PM 06-38-02 Disbursement Request

WAG 06-38-02

A funeral establishment and/or cemetery authority may submit a request for disbursement beginning July 1, 2023, for an occurrence on or after July 1, 2022. Requests for disbursement should be submitted via the IL444-1961, Application for Funeral and Burial Assistance for the Murdered Children Program and are processed by the Funeral and Burial Unit within LOTSS.

A funeral establishment and/or cemetery authority may submit a claim within 365 days of the occurrence of the crime for which the disbursement is sought. Any original claim submitted after this timeframe must be accompanied by a written statement from the establishment explaining the delay.

An amended request or additional substantiating materials can be submitted to correct inadvertent errors or omission any time before the original request for disbursement has been disposed of by the department. When an amended claim or additional substantiating information is submitted, it is considered to have been filed at the same time as the original request.

The request for disbursement must include the following:

  • name and address of the eligible survivor and his or her relationship to the child victim,
  • date and nature of the crime in which the request is based,
  • nature and extent of the injuries sustained by the child victim; and
    • the names and addresses of those giving any medical and hospitalization treatment to the child victim.
  • copy of the child victim's death certificate,
  • an affidavit of facts of death,
  • documentation verifying an eligible survivor's household income,
  • copy of the Statement of Funeral Goods and Services Selected detailing funeral and burial expenses including any applicable taxes, surcharges and fees; and
  • any other information the Department may reasonably require to process the request.

If a request is unable to be processed due to missing information, the department must issue a written notice to the funeral establishment or cemetery authority, requesting the additional documentation required to process the request. 

If the department requests additional information, the funeral establishment or cemetery authority has 30 days to submit the requested documentation. A funeral establishment or cemetery authority may request an extension of time from the department prior to the expiration of the 30-day time period.