only need to answer 'Yes' to one of the questions to appy under this category.

If you apply only under Category E, the Victims Register may need to contact you for additional information or documentation.

If you require practical or emotional support when completing this application, please call the Victims of Crime Helpline on 1800 819 817 and speak with trained Helpline staff or ask to speak with the Victims Register.

Applicants have the option to ' save and complete later ', which will allow you to come back to your application at a later date without losing the information you have already entered. To save your application please click on the link at the bottom of the page.

Section 2 of 5

At the time of your application, the prisoner / offender must be either

• In prison

• On parole

• Subject to a supervision or detention order, or

• Subject to an application for a supervision or detention order 
  

Offender Details

Offender 2 Details

Offender 3 Details

Offender 4 Details

Offender 5 Details

If you require practical or emotional support when completing this application, please call the Victims of Crime Helpline on 1800 819 817 and speak with trained Helpline staff or ask to speak with the Victims Register.

Applicants have the option to ' save and complete later ', which will allow you to come back to your application at a later date without losing the information you have already entered. To save your application please click on the link at the bottom of the page.

Section 3 of 5

Details on the types of information you can receive can be found on the website. Optional notifications on information you can choose to receive include Community Team Sports and the Prisoner Compensation Quarantine Fund. If you do not select an option you will receive the information.

If you have any further queries in relation to optional notifications, please contact the Victims Register.

Prisoners that meet strict criteria may be approved to participate in team sports in the community. Consideration is given to the safety and welfare of a registered victim before a permit is issued. Guidelines are in place to notify you if a Community Team Sports permit is approved for the offender.

Prisoners may be awarded damages of $10,000 or more that is held in the Prisoner Compensation Quarantine Fund (PCQF).

Victims may be able to make a claim against this money.

To find out more about the PCQF, visit the link below

https://files.victimsofcrime.vic.gov.au/2021-04/PCQF%20Application%20Form%202020.pdf

All applicants are required to provide a copy of one of the following:

• Current Australian Driver Licence

• Birth Certificate

• Current Passport

If you are applying under Category B (as next of kin, primary caregiver or family member): 

Please include one of the below documents that evidences your relationship to the victim:

If you are applying under Category D:

The Victims Register may need further information from you that will help to support your application. 

Please contact the Victims Register on 1800 819 817 to discuss what additional information is required for your application.

The Victims Register may contact you if further information is required for your application.

If you require practical or emotional support when completing this application, please call the Victims of Crime Helpline on 1800 819 817 and speak with trained Helpline staff or ask to speak with the Victims Register.

Applicants have the option to ' save and complete later ', which will allow you to come back to your application at a later date without losing the information you have already entered. To save your application please click on the link at the bottom of the page.

Section 4 of 5

The Victims Register is operated by the Department of Justice and Community Safety.

I ask to be registered and my details recorded on the Victims Register.

I understand that if I want to be removed from the Victims Register, I must ask in writing (by letter or email).

  1. I certify that:

• the information I have given is true and correct

• I have given my personal information voluntarily.

  2. I understand for my registration to remain active I must advise the Victims Register if my contact details change.

Any Information you receive from the Victims Register must be treated confidentially. This is set out in  sections 30H and 30I of the Corrections Act 1986.

3. I understand and accept that I must:

• treat any information that I (or my nominee) receives from the Victims Register in a confidential manner

• not publish the information or give it to anyone else to be published.

4. I understand and accept that publishing information from the Victims Register or giving it to someone else to publish:

• may lead to my registration being cancelled

• may be subject to penalties as set out in the Corrections Act 1986, section 30I.

Information you provide is confidential but maybe exchanged between appropriate agencies.

The information can only be exchanged between the Victims Register and appropriate agencies for the specific purpose of the service provided by the Victims Register. This includes to ensure eligibility for inclusion on the Victims Register and suitability of any proposed nominee. How this information may be shared is set out in the Privacy and Data Protection Act 2014.

5. I understand and agree that information I provide is confidential and may be shared for the purpose of my safety between:

• the Department of Justice and Community Safety

• Corrections Victoria

• the Adult Parole Board

• the Post Sentence Authority

• the Magistrates Court (if applying under Category C or D, for details of any relevant family violence intervention order made under the Family Violence Protection Act 2008)

• law enforcement agencies (as defined in Privacy and Data Protection Act 2014).

If you require practical or emotional support when completing this application, please call the Victims of Crime Helpline on 1800 819 817 and speak with trained Helpline staff or ask to speak with the Victims Register.

Applicants have the option to ' save and complete later ', which will allow you to come back to your application at a later date without losing the information you have already entered. To save your application please click on the link at the bottom of the page.

Section 5 of 5

We value diversity, inclusion and social justice. We are committed to treating people of all cultures, ethnicities, gender identities, bodily diversities, sexual orientations, ages, abilities, and religions with dignity and respect.