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Compensation Fund
Applicant Details
Are you submitting a claim for yourself or on behalf of someone else
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Myself
Another Person
A Corporation
An Estate
A Beneficiary
Name of individual(s) or entity you are submitting
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First name
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Middle name
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Last name
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Date of Birth (YYYY-MM-DD)
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Email Address
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Daytime Phone Number
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Subject
Lawyer/Paralegal Details
Law Society Number of Lawyer/Paralegal
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First Name (Lawyer/Paralegal)
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Last Name (Lawyer/Paralegal)
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Value of Loss
Amount of loss:
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I understand that a Compensation Fund grant is limited to the actual amount taken by the Lawyer/Paralegal and does not include damages, costs, expenses, interest or other consequential losses
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Yes
No
Date Lawyer/Paralegal received the funds (YYYY-MM-DD):
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Date Loss Known
Please provide the date, or approximate date, when you first discovered the loss (YYYY-MM-DD)
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How did you discover the loss? Please provide as much detail as possible:
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Referral Source
Who has referred you to the Compensation Fund?
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Other Avenues of Recovery
The Compensation Fund is a Fund of last resort. Please advise what steps you have taken to recover your loss. This might include: credit card dispute mechanisms, demanding repayment, initiating a civil action, or, having the Licensee’s fees assessed. Please outline the steps you have taken below. If you have not taken any steps, please explain why
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Required Documentation
I understand that the above-noted-type documents will be required to submit an Application (they are not required for completing this Inquiry form). If I do not have the required documents, I will make my best efforts to obtain them.
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Yes
No
Compensation Fund Guidelines, Policies and Procedures and FAQs
I have read the Compensation Fund's Guidelines for the Determination of Grants, the Fund's Policies and Procedures and the FAQs. I understand that to qualify for a grant, I must satisfy the Compensation Fund's Guidelines and that the loss must result from a Lawyer/Paralegal's dishonest conduct. I also understand that grants are discretionary.
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Yes
No
Police Report
Have you contacted the police about this matter?
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Yes
No
Please advise what action the Police have taken
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Summary/Description of Loss
In a few sentences, please describe why you are inquiring.
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