Northern Territory Numbered Acts Northern Territory Numbered Acts(1) An application for an award must include the following information:
(a) whether the applicant is applying as a primary victim, secondary victim or family victim of a violent act;
(b) a brief description of the violent act, the name of the offender (if known) and the date on which the violent act occurred;
(c) if the applicant is a primary victim – the date on which the applicant made a statement about the violent act to a police officer or the reasons why no statement has been made;
(d) if the applicant is a secondary victim or family victim – the date on which the applicant made a statement to a police officer or, if the applicant did not make a statement, whether the primary victim made a statement;
(e) if the applicant is a primary victim or secondary victim – a description of the injury resulting from the violent act;
(f) if the applicant is applying for financial assistance for one or more compensable injuries – the standard amount sought;
(g) if the applicant is applying for financial assistance for financial loss – the nature and amount of the loss;
(h) if financial assistance is sought for expenses incurred or reasonably likely to be incurred to assist the recovery from the effects of the violent act – a brief description of the applicant's exceptional circumstances;
(i) whether the applicant has applied for or received an immediate payment of financial assistance;
(j) whether a civil or criminal proceeding has been commenced as a result of the injury or death or financial loss (if any) and, if so, the nature and outcome of the proceeding;
(k) whether the applicant has made a claim for benefits or compensation under the Motor Accidents (Compensation) Act or Work Health Act as a result of the injury or death and, if so, the outcome or current status of the claim;
(l) whether the applicant believes any other person may be a victim of the violent act;
(m) any other information required by regulation.
(2) The application must be accompanied by the following documents:
(a) a copy of the applicant's statement about the violent act made to a police officer, unless the applicant has given reasons why a statement has not been made;
(b) all documents in the applicant's possession supporting the application, such as medical reports and invoices for expenses incurred;
(c) any other documents required by the Director or by regulation.