Form 1122-0003 Annual Progress Report for STOP Formula Grants Program

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U.S. Department of Justice
Office on Violence Against Women
ANNUAL PROGRESS REPORT FOR
STOP Violence Against Women
Formula Grant Program
Brief Instructions: This form must be completed for all STOP Violence Against Women Formula Grant Program
(STOP Program) subgrants received. The grant administrator or coordinator must ensure that the form is completed. Grant partners, however, may complete sections relevant to their portion of the grant. Grant administrators
and coordinators are responsible for compiling and submitting a single report that reflects all information collected
from grant partners.
All subgrantees should read each section to determine which questions they must answer, based on the activities
supported under this subgrant during the current reporting period. Sections B and F of this form must be completed by all subgrantees. Subsections A1 and C2 must be answered by all grantees. In sections D, E, and subsections A2, C1, C3-C7, subgrantees must answer an initial question about whether they supported certain
activities during the current reporting period. If the response is yes, then the subgrantee must complete that
section or subsection. If the response is no, the rest of that section or subsection is skipped.
For example, 1) if you are a victim services agency providing training and victim services with staff funded under
this grant, you would complete A1, A2, B, C1, C2, D, and F (and answer ‘no’ in C3-C7, and E1-5); or 2) if you are a
law enforcement agency receiving funds to pay for staff who provide training to other law enforcement, you would
complete A1, A2, B, C1, C2, and F (and answer ‘no’ in C3, C4, C5, C6, C7, D, and E1-5).
If you are required to provide a match for your STOP Program subgrant, report on activities supported with this
match. The activities of volunteers or interns may be reported if they are coordinated or supervised by STOP
Program-funded staff or if STOP Program funds substantially support their activities.
For further information on filling out this form, refer to the separate set of instructions, which contains detailed
definitions and examples, illustrating how questions should be answered.
SECTION
Section A:
Section B:
Section C:
C1:
C2:
C3:
C4:
C5:
C6:
C7:
Section D:
Section E:
E1:
E2:
E3:
E4:
Section F:

General Information
Purpose Areas
Function Areas
Training
Coordinated Community Response
Policies
Products
Data Collection and Communication Systems
Specialized Units
System Improvement
Victim Services
Criminal Justice System
Law Enforcement
Prosecution
Courts
Probation and Parole
Narrative

Page Number
1
4
5
5
7
8
9
10
11
12
13
17
17
18
20
23
24

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GENERAL INFORMATION
Grant information

A1

All subgrantees must complete this section.
(format date with 6 digits, like - 01/31/04)

1.

Date of report

2.

Current reporting period

3.

Subgrantee name

4.

Subgrant number(s) for each subgrant award under which activities were supported during
the current reporting period

/

/

January 1- December 31

(Year)

(List the numbers for all subgrants supporting activities engaged in during the current reporting period.)

5.

Type of funded organization
(Check all that apply that describe the organization receiving the STOP Program subgrant.)

Court
Domestic violence program
Domestic violence state coalition
Dual program (sexual assault and
domestic violence)
Dual state coalition (sexual assault and
domestic violence)
Faith-based organization
Government agency (Department of
Human Services, Bureau of Health)
Law enforcement
Probation, parole, or other correctional agency
6.

Prosecution
Sexual assault program
Sexual assault state coalition
Tribal coalition
Tribal government
Tribal sexual assault and/or domestic
violence program
Unit of local government
University/school
Other (specify):

Point of contact
(person responsible for the day-to-day coordination or administration of the subgrant)
Name
Agency/organization
(if different from subgrantee name)
Address

Telephone

Facsimile

E-mail

7.

Does this subgrant specifically address tribal populations?
(Check yes if your subgrant focuses on tribal populations and indicate which tribes or nations you served or
intend to serve.)

Yes

No

If yes, which tribes/nations:

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8.

What percentage of your STOP Program grant funds were directed to each of these areas?
(Report the area[s] addressed by your STOP Program grant during the current reporting period and estimate
the approximate percent of funds [or resources] used to address each area [consider training, victim
services, etc.]. The subgrantee may choose how to make this determination.)
Throughout this form, the term sexual assault includes both assaults committed by offenders who are
strangers to the victim/survivor and assaults committed by offenders who are known to, related by blood
or marriage to, or in a dating relationship with the victim. The term domestic violence applies to any pattern
of coercive behavior that is used by one person to gain power and control over a current or former intimate
partner. Domestic violence includes dating violence, which is violence committed by a person who is or has
been in a social relationship of a romantic or intimate nature with the victim. Stalking is defined as a course
of conduct directed at a specific person that places that person in reasonable fear of the death of, or serious
bodily injury to, herself or himself, a member of her/his immediate family, or her/his spouse or intimate
partner.
Percentage of grant funds

Sexual assault

%

Domestic violence

%

Stalking

%

TOTAL

100% 0 %

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A2

Staff information

Were STOP Program grant funds used to fund staff positions during the current reporting period?
Check yes if STOP Program funds were used to pay staff, including part-time staff and contractors.

Yes—answer question 9
No—skip to Section B
9.

Staff
(Report the total number of full-time equivalent (FTE) staff funded by the STOP Program grant during the
current reporting period. Include employees who are part-time and/or only partially funded with these grant
funds as well as contractors. Include employees who are funded with required grant match. If an employee or
contractor was not employed or utilized over the entire reporting period, report the average. Round to the
second decimal. See separate instructions for examples of how to calculate FTEs for part-time staff and
contractors.)
Staff

Grant-funded staff

Administrator (fiscal manager, executive director)
Civil attorney
Counselor
Court personnel
Information technology specialist
Law enforcement officer
Legal advocate
Paralegal
Probation officer
Program coordinator (training coordinator, victim services coordinator)
Prosecutor
Support staff (secretary, administrative assistant)
Trainer
Victim advocate
Victim-witness specialist
Other (specify):
TOTAL

0.00

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PURPOSE AREAS

B

All subgrantees must complete this section.

10. Statutory purpose areas
(Check all purpose areas that apply to activities supported with STOP Program funds during the current
reporting period.)
Check ALL
that apply

Purpose areas
Training law enforcement officers, judges, other court personnel, and prosecutors to more
effectively identify and respond to violent crimes against women, including crimes of sexual
assault, domestic violence, and dating violence.
Specialized units of law enforcement officers, judges, other court personnel, and prosecutors
specifically targeting violent crimes against women, including the crimes of sexual assault,
domestic violence, and dating violence.
Police, court, and prosecution policies, protocols, orders, and services specifically devoted to
preventing, identifying, and responding to violent crimes against women, including the crimes
of sexual assault and domestic violence.
Data collection and communication systems, including computerized systems, linking police,
prosecutors, and courts or for the purpose of identifying and tracking arrests, protection orders, violations of protection orders, prosecutions, and convictions for violent crimes against
women, including the crimes of sexual assault and domestic violence.
Victim services programs, including sexual assault, domestic violence and dating violence
programs; delivery of victim ser vices to underserved populations; specialized domestic
violence court advocates in courts where a significant number of protection orders are granted;
and increased reporting and reduced attrition rates for cases involving violent crimes against
women, including crimes of sexual assault, domestic violence, and dating violence.
Programs to address stalking.
Addressing the needs and circumstances of American Indian tribes in dealing with violent
crimes against women, including the crimes of sexual assault and domestic violence.
Supporting formal and informal statewide, multidisciplinary efforts, to the extent not supported
by state funds, to coordinate the response of state law enforcement agencies, prosecutors,
courts, victim service agencies, and other state agencies and departments to violent crimes
against women, including the crimes of sexual assault, domestic violence, and dating violence.
Training of sexual assault forensic medical personnel examiners in the collection and preservation of evidence, analysis, prevention, and providing expert testimony and treatment of trauma
related to sexual assault.
Programs to assist law enforcement, prosecutors, courts, and others to address the needs
and circumstances of older and disabled women who are victims of sexual assault or domestic
violence, including recognizing, investigating, and prosecuting instances of such violence or
assault and targeting outreach and support, counseling, and other victims’ services to such
older and disabled individuals.
Assisting victims of sexual assault and domestic violence in immigration matters.

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FUNCTION AREAS
Training

C1

Were your STOP Program funds used for training during the current reporting period?
Check yes if STOP Program-funded staff provided training or if grant funds were used to directly support training.

Yes—answer questions 11-13
No—skip to C2
11. Training provided with STOP Program grant funds
(Report the total number of training events provided during the current reporting period with STOP Program
grant funds. Do not include staff development training provided to STOP Program-funded staff.)
Total number of training events provided

12. Number of people trained
(Report the number of people trained with STOP Program funds during the current reporting period.
Use the category that is most descriptive of the people attending the training event.)
People trained

Number

Attorneys/law students
Batterer Intervention Program staff
Community advocacy organization staff (NAACP, Gray Panthers)
Correction personnel (probation, parole, and correctional facilities)
Court personnel (judges, clerks)
Disability organization staff (non-governmental)
Domestic violence coalition staff (state or tribal)
Domestic violence program staff
Elder organization staff (non-governmental)
Faith-based organization staff
Government agency staff (vocational rehabilitation, food stamps, TANF)
Health professionals (doctors, nurses)
Immigrant organization staff (non-governmental)
Law enforcement officers
Legal services staff
Mental health professionals
Multidisciplinary group
Prosecutors
Sexual assault forensic examiners
Social service organization staff
Sexual assault coalition staff (state or tribal)
Sexual assault program staff
Supervised visitation and exchange center staff
Tribal coalition staff
Tribal government/Tribal government agency
Victim-witness specialists
Volunteers
Other (specify):
TOTAL

0

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13. Training content areas
(Indicate all topics covered in training events provided by your STOP Program funds during the current
reporting period. Check all that apply.)

Sexual assault, domestic violence, and stalking
Advocate response
Child witnesses
Confidentiality
Dating violence overview, dynamics and
services
Domestic violence overview, dynamics and
services
Mandatory reporting requirements
Safety planning for victims/survivors
Sexual assault overview, dynamics and
services
Stalking overview, dynamics and services
Supervised visitation and exchange
Other (specify):

Justice system
Civil court procedures
Criminal court procedures
Domestic violence statutes/codes
Firearms and domestic violence
Immigration
Identification and arrest of
predominant aggressor
Judicial response
Law enforcement response
Pro-arrest policies
Probation response
Prosecution response
Protection orders (including full faith
and credit)
Sexual assault statutes/codes
Sexual assault forensic examination
Stalking statutes/codes
Tribal Jurisdiction and Public Law 280
Other (specify):

Underserved populations
Issues specific to victims/survivors who:
live in rural areas
are American Indian or Alaska Native
are Asian
are black or African American
are disabled
are elderly
are Hispanic or Latino
are institutionalized or isolated
are homeless or living in poverty
are immigrants, refugees, or asylum
seekers
are lesbian, gay, bisexual, transgender,
or intersex
are Native Hawaiian or other Pacific
Islander
have mental health problems
have substance abuse problems
Other (specify):

Community response
Coordinated community response
Response teams (DART, DVRT, SART)
Technology
Other (specify):

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C2

Coordinated Community Response
All subgrantees must complete this section.

14. Coordinated community response activities during the current reporting period
(Check the appropriate boxes to indicate the agencies or organizations that you provided victim/survivor
referrals to, received victim/survivor referrals from, engaged in consultation with, provided technical
assistance to, and/or attended meetings with, during the current reporting period, according to the usual
frequency of the interactions. If the interactions were not part of a regular schedule, you will need to
estimate the frequency with which these interactions occurred during the current reporting period.)
Agency/organization

Victim/survivor referrals,
consultations, technical assistance
Daily
Weekly Monthly

Meetings
Weekly

Monthly Quarterly

Batterer intervention program
Community advocacy
organization (NAACP, NAMI)
Corrections (probation,
parole, and correctional
facility staff)
Domestic violence organization
Faith-based organization
Court
Law enforcement
Prosecutor’s office
Government agency (INS,
Social Security, TANF)
Health/mental health
organization
Legal services organization
(legal services, bar association, law school)
Sexual assault organization
Social service organization
Tribal government/Tribal
government agency
Other (specify):

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C3

Policies

Were your STOP Program funds used to develop, substantially revise, or implement policies or
protocols during the current reporting period?
Check yes if STOP Program-funded staff developed, substantially revised or implemented polices or protocols, or if STOP Program funds were used to directly support the development, revision or implementation
of policies or protocols.

Yes—answer question 15
No—skip to C4
15. Types of protocols and/or policies developed, substantially revised or implemented during the
current reporting period
(Check all that apply.)

Victim Services
Appropriate response to underserved populations
Appropriate response to victims/survivors who are elderly or have disabilities
Confidentiality
Mandatory training standards for staff and volunteers
Staff, board, and/or volunteers represent the diversity of your service area
Victim/survivor informed about Crime Victims Compensation and Victim Impact Statements
Other (specify):
Law Enforcement
Appropriate response to underserved populations
Appropriate response to victims/survivors who are elderly or have disabilities
Identifying primary aggressor/discouraging dual arrest
Immediate access to protection order information
Mandatory training on sexual assault, domestic violence, and/or stalking
No victims polygraphed
No charge to victims/survivors for service of protection orders, warrants, or subpoenas
Pro-arrest/mandatory arrest
Protection order enforcement (including full faith and credit)
Providing information to victims/survivors about victim services
Other (specify):
Prosecution
Appropriate response to underserved populations
Appropriate response to victims/survivors who are elderly or have disabilities
Mandatory training on sexual assault, domestic violence, and/or stalking
No victims polygraphed
No charge to victims for any costs related to prosecution of domestic violence offense
Vertical prosecution
Victim-witness notification
Violation of protection orders
Other (specify):
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Courts
Accelerated trial schedules
Appropriate response to underserved populations
Appropriate response to victims/survivors who are elderly or have disabilities
Dedicated domestic violence docket
Full faith and credit for protection orders
Immediate access to obtaining protection orders
Judicial monitoring of sexual assault and/or domestic violence offenders
Mandatory training on sexual assault, domestic violence, and/or stalking
No charge to victims/survivors for any costs related to prosecution of a sexual assault and/or
domestic violence offense or to obtaining a protection order
Policy against mutual restraining orders
Procedures for courtroom security
Standard protection order form
Other (specify):
Probation and parole
Appropriate response for cases involving underserved populations
Appropriate response for cases involving victims/survivors who are elderly or have disabilities
Mandatory training on sexual assault, domestic violence, and/or stalking
Strategies to assist and protect victim during probation and parole
Victim notification
Other (specify):
Health care
Advocate response to emergency room
Appropriate response for underserved populations
Appropriate response to victims/survivors who are elderly or have disabilities
Forensic exams not billed to victim/survivor
Mandatory training on sexual assault, domestic violence, and/or stalking
Routine screening and referrals for sexual assault, domestic violence, and/or stalking
Other (specify):

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C4

Products

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Were your STOP Program funds used to develop, substantially revise and/or distribute products
during the current reporting period?
Check yes if STOP Program-funded staff developed, revised and/or distributed products or if STOP Program
funds directly supported the development, revision or distribution of products.

Yes—answer question 16
No—skip to C5
16. Use of STOP Program funds for product development, substantial revision and/or distribution
(Report the number of products developed, substantially revised, and/or distributed with STOP Program
funds during the current reporting period. Report the number of new products developed or substantially revised during the current reporting period; the title/topic and intended audience for each product developed,
revised, and/or distributed; and the number of products used or distributed. If a product was created in or
translated into a language other than English, including Braille, indicate the language. Report on products
that were newly developed during the current reporting period whether or not they were used or distributed,
and on products that were previously developed or revised that were used or distributed during the current
reporting period.)
Number
Products developed
or revised

Title/topic

Intended
audience

Number
used or
distributed

Other
languages

Brochures

Manuals

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Number
Products developed
or revised

Title/topic

Intended
audience

Number
used or
distributed

Other
languages

Training
curricula

Training
materials

Other
(specify):

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C5

Data Collection and Communication Systems

Were your STOP Program funds used to develop, install, or expand data collection and/or
communication systems during the current reporting period?
Check yes if STOP Program funds or STOP Program-funded staff were used to develop, install,
or expand data collection and/or communication systems.

Yes—answer questions 17-18
No—skip to C6
17. Use of STOP Program funds for data collection and/or communication systems
(Check all that apply.)

Develop new data collection/communication systems
Install data collection/communication systems
Expand existing data collection/communication systems
Link existing data collection/communication systems
Share information with other community partners
Manage data collection and communication
Purchase computers and other equipment
18. Purpose of data collection and/or communication systems
(Indicate all types of information identified or tracked with this technology by checking all that apply.)

Arrests
Bail/bond orders
Case management
Compliance with court-ordered sanctions
Convictions
Court docket management
Evaluation/outcome measures
Incident reports
Probation conditions/violations
Prosecutions
Protection orders
Recidivism
Sentencing
Stalking and harassment orders
Victim notification
Victim service availability
Violations of protection orders
Warrants
Other (specify):

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C6

Specialized Units

Were your STOP Program funds used for specialized units in the criminal justice system during the
current reporting period?
Check yes if any STOP Program-funded staff were part of a specialized unit in any of the categories listed
below or if STOP Program funds were used to directly support a specialized unit. (A specialized unit is a
centralized or coordinated group or unit of police officers, prosecutors, probation officers, judges, or other
court staff responsible for handling sexual assault, domestic violence, or stalking cases. A specialized unit
may consist of one person, even if that person is partially funded by your STOP Program subgrant.)

Yes—answer question 19
No—skip to C7
19. Use of STOP Program funds for specialized units
(Check all that apply for the current reporting period.)
Law enforcement

Prosecution

Court

Probation or parole

Develop a new unit
Support, expand, or coordinate
an existing unit
Train a specialized unit
Other (specify):

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C7

System Improvement

Were your STOP Program funds used for system improvement during the current reporting period?
Check yes if any STOP Program-funded staff engaged in system improvement activities or if STOP Program
funds directly supported system improvements (e.g., interpreters, safety audits, security).

Yes—answer question 20
No—skip to Section D
20. Use of STOP Program funds for system improvement
(Check all that apply.)
Victim services

Law enforcement

Prosecution Court

Probation or parole

Evaluation
Interpreters
Language lines
Meetings between
tribal and non-tribal
entities
Safety audits
Security personnel
or equipment
Translation of forms
and documents
Other (specify):

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VICTIM SERVICES

D

Were your STOP Program funds used for victim services?
Check yes if STOP Program-funded staff provided victim services or if STOP Program funds were used to
support victim services during the current reporting period. Report all victims served, and services provided
with STOP Program funds, whether by a victim services agency or victim services within law enforcement,
prosecution, or the court system. Report criminal justice activities, such as 911 calls and investigations, in
Section E only.

Yes—answer questions 21-27
No—skip to Section E
21. Number of victims/survivors served, partially served, and victims/survivors seeking services
who were not served
Please do not answer this question without referring to the separate set of instructions for further explanation
and examples of how to distinguish among these categories. (Report the following, to the best of your ability,
as an unduplicated count for each category during the current reporting period. This means that each victim/
survivor who sought or received services during the current reporting period should be counted only once and in
only one of the listed categories. For purposes of this question, victims/survivors are those against whom the
sexual assault, domestic violence, and/or stalking was directed. If the victim/survivor experienced more than
one victimization, that person should be counted only once under the primary victimization.)
Sexual
assault

Domestic
violence

Stalking

A. Served: Victims/survivors who received the service(s) they needed,
if those services were provided under your STOP Program subgrant
B. Partially served: Victims/survivors who received some service(s),
but not all of the services they needed, if those
services were provided under your STOP Program subgrant
C. Victims seeking services who were not served: Victims/survivors
who sought services and did not receive the service(s) they needed,
if those services were provided under your STOP Program subgrant

22. Reasons that victims/survivors seeking services were not served or were partially served
(Check all that apply.)
Reasons not served or partially served

Program reached capacity
Need not documented
Did not meet eligibility or statutory requirements
Program rules not acceptable to victim/survivor
Services not appropriate for victim/survivor
Transportation problems
Conflict of interest
Services inappropriate or inadequate for victims/survivors with substance abuse problems
Services inappropriate or inadequate for victims/survivors with mental health problems
Services not available for victims/survivors accompanied by male adolescents
Inadequate language capacity (including sign language)
Insufficient/lack of culturally appropriate services
Insufficient/lack of services for people with disabilities
Geographic or other isolation of victim/survivor
Hours of operation
Other (specify):
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23. Demographics of victims/survivors served or partially served
(Based on the victims/survivors reported in 21A and 21B, report the total numbers for all that apply. Because victims/survivors may identify as more than one race/ethnicity and with more than one of the “other
demographics” options, the totals for these two categories may exceed the total number of victims/survivors
reported in 21A and 21B. However, the total number of victims/survivors reported in the “gender” and “age”
categories should equal the total number of victims/survivors reported in 21A and 21B.)

Race/Ethnicity (victims/survivors may be counted
for each ethnicity that applies)
Black or African American

Number of victims/survivors

American Indian and Alaska Native
Asian
Native Hawaiian and other Pacific Islander
Hispanic or Latino
White
Unknown
Gender
Female

Number of victims/survivors

Male
Unknown
TOTAL
GENDER
(should equal
of 21A
andand
21B)
0 ,sum
the sum
of 21A
21B)
Total (should
equal
Age
0-17

0

Number of victims/survivors

18-24
25-59
60+
Unknown
0 , of
TOTAL(should
AGE (should
21B)
the21A
sumand
of 21A
and 21B)
Total
equal equal sum

Other demographics

0
Number of victims/survivors

People with disabilities
People with limited English proficiency
People who are immigrants/refugees/asylum seekers
People who live in rural areas

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24. Victims/survivors’ relationship to offender
(For those victims/survivors reported in 21A and 21B, report the relationship of the victim/survivor to the
offender by type of victimization. If a victim/survivor experienced more than one type of victimization and/
or was victimized by more than one perpetrator, count the victim/survivor in all categories that apply. The
number of victims/survivors reported here may total more than the sum of 21A and 21B.)
Relationship to offender

Number of victims/survivors
Sexual assault Domestic violence Stalking

Current or former spouse or intimate partner
Other family or household member (in-law, sibling,
grandparent, roommate, etc.)
Dating relationship
Acquaintance (friend, neighbor, co-worker,
schoolmate, etc.)
Stranger
Relationship unknown
Other (specify):

25. Victim services
(Report the number of victims/survivors from 21A and 21B provided with hotline assistance; crisis intervention; hospital response; counseling/support group services; criminal justice advocacy/court accompaniment;
civil legal advocacy/court accompaniment; civil legal assistance; victim witness notification; or victim/survivor advocacy. Count a victim/survivor once for each type of service received during the current reporting
period. The number of victims/survivors reported here may total more than the sum of 21A and 21B.)
Type of service

Number of victims/
survivors served

Hotline calls
(Crisis or information and referral calls received by an agency’s hotline or office telephone.)

Crisis intervention
(Crisis intervention is a process by which a person identifies, assesses, and intervenes with
an individual in crisis so as to restore balance and reduce the effects of the crisis in her/his
life. In this category, report only crisis intervention that occurs in person.)

Hospital response
(Accompanying or meeting a victim/survivor at the hospital, usually for a forensic exam.)

Counseling/support group
(Individual or group counseling or support provided by a volunteer, peer, or professional.)

Criminal justice advocacy/court accompaniment
(Assisting a victim/survivor with criminal legal issues including preparing paperwork such as
victim impact statements; accompanying a victim/survivor to a criminal court proceeding or
law enforcement interview; and all other advocacy within the criminal justice system.)

Civil legal advocacy/court accompaniment
(Assisting a victim/survivor with civil legal issues including preparing paper work for
protection orders, accompanying a victim/survivor to a protection order hearing or other civil
proceeding; and all other advocacy within the civil justice system.)

Civil legal assistance
(Civil legal services provided by an attorney.)

Victim witness notification
(Notifying victims/survivors of case status, hearing dates, providing information regarding
criminal process.)

Victim/survivor advocacy
(Actions designed to help the victim/survivor obtain needed resources or services
including employment, housing, shelter services, health care, victim’s compensation, etc.)

Other (specify):
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26. Shelter services
(Report the number of victims/survivors and accompanying family members who received emergency shelter
or transitional housing provided with STOP Program funds during the current reporting period. This should be
an unduplicated count for both victims/survivors and for family members. This means that each victim/survivor and each family member who received shelter services during the current reporting period should be
counted only once. Report the total number of bed days provided in emergency shelter or transitional housing
to victims/survivors and family members. Bed days are determined by multiplying the total number of nights
each victim/survivor and family member stays in a shelter by the number of victims/survivors and family
members served.)
Shelter
service

Number of victim/
survivors

Number of
family members

Number of
bed days

Emergency shelter
Transitional housing
27. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which STOP
Program-funded victim services staff provided assistance to victims/survivors during the current reporting
period.)
Temporary protection orders

Final protection orders

Number of protection orders requested
Number of protection orders granted

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E1

CRIMINAL JUSTICE SYSTEM
Law Enforcement

Were your STOP Program funds used for law enforcement activities during the current reporting period?
Check yes if your STOP Program funded law enforcement activities.

Yes—answer question 28-29. Provide information only for STOP Program-funded law
enforcement activities engaged in during the current reporting period.
No—skip to E2.
28. Activities
(Report the activities on sexual assault, domestic violence, and stalking cases/incidents for the current
reporting period.)
Activity

Number

Calls for assistance
(All 911 and other calls made to law enforcement.)

Incident reports
(All responses to an incident as reported on an incident report.)

Cases/incidents investigated
(All cases in which evidence was collected/witnesses interviewed
relating to an incident.)

Arrests of predominant aggressor
(Responses by law enforcement in which only the predominant or
primary aggressor was arrested.)

Dual arrests
(Responses by law enforcement in which two parties involved in the
incident are arrested.)

Protection/ex parte/temporary restraining orders served
(All instances in which these types of orders were served on offenders.)

Arrests for violation of bail bond
(All instances in which arrests were made of offenders who violated conditions
set out in their bail bonds.)

Enforcement of warrants
(All instances in which warrants relating to these incidents were enforced.)

Arrests for violation of protection order
Protection orders issued
(All orders issued by law enforcement or at the request of law enforcement in a
sexual assault, domestic violence, or stalking case.)

Referrals of cases to prosecutor
Referrals of federal firearms charges to federal prosecutor
29. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which STOP
Program-funded law enforcement staff provided assistance to victims/survivors during the current reporting
period.)
Temporary protection orders

Final protection orders

Number of protection orders requested
Number of protection orders granted

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Prosecution

E2

Were your STOP Program funds used for prosecution during the current reporting period?
Check yes if your STOP Program funded prosecution activities.

Yes—answer questions 30-34. Provide the information only for STOP Program-funded
prosecution activities engaged in during the current reporting period.
No—skip to E3.
30. Number of sexual assault, domestic violence, and stalking cases received, charged, not
charged, or transferred
(Report the following for all sexual assault, domestic violence and stalking case referrals received, cases
resulting in charges filed, cases in which an affirmative decision was made not to file charges and cases
transferred to a higher or lower court during the current reporting period.)
a. Number of case referrals received
b. Number of cases in which charges were filed
c. Number of cases in which an affirmative decision was made not to file charges
d. Number of cases transferred to a higher or lower court

31. Number of pending charges and number of new offenses charged
(Report the total number of sexual assault, domestic violence, and/or stalking charges pending from the
previous reporting period and new offenses charged during the current reporting period. If you have not
previously filed an annual report, include all charges pending at the beginning of the current reporting
period as “pending charges.”)
Misdemeanor and felony domestic violence offenses include any assaults, battery, vandalism, or other offenses
that occurred in a domestic violence incident. Your state law or tribal code does not have to name the offense
“domestic violence” for it to be counted here. Similarly, sexual assault and stalking offenses should be counted,
even if your state law uses other names for these types of offenses, such as “sexual battery” or “harassment.”
Type of offense

Number of pending charges
from last reporting period

Number of new charges

Misdemeanor sexual assault
Felony sexual assault
Homicide related to sexual assault,
domestic violence, and/or stalking
Domestic violence ordinance
Misdemeanor domestic violence
Felony domestic violence
Stalking ordinance
Misdemeanor stalking
Felony stalking
Violation of protection order
Violation of bail
Violation of probation or parole
Violation of other court order
Other (specify):

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32. Disposition of charges
(Report the dispositions of all charges resolved during the current reporting period. [Deferred adjudication is
a process where the judge requires the defendant to adhere to certain terms, prior to any adjudication of
guilt. If a defendant successfully completes those terms, the charges are dismissed.])
Number dismissed

Type of offense

Request Lack of
Plea
of victim evidence bargain Other

Number convicted
Number of
deferred
Guilty of Guilty of Plead as Plead
charged lesser
lesser
adjudications highest

Number
acquitted

Misdemeanor
sexual assault
Felony sexual
assault
Homicide related
to sexual assault,
domestic violence,
and/or stalking
Domestic violence
ordinance
Misdemeanor
domestic violence
Felony domestic
violence
Stalking ordinance
Misdemeanor
stalking
Felony stalking
Violation of
protection order
Violation of bail
Violation of probation or parole
Violation of other
court order
Other (specify):

33. Tribal subgrantees
(Report the total number of sexual assault, domestic violence, and stalking cases referred for state
or federal prosecution during the current reporting period.)
Number
Cases referred to federal entity for prosecution
Cases referred to state entity for prosecution
TOTAL

0

34. Protection orders
(Report the total number of temporary and/or final protection orders STOP Program-funded prosecutors
requested and the number granted during the current reporting period.)
Temporary protection orders
Final protection orders
Number of protection orders requested
Number of protection orders granted
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Courts

E3

Were your STOP Program funds used for courts during the current reporting period?
Check yes if your STOP Program funded court activities.

Yes—answer questions 35-39. Provide the information only for STOP Program-funded court
activities engaged in during the current reporting period.
No—skip to E4.
35. Number of criminal charges
(Report the total number of sexual assault, domestic violence, and stalking cases pending from the previous
reporting period and new cases filed during the current reporting period. If you have not previously filed an
annual report, include all pending cases at the beginning of the current reporting period as “charges pending.”)
Misdemeanor and felony domestic violence offenses include any assaults, battery, vandalism, or other
offenses that occurred in a domestic violence incident. Your state law or tribal code does not have to name
the offense “domestic violence” for it to be counted here. Similarly, sexual assault and stalking offenses
should be counted, even if your state law uses another name for these types of offenses, such as “sexual
battery” or “harassment.”
Type of offense

Charges pending from
last reporting period

New charges filed during
the current reporting period

Misdemeanor sexual assault
Felony sexual assault
Homicide related to sexual assault,
domestic violence, or stalking
Domestic violence ordinance
Misdemeanor domestic violence
Felony domestic violence
Stalking ordinance
Misdemeanor stalking
Felony stalking
Violation of protection order
Violation of bail
Violation of probation/parole
Violation of other court order
TOTAL

0

0

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36. Disposition of criminal charges
(Report the disposition of any sexual assault, domestic violence, or stalking charges resolved during the
current reporting period.)
Type of offense

Number
dismissed

Number of
deferred adjudications

Number
convicted

Number
acquitted

0

0

Misdemeanor sexual assault
Felony sexual assault
Homicide related to sexual assault,
domestic violence, or stalking
Domestic violence ordinance
Misdemeanor domestic violence
Felony domestic violence
Stalking ordinance
Misdemeanor stalking
Felony stalking
Violation of protection order
Violation of bail
Violation of probation/parole
Violation of other court order

0

TOTAL

0

37. Judicial monitoring
(Report the number of sexual assault, domestic violence and/or stalking offenders whose cases were reviewed
by the court for compliance with conditions of probation or other court-ordered conditions, or for violations of
those conditions during the current reporting period. Also report the total number of review hearings conducted.)
Number of offenders reviewed
Number of review hearings conducted
TOTAL

38. Dispositions of violations
(Report the
the number
number of
of sexual
sexual assault,
assault, domestic
domesticviolence
violence and/or
and/orstalking
stalkingcases
casesininwhich
whichthere
therewere
weredispositions
disposi(Report
tions
of
violations
during
the
current
reporting
period.
The
violation
does
not
have
to
have
occurred
during
of violations during the current reporting period. The violation does not have to have occurred during this
this reporting
period,
onlydisposition.
the disposition.
A case
maycounted
be counted
if there
multiple
vioreporting
period,
only the
A case
may be
moremore
than than
onceonce
if there
werewere
multiple
violations.)
lations.)
No
Conditions Partial reProbation
Verbal/
Fine
Violation
Violation
action
added
vocation of revoked/
written
taken
probation Incarcerated
warning
Protection order
New criminal behavior
Failure to attend mandated offender treatment
program
Other condition of
probation or parole
TOTAL

0

0

0

0

0

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39. Civil protection orders
(Report the total number of temporary and/or final civil protection orders requested and granted by the court
to victims/survivors of sexual assault, domestic violence, and stalking during the current reporting period.
Include only civil orders.)
Temporary protection orders

Final protection orders

Number of protection orders requested
Number of protection orders granted

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Probation and Parole

E4

Were your STOP Program funds used for probation and parole during the current reporting period?
Check yes if your STOP Program funded probation and parole activities.

Yes—answer questions 40-42. Provide the information only for STOP Program-funded
probation and parole activities engaged in during the current reporting period.
No—skip to FE5.
40. Number of cases
(Report the total number of continuing and new cases involving offenders charged with sexual assault,
domestic violence, and/or stalking. This is an unduplicated count. If you have not previously filed an annual
report, include all pending cases at the beginning of the current reporting period as “number of continuing
cases.”)
Misdemeanor and felony domestic violence offenses include any assaults, battery, vandalism, or other offenses
that occurred in a domestic violence incident. Your state law or tribal code does not have to name the offense
“domestic violence” for it to be counted here. Similarly, sexual assault and stalking offenses should be counted,
even if your state law uses another name for these types of offenses, such as “sexual battery” or “harassment.”
Number of
continuing cases

Number of
new cases

Completed probation
Without
violations

With
violations

Total unduplicated count
of cases (offenders)

41. Monitoring activities
(For new and continuing cases reported in question 40, report the number of the monitoring activities
engaged in during the current reporting period.)
Activity

Number of offenders

Total contacts

Number of victims/survivors

Total contacts

Face-to-face meeting with offender
Telephone contact with offender
Unscheduled surveillance of offender
Activity
Outreach to victims/survivors

42. Disposition of violations
(Report the total number of sexual assault, domestic violence, and stalking cases in which there were
dispositions of violations during the current reporting period. The violation does not have to have occurred
during this reporting period, only the disposition. A case may be counted more than once if there were
multiple violations.)
Verbal/
Violation
No action
Fine
Conditions
Partial
Probation
written
taken
added
revocation
revoked/
warning
Incarcerated
Protection order
New criminal behavior
Failure to attend mandated
offender treatment program
Other condition of
probation or parole
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F

NARRATIVE

All subgrantees must answer questions 43 and 44.
Please limit your responses to two pages per question.
43. What do you see as the most significant areas of remaining need, with regard to increasing
Page 27
victim/survivor safety and offender accountability? To answer this question go to
(Consider geographic regions, underserved populations, service delivery systems, types of victimization,
and challenges and barriers unique to your jurisdiction.)

44. What has STOP Program funding allowed you to do that you could not do prior to receiving this
funding? (e.g., expand coordination and cross-referrals with victim/survivor services, or track data
Page 29
on arrests and prosecutions) To answer this question go to
Question 45 is optional.
45. Provide any additional information that you would like us to know about your STOP Program
Page 31
To answer this question go to
subgrant and/or the effectiveness of your grant.
subgrant.
(If you have not already done so elsewhere on this form, feel free to discuss any of the following: institutionalization of staff positions, policies, and/or protocols; systems-level changes; community collaboration; the
removal or reduction of barriers and challenges for victims/survivors; utilization of volunteers and/or interns
to complete activities; promising practices; and positive or negative unintended consequences.)

Public Reporting Burden
Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to respond to a collection
of information unless it displays a currently valid OMB control number. We try to create forms and instructions that are
accurate, can be easily understood, and which impose the least possible burden on you to provide us with information.
The estimated average time to complete and file this form is 60 minutes per form. If you have comments regarding the
accuracy of this estimate, or suggestions for making this form simpler, you can write to the Office on Violence Against
Women, U.S. Department of Justice, 810 7th Street, NW, Washington, DC 20531.

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What do you see the most significant areas of remaining need, with regard to increasing
victim/survior safety and offender accountablility? - Question # 43

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What do you see the most significant areas of remaining need, with regard to increasing
victim/survior safety and offender accountablility? - Question # 43 (cont.)

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What has STOP funding allow you to do that you could not do prior to receiving this funding? - Question #44

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What has STOP funding allow you to do that you could not do prior to receiving this funding? - Question #44
(cont.)

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45. Provide any additional information that you would like us to know about you STOP program subgrant
and/or effectiveness of your subgrant.

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Provide any additional information that you would like us to know about you STOP program subgrant and/or
effectiveness of your subgrant. (Question # 45 cont.)

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Click to validate the form

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