Home Victim Assistance Victim Notification Questionnaire Exit the Site If you are a victim in an appellate case that is currently being handled by the Office of Attorney General and would like to be kept informed of the proceedings in the case, please complete the Victim Notification Form to provide us with your contact information. If your case is being handled by the Special Prosecutions Unit, after a complaint is filed, you will receive a Victim’s Rights Notification Form in the mail. In order to be awarded your statutory and Constitutional rights, you must promptly complete the form and mail it to the OAG address on the form. If your case is not being handled by our office, please contact your local victim/witness coordinator. The following information will be collected and sent directly to the Office of Attorney General. If you would prefer to print a copy of this form and send it to our office by mail, you may download the Victim Notification Questionnaire here. Fields marked with an asterisk (*) are required for submission. CASE INFORMATIONCase NumberCase NameVICTIM INFORMATIONVictim Name* First Last Victim Address* Street Address City State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Enter Email Confirm Email Do you want to be notified of appellate proceedings?*Do you want to be notified of appellate proceedings? *YesNoWould you like us to notify you of the date, time and place of any oral arguments?*Would you like us to notify you of the date, time and place of any oral arguments? *YesNoWould you like us to notify you of any final decisions made by the Appellate Courts?*Would you like us to notify you of any final decisions made by the Appellate Courts? *YesNoOther comments Other Comments:CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.