Restitution Request

Press Enter to show all options, press Tab go to next option

Please correct the field(s) marked in red below:

If you have incurred out-of-pocket expenses as a direct result of this crime, you may be eligible to request restitution. Expenses may include, but is not limited to:

  • Repairs to damaged property or replacement costs
  • Medical/Dental bills
  • Lost Wages
  • Transportation to and from court hearings
  • Counseling
  • Funeral Expenses
  • Crime Scene Clean-up

Full Name
Date of Birth
Docket Number
Mailing Address
Primary Phone
Primary Phone
Secondary Phone
Secondary Phone
Email Address
Restitution Requested
Restitution Requested

Criminal restitution covers out-of-pocket expenses only. Expenses covered by insurance, pain and suffering, and other related losses are not eligible if covered by some other means. Please contact our office for more information or regarding other civil remedies.

DOCUMENTATION REQUIRED: Documentation may include, receipts, estimates, pay stubs, invoices, etc. Please upload your documentation below or send to:

Mesa City Prosecutor’s Office
Victim Services
PO Box 1466
Mesa, AZ 85213

email: or
fax: 480-644-2584

  1. To receive a copy of your submission, please fill out your email address below and submit.
    Change the CAPTCHA codeSpeak the CAPTCHA code