Submit a Claim

To submit a claim to the OneOrlando Fund, please follow these 3 steps:

1. Download and complete the forms below
2. Once completed, print your forms and have them notarized
3. Mail your completed, notarized forms and supporting documentation to:
   National Compassion Fund: OneOrlando Fund
   c/o National Center for Victims of Crime
   2000 M Street NW, Suite 480
   Washington, DC 20036

To Qualify:
All Claim Forms must be postmarked by September 12, 2016.

IMPORTANT NOTICE TO CLAIMANTS FROM THE FUND ADMINISTRATOR:

THE DEADLINE FOR FILING A CLAIM WITH THE ONEORLANDO FUND IS SEPTEMBER 12, 2016

It is the goal of the Fund Administrator for the OneOrlando Fund to complete the review of all claims on or before September 26, 2016.  The Fund Administrator will authorize payment of all claims to eligible claimants to be issued beginning September 27, 2016.

In the case of conflicting claims submitted for a deceased victim, I urge that families of the victims resolve all issues which may exist with regard to who is the person legally responsible for administering the estate of the deceased and therefore eligible to file the claim. 

In the case of conflicting claims which have not been resolved by the deadline for distribution, September 27, 2016, the Fund Administrator will recommend that the allocated funds be deposited with the appropriate Probate Court, to be held in a separate account and to be distributed only in accordance with a valid court order.

Save these documents to your computer, fill out the required forms and then print.

Deceased Victim Claim

If you are filing a claim for a deceased victim, you will need to complete the following forms:

English	Spanish
Deceased Claim Form(PDF, 143KB) Beneficiary Form(PDF, 1003KB) Consent to Distribution Plan(PDF, 98KB)	Formulario de Reclamación por Víctima Fallecida(PDF, 146KB) Formulario de Beneficiarios(PDF, 1MB) Consentimiento al Plan de Distribución(PDF, 80KB)

---

Injured Victim Claim

If you are filing a claim as an injured victim, you will need to complete the following form:

English	Spanish
Injured Claim Form(PDF, 139KB) Authorization Form for Release of Medical Records(PDF, 108KB)	Formulario de Reclamación por Lesiones Físicas(PDF, 193KB) Formulario de Autorización HIPAA(PDF, 89KB)

---

Present at Pulse Claim

If you are filing a claim because you were present at Pulse the night of the shooting, you will need to complete the following form:

English	Spanish
Present Claim Form(PDF, 145KB)	Formulario por Presencia en el Club Pulse(PDF, 136KB)

---

Reminder: Before mailing your completed form(s), be sure to include the supporting documentation specified in the claim forms.

Culturally-experienced representatives are available to assist claimants with completing their claim forms at 855-4-VICTIM or by email OneOrlando@ncvc.org.

---

If you need assistance completing your forms, Jeff Dion from the National Center for Victims of Crime will be available at the below dates and times.

For notary assistance, please call the Orlando United Assistance Center at 407.500.HOPE.

All claimants needing assistance must make an appointment by emailing oneorlando@ncvc.org

• Thursday, August 18 – 10 a.m. to 8 p.m.
  Park Place Behavioral Health Care
  200 Park Place Boulevard
  Kissimmee, FL 32809
• Saturday, August 20 – 10 a.m. to 5 p.m.
  Beardall Senior Center
  800 South Delaney Avenue
  Orlando, FL 32801