Certificate of earnings template

This template can be used by an employer or accountant to provide information for an applicant’s claim for loss of earnings under the Victims Support Scheme.

Visit Supporting documents for Victims Support Scheme applications to learn more about claiming loss of earnings.

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Download Certificate of earnings PDF 320.44KB File last updated on: 13 November 2025.

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Type: Template, Form
Author: Victims Services
Publication Date: 01 May 2024

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Legal and justiceVictims Support Scheme
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