Claim Withdrawal Form
Form Instructions
Claimants wishing to withdraw their claim should complete this form and return it to:
Virginia Victims Fund
P.O. Box 26927
Richmond, VA 23261
Via fax: 804-823-6905
Via email: info@vvf.virginia.gov
Claimants may withdraw their claim at anytime for a variety of reasons, including:
- Other resources are available such as insurance, discounted billing by providers
- No longer interested
- Cannot find supporting documentation
