Statement on Restitution (SJ-1021B)
For more information on the Statement on Restitution (SJ-1021B) - Additional information.
Version: July 2015
Type of File:dynamic pdf
Only forms with a duly completed File number section that concern an offence committed after July 22, 2015 will be processed.
A copy of all the supporting documents for the loss or damage resulting from the offence (receipts, bills, estimates or other relevant documents) must be submitted with this form.
Provide only a photocopy of the supporting documents. Keep the originals for your records.
Contact the police force responsible for investigating the offence for more details concerning the information required in the File identification section.
Send the form to the clerk’s office at the Court of Québec, Criminal and Penal Division, in the judicial district where judicial proceedings were instituted against the accused.
A printed version of the form may be obtained from a victim of crime assistance centre (CAVAC).