Request Restitution

Restitution is the repayment for expenses a victim incurred as a direct result of the crime committed against her or him. If criminal charges are filed, the defendant is convicted, and you incurred expenses as a direct result of the crime, you may be eligible for restitution.

Restitution may include any out-of-pocket expenses such as: unreimbursed medical bills, property damage or loss, lost wages, insurance deductibles, and other expenses not covered by insurance.

A judge will determine whether restitution is to be paid and in what amount; you may be required to attend a hearing for this.

If you would like to request restitution, fill out the Restitution Request Form below. You must also send copies of any receipts or bills as proof of your claim within 10 days, either by emailing PDF copies to vs.web.page@phoenix.gov or faxing them to 602-534-4540 or mailing them to:

Phoenix City Prosecutor's Office
P.O. Box 4600
Phoenix, AZ 85030-4600
ATTN: Victim Services Unit

602-261-8192 (Phone)

602-534-4540 (Fax)

The Arizona Supreme Court has additional information on Restitution.

*denotes required field

* I am requesting restitution: Yes No

* If YES, do you have exact dollar amounts? Yes No
If YES, please fill in the form below.

* If NO, do you have partial information? Yes No

If YES, please fill out what you have and describe what's missing and supplement as soon as possible.
If NO, please submit your requested restitution as soon as you have all final amounts.

If you have only partial information, or do not know the answer, please answer "unknown" or "na" for not applicable.

* Defendant's First Name Middle Initial
* Defendant's Last Name

* Complaint Number
* Your First Name Your Middle Initial
* Your Last Name
* Your Phone Number
Your E-mail Address

Property:	$
Vehicle Damage:	$
Medical Bills:	$
Funeral Expenses:	$
Lost Wages:	$
Insurance Deductible:	$
Other:	$
SUB-TOTAL:	$
- Paid by Insurance:	$
TOTAL RESTITUTION:	$

* FOR ALL RESTITUTION REQUESTS: Please provide copies of bills or other supporting documents within 10 days of submitting this form. You may provide copies by e-mailing PDF copies to vs.web.page@phoenix.gov, faxing them to the Victim Services Unit at 602-534-4540 or mailing them to:

Phoenix Prosecutor's Office
P.O. Box 4600
Phoenix, AZ 85030-4600
ATTN: Victim Services Unit

PLEASE NOTE: THE DEFENDANT MAY PLEAD AT ANY SETTING.

If you have questions or want to speak with an Advocate, contact the Victim Services Unit by calling 602-261-8192 or send an email here.

Before you submit this form, please be aware of the city's policy on use of its systems. The message you are about to send is subject to public disclosure under the Public Records Law. It is not private or confidential and is retained for 90 days.

*Required field.

Request Restitution

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