Vandalism Relief Fund

Business Name:*

Primary Name:*

Full Business Address (include postal code):*

Business Phone Number:*

Business Email:*

Business License Number:*

Is your business license and property tax status in good standing with the City?*

Have you submitted a claim within this calendar year?*

If yes what date?

Date and Time of Incident:

Full description of Property Damage:

Vandalism Relief Grant Amount Requested:*

* allotted up to $1000.00*

Acceptable proof of damage and expenses, in one or more of the following forms:*

Upload file here:

Acceptable proof of damage and expenses, in one or more of the following forms:

Upload file here:

Acceptable proof of damage and expenses, in one or more of the following forms:

Police file number, if applicable:*

Confirmation of any expenses to be recovered through the Applicant's Insurance:*

I hereby acknowledge that the information provided on this application is true and that the Grant amount requested is not covered by my Insurance. Printed Name:*

Signed Name*

Date:*

Business Resource & Relocation Guide

Business Hours

Nanaimo Weather

Sign Up for Updates

Annual Reports, By-Laws & Policies