Art. 56B.051.  APPLICATION FOR COMPENSATION.  (a)  An applicant for compensation under this chapter must apply in writing on a form prescribed by the attorney general.
(b)  An application for compensation under this chapter must be verified and contain:
(1)  the date on which the criminally injurious conduct occurred;
(2)  a description of the nature and circumstances of the criminally injurious conduct;
(3)  a complete financial statement, including:
(A)  the cost of medical care or burial expenses and the loss of wages or support the claimant or victim has incurred or will incur; and
(B)  the extent to which the claimant or victim has been indemnified for the expenses under Paragraph (A) from a collateral source;
(4)  a statement indicating the extent of any disability resulting from the injury incurred;
(5)  an authorization permitting the attorney general to verify the contents of the application; and
(6)  any other information the attorney general requires.
Added by Acts 2019, 86th Leg., R.S., Ch. 469 (H.B. 4173), Sec. 1.06, eff. January 1, 2021.