Form 1122-0013 Semi-Annual Progress Report for the Rural Domestic Viole

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U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
Rural Domestic Violence and
Child Victimization Enforcement Grants
Brief Instructions: This form must be completed for each Rural Domestic Violence and Child Victimization Enforcement Grant (Rural Program). A 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 or coordinators are responsible for compiling and submitting a single report that reflects all information collected from grant
partners.
All grantees should read each section to determine which questions they must answer, based on activities supported under this grant during the current reporting period. Sections B and F of this form must be completed by all
grantees. In Section A, subsection A1 must be answered. In Section C, subsection C2 must be answered. In sections D, E, and subsections A2, C1, and C3-C8 grantees must answer an initial question about whether they engaged in certain activities during the current reporting period. If the response is yes, then the grantee must
complete that subsection. If the response is no, the rest of that section/subsection is skipped.
For example, 1) if you are a victim services agency providing training, coordinated community response and victim
services with staff funded under this grant, you would complete sections A1, A2, B, C1, C2, D, and F (and answer
“no” in subsections C3-C8 and section E); or, 2) if you receive funds for training, coordinated community response,
victim services, and law enforcement, you would complete sections A1, A2, B, C1, C2, D, E1, and F (and answer
“no” in subsections C3-C8 and E2-E5). For complete instructions and definitions, see attached instructions.
The activities of volunteers or interns may be reported if they are coordinated or supervised by Rural Programfunded staff or if Rural Program grant 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 A:
Section
Section B:
B:
Section C:
C:
Section
C1:
C1:
C2:
C2:
C3:
C3:
C4:
C4:
C5:
C6:
C5:
C7:
C6:
C8:
C7:
SectionC8:
D:
Section E:
Section D:
E1:
SectionE2:
E:
E1:
E3:
E2:
E4:
E3:
E5:
SectionE4:
F:
AppendixE5:
A:
Section F:
Appendix A:

General
General Information
Information
Purpose
Purpose Areas
Areas
Function
Function Areas
Areas
Training
Training
Coordinated Community Response
Coordinated Community Response
Policies
Policies
Products
Products Education
Community
Data
Collection
and Communication Systems
Community
Education
Specialized
Unitsand Communication Systems
Data Collection
System
Improvement
Specialized
Units
Victim
Services
System Improvement
Justice System
Victim Services
Law Enforcement
Justice
System
Prosecution
Law
Enforcement
Courts
Prosecution
Probation
and Parole
Courts Intervention Program
Batterer
Narrative
Probation and Parole
Status
Goals and Objectives
BattererofIntervention
Program Table
Narrative
Status of Goals and Objectives Table

Page Number
11
44
55
5
5
8
89
9
10
10
11
13
12
14
14
15
15
16
16
20
17
20
21
22
21
25
23
28
26
29
30
29
31
30
31
32

Domestic
Violence
and Child
Victimization
Enforcement
Grants
Semi-Annual
Progress
Report
Women
RuralRural
Domestic
Violence
and Children
Victimization
Enforcement
Grants
Program
Semi-annual
Progress
Report• •Office
Officeon
onViolence
Violence Against
Against Women

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GENERAL INFORMATION
Grant information

A1

All grantees must complete this section.
/

1.

Date of report

2.

Current reporting period

3.

Grantee name

4.

Grant number

/

(format date with 6 digits - 01/31/04)
✔

January 1- June 30

✔

July 1 - December 31

(Year)

(the federal grant number assigned to your Rural Program grant)

5.

Type of lead agency/organization
(Check the one answer that best describes the type of agency/organization administering Rural Program
funds. States administering Rural Program funds should see the instructions for additional information.)
State coalition
Court
Court
State Coalition
Government
agency
(e.g.
state
criminal
jusTribal government
Government agency (e.g. state criminal jusTribal government
ticeagency,
agency,child
childprotective
protectiveservices)
services)
tice
Unit of local government
Unit of local government
Lawenforcement
enforcement
Law
University/school
University/school
Probation,parole,
parole,ororother
othercorrectional
Probation,
Victim services
correctional agency
agency
Other
(specify):
Victim
services
Prosecution
Prosecution
Other (specify):

6.

Point of contact
(person responsible for the day-to-day coordination or administration of the grant)
First Name
MI
Last Name
Name
Agency/Organization (if different from grantee)
Agency/organization (if different from grantee)
Address
Address
State

City
Telephone
Telephone

Zip Code

Facsimile
Facsimile

E-mail
Email

7.

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

Yes

No

If yes, which tribes/nations

Rural
Domestic
Violence
and Child
Victimization
Enforcement
Grants
Semi-Annual
Progress
Report
• 1• 1•• Office
Officeon
onViolence
ViolenceAgainst
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Women
Rural
Domestic
Violence
and Children
Victimization
Enforcement
Grants
Program
Semi-annual
Progress
Report
Women

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8.

What percentage of your Rural Program funds were directed to each of these areas?
(Report the area[s] addressed by your Rural Program grant during the current reporting period and estimate
the approximate percentage of funds [or resources] used to address each area [consider education, training,
victim services, etc.]. The grantee may choose how to make this determination.)
Throughout this form, 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. Child victimization is defined by your state statute. However, child
victimization may only be reported on this form if it occurs within the context of domestic violence. See the
separate instructions for more complete definitions.
Percentage of grant funds
Domestic violence

%

Child victimization

%

100% 0 %

TOTAL

9.

What percentage of Rural Program funds were used for prevention activities during the current
reporting period?
%

RuralDomestic
Domestic
Violence
Child Victimization
VictimizationEnforcement
Enforcement
Grants
Semi-Annual
Progress
Report
• 2 ••2 Office
Women
Rural
Violence
andand
Children
Grants
Program
Semi-annual
Progress
Report
• Officeon
onViolence
Violence Against
Against Women

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A2

Staff Information

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

Yes—answer question 10
No—skip to Section B
10. Staff
(Report the total number of full-time equivalent [FTE] staff funded by the Rural 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. 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 how to
calculate FTEs for part-time staff or contractors.)
Staff

Grant-funded staff

Administrator (director, fiscal manager)
Civil attorney
Children’s advocate
Counselor
Court personnel
Information technology specialist
Law enforcement officer
Legal advocate
Outreach worker
Paralegal
Probation officer
Program coordinator (training coordinator, victim ser vices coordinator)
Prosecutor
Support staff (secretary, administrative assistant)
Trainer/educator
Victim advocate
Victim-witness specialist
Other (specify):
TOTAL

0.00

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Domestic
Violence
ChildVictimization
Victimization
Enforcement
Grants
Semi-Annual
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Report
• 3 • •3 •Office
ViolenceAgainst
AgainstWomen
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Rural
Domestic
Violence
andand
Children
Enforcement
Grants
Program
Semi-annual
Progress
Report
Office on
on Violence

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PURPOSE AREAS

B

All grantees must complete this section.

11. Purpose areas
(Check all purpose areas that apply to activities supported by Rural Program funds during the current
reporting period.)
Check ALL
that apply

Purpose areas
Implement, expand, and establish cooperative efforts and projects between law enforcement
officers, prosecutors, victim advocacy groups, and other related parties to investigate and prosecute incidents of domestic violence, dating violence, and child abuse.
Provide treatment, counseling and assistance to victims of domestic violence, dating violence,
and child abuse, including in immigration matters.
Work in cooperation with the community to develop education and prevention strategies directed toward such issues.

12. Program priority areas addressed by your grant
(In addition to the purpose areas identified above, the Rural Grant Program Application and Program Guidelines may have identified several program priorities that would receive priority consideration. If your project
addressed any of these priority areas during the current reporting period, list them below.)

Rural
Domestic
Violence
ChildVictimization
Victimization
Enforcement
Grants
Semi-Annual
Progress
Report
• 4• 4• • Office
on Violence
ViolenceAgainst
AgainstWomen
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Rural
Domestic
Violence
and and
Children
Enforcement
Grants
Program
Semi-annual
Progress
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Office on

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C1

FUNCTION AREAS
Training

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

Yes—answer questions 13-15
No—skip to C2
For the purposes of this reporting form, training means providing information on domestic violence and child victimization that enables a person to improve her/his response to victims/survivors of domestic violence and child
victimization as it relates to her/his role in the system. Training should be reported in this subsection. Education
means providing general information that will increase awareness of domestic violence and/or child victimization.
Education events should be reported in subsection C5.

13. Training provided
(Report the total number of training events provided during the current reporting period that were either provided by Rural Program-funded staff or directly supported by Rural Program funds. Staff development training
provided to Rural Program-funded staff should not be counted.)
Total number of training events provided

Rural
Domestic
Violence
and Child
Victimization
Enforcement
Grants
Semi-Annual
Progress
Report
OfficeononViolence
Violence
Against
Women
Rural
Domestic
Violence
and Children
Victimization
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Grants
Program
Semi-annual
Progress
Report• 5• 5 •• Office
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14. Number of people trained
(Report the number of people trained during the current reporting period by Rural Program-funded staff or
training supported by Rural Program funds. Use the category that is most descriptive of the people who attended the training event. Rural Program-funded staff attending staff development training should not be
counted.)
People trained

Number

Attorneys/law students
Batterer Intervention Program staff
Child protective service workers
Children’s advocates (not affiliated with CPS)
Community advocacy organization staff (NAACP, NAMI, NAPCA)
Correction personnel (probation, parole, and correctional facilities)
Court personnel (tribal)
Court personnel (non-tribal)
Educators (teachers, administrators, etc.)
Faith-based organization staff
Government agency staff (vocational rehabilitation, food stamps, TANF)
Health professionals (doctors, nurses)
Immigrant organization staff
Law enforcement officers (tribal)
Law enforcement officers (non-tribal)
Legal services staff
Mental health professionals
Multidisciplinary group
Prosecutors (tribal)
Prosecutors (non-tribal)
Social service organization staff
State or tribal domestic violence coalition staff
Supervised visitation and exchange center staff
Tribal government/Tribal government agency staff
Victim advocates (tribal)
Victim advocates (non-tribal)
Victim-witness specialists (tribal)
Victim-witness specialists (non-tribal)
Volunteers
Other (specify):
Total

0

Rural Domestic
Victimization Enforcement
Enforcement Grants
Semi-annual
Progress
• Office
ViolenceAgainst
AgainstWomen
Women
Rural
DomesticViolence
Violenceand
andChildren
Child Victimization
GrantsProgram
Semi-Annual
Progress
ReportReport
• 6 •• 6Office
onon
Violence

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15. Training content areas
(Indicate all topics covered in training events provided or directly supported by your Rural Program funds during the current reporting period. Check all that apply.)

Domestic violence and child victimization
Advocate response

Underserved populations
Issues specific to rural victims/survivors who:

Child witnesses

are American Indian or Alaska Native

Child victimization overview, dynamics and
services

are Asian

Child development

are disabled

Confidentiality

are elderly

Dating violence overview, dynamics and
services

are Hispanic or Latino

Domestic violence overview, dynamics and
services

are immigrants, refugees, or asylum seekers

are black or African American

are homeless or living in poverty

Mandator y reporting requirements

are institutionalized or isolated

Parenting issues

are lesbian, gay, bisexual, transgender, or intersex

Safety planning for victims/survivors

are Native Hawaiian or other Pacific Islander

Sexual assault overview, dynamics and
services

have mental health problems

Stalking overview, dynamics and services

Other (specify):

have substance abuse problems

Supervised visitation and exchange
Other (specify):

Justice system
Civil court procedures
Child victimization statutes/codes

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

Criminal court procedures
Identification and arrest of predominant
aggressor
Domestic violence statutes/codes
Family court procedures
Firearms and domestic violence
Immigration
Judicial response
Juvenile court procedures
Law enforcement response
Pro-arrest policies
Probation response
Prosecution response
Protection orders (including full faith and
credit)
Sexual assault statutes/codes
Stalking statutes/codes
Tribal jurisdiction and Public Law 280
Other (specify):
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C2

Coordinated Community Response
All grantees must complete this section.

16. Coordinated community response activities supported with Rural Program funds during the current reporting period
(Check the appropriate boxes to indicate the agencies or organizations, even if they are not memorandum of
understanding [MOU] partners, 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. In the last column, indicate the agencies or organizations with
which you have an MOU for purposes of the Rural Program grant.)
Victim/survivor referrals,
Agency/organization/
MOU
Meetings
consultations, technical assistance
community group
Partner
Daily
Weekly Monthly
Weekly Monthly Quarterly
Batterer Intervention Program
Child Protective Services
Children’s advocacy program
Community advocacy organization (NAACP, NAMI, NAPCA)
Corrections (probation, parole,
and correctional facility)
Court (tribal)
Court (non-tribal)
Domestic violence program
(tribal)
Domestic violence program
(non-tribal)
Educational institution
Faith-based organization
Government agency (INS,
Social Security, TANF)
Health/mental health
organization
Immigration organization
Law enforcement (tribal)
Law enforcement (non-tribal)
Legal services organization
(legal services, bar associations,
law schools)
Prosecutor’s office (tribal)
Prosecutor’s office (non-tribal)
Sexual assault program (tribal)
Sexual assault program
(non-tribal)
Social service organization
Supervised visitation and
exchange centers
Tribal government/Tribal
government agency
Other (specify):
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C3

Policies

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

Yes—answer question 17
No—skip to C4
17. Types of protocols or policies developed, substantially revised, and/or implemented during the
current reporting period
(Check all that apply.)

Victim services

Court

Tribal Non-tribal

Tribal Non-tribal

Appropriate response to underserved
populations
Confidentiality
Mandatory training standards for staff and
volunteers
Staff, board, and/or volunteers represent
the diversity of your service area
Victim informed about Crime Victims Compensation and Victim Impact Statements
Other (specify):

Law enforcement
Tribal Non-tribal

Appropriate response to underserved
populations
Identifying primary aggressor/discouraging
dual arrest
Immediate access to protection order
information
Mandatory training on domestic violence
and child victimization
No victims polygraphed
Pro-arrest/mandatory arrest
Protection order enforcement (including full
faith and credit)
Providing information to victims/survivors
about victim services
Other (specify):

Prosecution
Tribal Non-tribal

Appropriate response to underserved
populations
Mandatory training on domestic violence
and child victimization
Protection order enforcement (including full
faith and credit)
No victims polygraphed
Vertical prosecution
Victim-witness notification
Other (specify):

Accelerated trial schedules
Appropriate response to underserved
populations
Dedicated domestic violence docket
Full faith and credit for protection orders
Immediate access to obtaining protection
orders
Judicial monitoring of domestic violence
offenders
Mandatory training on domestic violence
and child victimization
Policy against mutual restraining orders
Procedures for courtroom security
Standard protection order
Other (specify):

Probation and Parole
Tribal Non-tribal

Appropriate response to underserved
populations
Mandatory training on domestic violence
and child victimization
Strategies to assist and protect victim
during probation and parole
Victim notification
Other (specify):

Child Protective Services
Tribal Non-tribal

Advocate response or accompaniment to
emergency room
Appropriate services for underserved
populations
Documentation
Forensic exam programs
Mandatory training on domestic violence
Routine screening and referrals for domestic
violence and child victimization
Other (specify):

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C4

Products

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Expiration Date: 10/31/2007

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

Yes—answer question 18
No—skip to C5
18. Use of Rural Program funds for product or code development, substantial revision, and/or distribution
(Report the number of products developed, substantially revised, and/or distributed with Rural 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; the 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 lanugage. 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 but 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

Newsletters

Posters

Question 18 continued on next page

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Number
Products developed
or revised

Title/topic

Intended
audience

Number
used or
distributed

Other
languages

Public
service
announce
ments

Training
curricula

Training
materials

Web site
(report no.
of page
views in
the used or
distributed
column)

Videos

Other
(specify):

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Community Education

C5

Were your Rural Program funds used for community education during the current reporting period?
Check yes if Rural Program-funded staff were used to support community education activities or if Rural
Program funds directly supported community education activities.

Yes-answer question 19-21
No-skip to C6
For the purposes of this reporting form, education means providing general information that will increase
awareness of domestic violence and child victimization. Education should be reported in this section. Training
means providing information on domestic violence and child victimization that enables a person to improve
her/his response to victims/survivors of domestic violence and child victimization as it relates to her/his
role in the system. Training should be reported in subsection C1.

19. Education events
(Report the total number of education events provided during the current reporting period that were either
provided by Rural Program-funded staff or directly supported by Rural Program funds.)
Total number of education events provided

20. Number of people educated
(Report the number of people attending domestic violence and/or child victimization education events provided by Rural Program-funded staff or supported by Rural Program funds during the current reporting period.
Use the category that is most descriptive of the people attending the education event.)
People educated

Number

Child care providers
Community advocacy groups (NAPCA, NAACP, NAMI)
Community businesses (retail stores, pharmacies)
Community groups (service or social groups)
Community members (unaffiliated adults)
Educators and/or school administrators
Elementary school students
Faith-based groups
Middle and high school students
Parents or guardians
University or college students
Victims/sur vivors (do not count psychoeducation groups)
Other (specify):
0

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Violenceand
andChildren
Child Victimization
Grants Program
Semi-Annual
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Report Report
• 11 •
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Domestic Violence
VictimizationEnforcement
Enforcement Grants
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• Office
ViolenceAgainst
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Women

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21. Topics of education events provided with Rural Program funds
(Indicate all topics covered in education events provided with your Rural Program funds during the current reporting period. Check all that apply).

Domestic violence and child victimization
Anti-bullying/Violence prevention (pre-k-5th grade)
Child victimization overview, dynamics and services
Child victimization prevention program
Child witness overview, dynamics and services
Domestic violence prevention program
Dating violence overview, dynamics and services
Domestic violence overview, dynamics and services
Healthy relationships/Domestic violence prevention (6-12th grade)
Healthy relationships/Domestic violence prevention (university)
Healthy relationships/Domestic violence prevention (community)
Indigenous prevention programs
Mandated reporting of child victimization
Parent-child interaction (parent-child play program, parent-child music class)
Parenting skills (child development, appropriate interventions)
Safety planning
Workplace violence
Other (specify):

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

Rural
Domestic
Victimization
Enforcement
Grants
Progress Report
12 • •Office
on Violence
Against
Women
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DomesticViolence
Violenceand
andChild
Children
Victimization
Enforcement
GrantsSemi-Annual
Program Semi-annual
Progress•Report
13 • Office
on Violence
Against
Women

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C6

Data Collection and Communication Systems

Were your Rural Program funds used for data collection systems or communication systems or for the
purchase of hardware or other equipment during the current reporting period?
Check yes if Rural Program funds or Rural Program-funded staff were used to develop, install, or expand data
collection and/or communication systems.

Yes-answer question 22-23
No-skip to C7
22. Use of Rural 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
23. Purpose of data collection and/or communication systems
(Indicate all types of information being identified or tracked with this technology by checking all that apply.)

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

Rural
Domestic
Violence
andand
Children
Grants
Program
Semi-annual
Progress
Report
Office on
on Violence
Rural
Domestic
Violence
ChildVictimization
VictimizationEnforcement
Enforcement
Grants
Semi-Annual
Progress
Report
• 13• 14
• •Office
ViolenceAgainst
AgainstWomen
Women

SECTION

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

C7

Specialized Units

Were your Rural Program funds used for specialized units during the current reporting period?
Check yes if any Rural Program-funded staff were part of a specialized unit in any of the categories listed
below, or if Rural Program funds were used to directly support a specialized unit. (A specialized unit is a centralized or coordinated group, unit, or dedicated staff of police officers, prosecutors, probation officers, or
judges responsible for handling domestic violence and/or child victimization cases. A specialized unit may
consist of one person, even if that person is partially funded by your Rural Program grant.)

Yes—answer question 24
No—skip to C8
24. Use of Rural Program funds for specialized units
(Use the DV columns for domestic violence and the CV columns for child victimization. Check all that apply.)
Law enforcement
DV
CV

Prosecution
Court
DV
CV
DV
CV

Probation or parole
DV
CV

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

Rural
Child Victimization
Enforcement
ProgressProgress
Report •Report
14 • •Office
on Violence
Against
Women
RuralDomestic
DomesticViolence
Violence and
and Children
Victimization
EnforcementGrants
GrantsSemi-Annual
Program Semi-annual
15 • Office
on Violence
Against
Women

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C8

System Improvement

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

Yes—answer question 25
No—skip to Section D
25. Use of Rural Program funds for system improvement
(Indicate the system improvement activities supported with your Rural Program funds. Check all that apply.)
Victim services

Law enforcement

Prosecution Court

Probation or parole

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

Rural Domestic
Domestic Violence
VictimizationEnforcement
Enforcement Grants
Semi-annual
Progress
• Office
on Violence
Against
Women
Rural
Violenceand
andChildren
Child Victimization
Grants Program
Semi-Annual
Progress
Report Report
• 15 •• 16
Office
on Violence
Against
Women

SECTION

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ClearanceNo.:
# 1121-NNNN
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1122-0013
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Date:10/31/2007
Expiration

D

VICTIM SERVICES
For the purposes of the Rural Program, grant funds may be used to address
sexual assault, stalking and child victimization only within the context of domestic violence.
In Section D, report data only for victims/survivors and children served with Rural Program funds.

Were your Rural Program funds used to provide victim services to victims/survivors and children
during the current reporting period?
Check yes if Rural Program-funded staff provided victim services or if Rural Program grant funds were used to
support victim services during the current reporting period. Report all victims served, and services provided with
Rural 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 26-33
No-skip to Section E
26. Number of victims/survivors and children served, partially served, and victims/survivors and
children 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 or child 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 domestic violence [including dating violence] was directed. Children who have
been victimized (except victims/survivors of dating violence) and the children of domestic violence victims/
survivors receiving grant-funded services should be counted in the second column.)
Victims/Survivors Children
A. Served: Victims/survivors and children who received the service(s) they needed,
if those ser vices were provided under your Rural Program grant
B. Partially served: Victims/survivors and children who received some service(s),
but not all of the services they needed, if those services were provided under
your Rural Program grant
C. Victims/survivors and children seeking services who were not served: Victims/
sur vivors and children who sought ser vices and did not receive the service(s)
they needed, if those services were provided under your Rural Program grant

27. Reasons that victims/survivors and children seeking services were not served or were partially
served
(Check all that apply.)
Reasons not served or partially served
Program reached capacity
Program unable to provide service due to limited resources/priority-setting
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):
Rural Domestic
DomesticViolence
Violenceand
and
Child Victimization
EnforcementGrants
GrantsProgram
Semi-Annual
Progress
ReportReport
• 16 •
onon
Violence
Rural
Children
Victimization Enforcement
Semi-annual
Progress
• 17Office
• Office
ViolenceAgainst
AgainstWomen
Women

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28. Demographics of victims/survivors and children served or partially served
(Based on the victims/survivors and children reported in 26A and 26B, provide the total numbers for all that
apply. This should be an unduplicated count for victims’/survivors’ and children’s “gender” and “age.”)
Race/Ethnicity (Count all that apply.)

Victims/Survivors

Children

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

Female
Male
Unknown
TOTAL
TOTAL(should
(Shouldequal
equal sum of 026A
, theand
sum26B)
of 26A and 26B)

0

0

0

0

Age

0-6
7-12
13-17
18-24
25-59
60+
Unknown
TOTAL
(Should equal sum of 026A
, theand
sum26B)
of 26A and 26B)
TOTAL (should
Other demographics

People with disabilities
People with limited English proficiency
People who are immigrants/refugees/asylum seekers
People who live in rural areas
29. Victims’/survivors’ and children’s relationship to offender
(For those victims/survivors and children reported in 26A and 26B, report the relationship of the victim/survivor or child to the offender. Count the relationship to each offender for victims/survivors victimized by more
than one perpetrator. The number of victims/survivors and children reported here may total more than the
sum of 26A and 26B.)
Relationship to offender
Victims/Survivors
Children
Current or former spouse or intimate partner
Parent, step-parent or guardian, or intimate partner of parent
Other family or household member (sibling, grandparent, etc.)
Dating relationship
Relationship unknown
Other (specify):
TOTAL

0

0

Rural
Violenceand
andChildren
Child Victimization
Grants Program
Semi-Annual
Progress
Report Report
• 17 •• 18
Office
on on
Violence
Against
Rural Domestic
Domestic Violence
VictimizationEnforcement
Enforcement Grants
Semi-annual
Progress
• Office
Violence
AgainstWomen
Women

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

30. Victim services
(Report the number of domestic violence victims/survivors [including dating violence] and children from 26A
and 26B provided with hotline calls; crisis intervention; hospital response; support group/counseling services; criminal justice advocacy/court accompaniment; civil legal advocacy; civil legal assistance; victim-witness notification; victim/survivor advocacy; child advocacy; or supervised visitation and exchange. A victim/
survivor or child may be counted once for each type of service received during the current reporting period.
The number of victims/survivors and children reported here may total more than the sum of 26A and 26B.
Shelter services should be reported in question 31.)
Type of service

Number of victims/
survivors served

Number of
children served

Hotline calls
(Crisis or information and referral calls received by a program’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.)
Support group/counseling services
(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 paperwork for a protection order, accompanying a
victim/survivor to a protection order hearing or other civil court
proceeding.)
Civil legal assistance
(Civil legal services provided by an attorney.)
Victim-witness notification
(Notifying victims/survivors of case status, hearing dates,
providing information regarding the criminal process.)
Victim/survivor advocacy
(Actions designed to help the victim/survivor obtain needed
support, resources or services including employment, health
care, victim’s compensation, etc.)
Child advocacy
(Including guardian ad litem.)
Supervised visitation and exchange
(Supervising visitation or exchange of children with non-custodial
parent.)
Other (specify):

Rural
Domestic
Victimization
Enforcement
Progress Progress
Report •Report
18 • • Office
on Violence
Against
Women
Rural
DomesticViolence
Violenceand
and Child
Children
Victimization
EnforcementGrants
GrantsSemi-Annual
Program Semi-annual
19 • Office
on Violence
Against
Women

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

31. Shelter services
(Report the total number of domestic violence victims/survivors and accompanying family members who received emergency shelter or transitional housing provided with Rural Program funds during the current reporting period. 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 victims/
survivors

Number of family
members (include all
children here)

Number of
bed days

Emergency shelter
Transitional housing

32. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which Rural
Program-funded victim services staff provided assistance to victims/survivors during the current reporting
period. Protection orders include those ordered on the behalf of children.)
Temporary protection orders

Final protection orders

Number of protection orders requested
Number of protection orders granted

33. Referrals to and from Child Protective Services
(Report the total number of referrals made to and received from Child Protective Services. Count each child
covered in a referral as one referral.)
Referrals

Number of children referred

To Child Protective Services
From Child Protective Services

Rural
Violenceand
andChildren
Child Victimization
Grants Program
Semi-Annual
Progress
Report Report
• 19 •
onon
Violence
Rural Domestic
Domestic Violence
VictimizationEnforcement
Enforcement Grants
Semi-annual
Progress
• 20Office
• Office
ViolenceAgainst
AgainstWomen
Women

SECTION

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

E1

JUSTICE SYSTEM
Law Enforcement
Rural Program funds may be used to address sexual assault, stalking and
child victimization only within the context of domestic violence.

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

Yes—answer questions 34-36
No—skip to E2
34. Domestic violence activities
(Report activities on domestic violence cases/incidents for the current reporting period. Child victimization
incidents are repor ted below in question 35.)
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
(All responses by law enforcement in which only the predominant or primary aggressor was arrested.)

Dual arrests
(All 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 domestic violence cases.)

Referrals of cases to prosecutor
Referrals of federal firearms charges to federal prosecutor

RuralDomestic
Domestic
Violence
Child Victimization
VictimizationEnforcement
Enforcement
Grants
Semi-Annual
Progress
Report
• 20 • •21 Office
Rural
Violence
andand
Children
Grants
Program
Semi-annual
Progress
Report
• OfficeononViolence
ViolenceAgainst
Against Women
Women

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

35. Child victimization activities
(Report the activities on child victimization cases [report only child victimizations which occur within the
context of domestic violence] for the current reporting period. An incident or case may involve one or more
children.)
Activity

Number

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

Arrests of offender
(Responses by law enforcement in which the offender is arrested.)

Referral of cases to prosecutor
Referral of cases to Child Protective Services

36. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which Rural
Program-funded law enforcement staff provided assistance to victims/survivors during the current reporting
period. Protection orders include those ordered on the behalf of children.)
Temporary protection orders

Final protection orders

Number of protection orders requested
Number of protection orders granted

Rural
Domestic
Violence
ChildVictimization
Victimization
Enforcement
Grants
Semi-Annual
Progress
Report
• 21
on Violence
ViolenceAgainst
AgainstWomen
Women
Rural
Domestic
Violence
and and
Children
Enforcement
Grants
Program
Semi-annual
Progress
Report
• 22• • Office
Office on

SECTION

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

E2

Prosecution
Rural Program funds may be used to address sexual assault, stalking and
child victimization only within the context of domestic violence.

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

Yes—answer questions 37-41
No—skip to E3
37. Number of domestic violence and child victimization cases received, charged, not charged, or
transferred
(Report the following for all domestic violence and child victimization 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.)
Domestic violence

Child victimization

Number of case referrals received
Number of cases in which charges were filed
Number of cases in which an affirmative decision was made
not to file charges
Number of cases transferred to a higher or lower court

Rural
DomesticViolence
Violenceand
andChildren
Child Victimization
GrantsProgram
Semi-Annual
Progress
ReportReport
• 22 ••23Office
onon
Violence
Rural Domestic
Victimization Enforcement
Enforcement Grants
Semi-annual
Progress
• Office
ViolenceAgainst
AgainstWomen
Women

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

38. Number of pending charges and number of new offenses charged
(Report the total number of domestic violence, sexual assault, stalking, and child victimization charges pending from the previous reporting period and new offenses charged during the current reporting period. If you
have not previously filed a semi-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 does not have to name the offense "domestic violence’’ for it to be counted here. Child victimization offenses include any physical or sexual abuse,
or child neglect that occur in the context of domestic violence. Sexual assault and stalking offenses should
only be used to report offenses against victims/survivors of domestic violence (including dating violence),
not children. Report sexual assault and stalking offenses against children as child victimization offenses.
Type of offense

Number of pending charges
from last reporting period

Number of new charges

Domestic violence ordinance
Misdemeanor domestic violence
Felony domestic violence
Domestic violence homicide
Misdemeanor sexual assault
Felony sexual assault
Stalking ordinance
Misdemeanor stalking
Felony stalking
Misdemeanor child abuse or neglect
Felony child abuse or neglect
Child victimization homicide
Violation of protection order
Violation of bail
Violation of probation or parole
Violation of other court order
Other (specify):

Rural
Violence and
andChildren
Child Victimization
Semi-Annual
ProgressProgress
Report Report
• 23 •• 24
Office
on on
Violence
Against
RuralDomestic
Domestic Violence
VictimizationEnforcement
Enforcement Grants
Grants Program
Semi-annual
• Office
Violence
AgainstWomen
Women

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

39. Disposition of charges
(Report the dispositions of violations by domestic violence offenders/child victimization offenders during the
current reporting period.)
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

Domestic violence
ordinance
Misdemeanor
domestic violence
Felony domestic
violence
Domestic violence
homicide
Misdemeanor
sexual assault
Felony sexual
assault
Stalking ordinance
Misdemeanor
stalking
Felony stalking
Misdemeanor child
abuse or neglect
Felony child abuse
or neglect
Child victimization
homicide
Violation of protection order
Violation of bail
Violation of probation or parole
Violation of other
court order
Other (specify):

40. Tribal grantees
(Report the total number of domestic violence and child victimization cases referred for state or federal prosecution during the current reporting period.)
Domestic violence

Child victimization

Cases referred to federal entity for prosecution
Cases referred to state entity for prosecution
TOTAL

0

0

41. Protection orders
(Report the total number of temporary and/or final protection orders Rural Program-funded prosecutors requested and the number granted during the current reporting period. Protection orders include those ordered
on the behalf of children.)
Temporary protection orders
Final protection orders
Number of protection orders requested
Number of protection orders granted
Rural
DomesticViolence
Violenceand
and Child
Children
Victimization
EnforcementGrants
GrantsSemi-Annual
Program Semi-annual
25 • Office
on Violence
Against
Women
Rural
Domestic
Victimization
Enforcement
Progress Progress
Report •Report
24 • • Office
on Violence
Against
Women

SECTION

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# 1121-NNNN
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1122-0013
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Date:10/31/2007
Expiration

Courts

E3

Rural Program funds may be used to address sexual assault, stalking and
child victimization only within the context of domestic violence.

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

Yes—answer questions 42-46
No—skip to E4
42. Number of criminal charges
(Report the total number of domestic violence and child victimization cases pending from the previous reporting period and new cases filed during the current reporting period. If you have not previously filed a semi-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 does not have to name the offense ‘’domestic violence’’ for it to be counted here. Child victimization offenses include any physical or sexual abuse,
or child neglect, that occur in the context of domestic violence. Sexual assault and stalking offenses should
only be used to report offenses against victims/survivors of domestic violence (including dating violence),
not children. Report sexual assault and stalking offenses against children under child victimization offenses.

Type of offense

Charges pending from
last reporting period

New charges filed during the
current reporting period

Domestic violence ordinance
Misdemeanor domestic violence
Felony domestic violence
Domestic violence homicide
Misdemeanor sexual assault
Felony sexual assault
Stalking ordinance
Misdemeanor stalking
Felony stalking
Misdemeanor child abuse or neglect
Felony child abuse or neglect
Child victimization homicide
Violation of protection order
Violation of bail
Violation of probation or parole
Violation of other court order
TOTAL

0

0

Rural
Domestic
Victimization
Enforcement
Grants
Progress Report
25 • •Office
on Violence
Against
Women
Rural
DomesticViolence
Violenceand
andChild
Children
Victimization
Enforcement
GrantsSemi-Annual
Program Semi-annual
Progress•Report
26• Office
on Violence
Against
Women

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

43. Disposition of criminal charges
(Report the disposition of any domestic violence and/or child victimization charges resolved during the
current reporting period.)
Number
dismissed

Type of offense

Number of deferred
adjudications

Number
convicted

Number
acquitted

Domestic violence ordinance
Misdemeanor domestic violence
Felony domestic violence
Domestic violence homicide
Misdemeanor sexual assault
Felony sexual assault
Stalking ordinance
Misdemeanor stalking
Felony stalking
Misdemeanor child abuse or neglect
Felony child abuse or neglect
Child victimization homicide
Violation of protection order
Violation of bail
Violation of probation or parole
Violation of other court order
TOTAL

0

0

0

0

44. Judicial monitoring
(Report the number of domestic violence and/or child victimization cases reviewed by the court for compliance with conditions of probation or other court-ordered conditions, or for violations of those conditions. Also
report the total number of review hearings conducted. Include family and juvenile courts.)
Number of cases reviewed

Number of review hearings conducted

Domestic violence
Child victimization

45. Dispositions of violations
(Report the number of domestic violence and/or child victimization 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.)
Violation

No
action
taken

Verbal/
written
warning

Conditions Partial reProbation
added
vocation of revoked/
probation Incarcerated

Fine

Protection order
New criminal behavior
Failure to attend mandated
offender treatment program
Failure to attend mandated
parenting program
Other condition of
probation or parole
TOTAL

0

0

0

0

0

0

Rural
Domestic
Victimization
Enforcement
Progress Progress
Report •Report
26 • •Office
on Violence
Against
Women
Rural
DomesticViolence
Violenceand
andChild
Children
Victimization
EnforcementGrants
GrantsSemi-Annual
Program Semi-annual
27 • Office
on Violence
Against
Women

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

46. Civil protection orders
(Report the total number of temporary and/or final civil protection orders requested and granted by the court
during the current reporting period. Protection orders include those ordered on the behalf of children. Include
only civil orders.)
Temporary protection orders

Final protection orders

Number of protection orders requested
Number of protection orders granted

Rural
Victimization
Enforcement
Progress Progress
Report •Report
27 • • Office
on Violence
Against
Women
RuralDomestic
DomesticViolence
Violenceand
and Child
Children
Victimization
EnforcementGrants
GrantsSemi-Annual
Program Semi-annual
28 • Office
on Violence
Against
Women

SECTION

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

E4

Probation and Parole
Rural Program grant funds may be used to address sexual assault, stalking,
and child victimization only within the context of domestic violence.

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

Yes—answer questions 47-49
No—skip to E5
47. `Number of cases
(Report the total number of continuing and new cases involving offenders charged with domestic violence
and/or child victimization. This is an unduplicated count. If you have not previously filed a semi-annual report,
include all pending cases at the beginning of the current reporting period as “number of continuing cases.”)
Completed probation
Number of Number of
continuing new cases
Without
With
cases
violations
violations
Total unduplicated count of domestic
violence cases (offenders)
Total unduplicated count of child
victimization cases (offenders)
Total unduplicated count of dual offense
(domestic violence and child victimization)
cases (offenders)

48. Monitoring activities
(For new and continuing cases reported in question 47, report the number of the monitoring activities
engaged in during the current reporting period.)
Total contacts
Activity
Number of offenders
Face-to-face meeting with offender
Telephone contact with offender
Unscheduled surveillance of offender
Activity

Number of victims/survivors

Total contacts

Outreach to domestic violence victims/survivors
(including dating violence)
Outreach to child victims/survivors

49. Dispositions of violations
(Report the total number of domestic violence and/or child victimization 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.)
Violation

No action
taken

Verbal/
written
warning

Fine

Conditions Partial reProbation
added
vocation of revoked/
probation Incarcerated

Protection order
New criminal behavior
Failure to attend mandated
offender treatment program
Failure to attend mandated
parenting program
Other condition of probation
or parole
TOTAL

0

0

0

0

0

0

Rural
Violenceand
andChildren
Child Victimization
Semi-Annual
ProgressProgress
Report Report
• 28 •• 29
Office
on on
Violence
Against
Rural Domestic
Domestic Violence
VictimizationEnforcement
Enforcement Grants
Grants Program
Semi-annual
• Office
Violence
AgainstWomen
Women

SECTION

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

E5

Batterer Intervention Program (BIP)

Were your Rural Program funds used for BIP during the current reporting period?
Check yes if Rural Program-funded staff or Rural Program funds directly supported BIP activities.

Yes—answer questions 50-52, providing information for Rural Program-funded activities
No—skip to Section F
50. Offenders in program
(Report the number of continuing and new offenders in your batterer intervention program during the current
reporting period. If you have not previously filed a semi-annual report, include all cases at the beginning of
the current reporting period as “offenders continuing in BIP.”)
Number of offenders
continuing in BIP from
last reporting period

Number of offenders
entering BIP during
current reporting period

Offenders in program

51. Outcomes
(Report the total number of domestic violence offenders in your program who completed the program, who
were terminated from the program, or who returned to the program after termination during the current reporting period.)
Number of offenders
Completed program
Terminated from program
Returned to program after termination
Other (specify):

52. Length of BIP in weeks
(Report the number of weeks that batterers are expected to remain in the program in order to complete it. If
your BIP has more than one program length, provide the length for each type of program and indicate the
number of programs of each length.)
Length of program

26 weeks

52 weeks

Other (specify):
weeks

Other (specify):
weeks

Number of programs

RuralDomestic
DomesticViolence
Violence
and
Child Victimization
EnforcementGrants
GrantsProgram
Semi-Annual
Progress
ReportReport
• 29 • •30Office
Rural
and
Children
Victimization Enforcement
Semi-annual
Progress
• OfficeononViolence
ViolenceAgainst
Against Women
Women

SECTION

OMBClearance
ClearanceNo.:
# 1121-NNNN
OMB
1122-0013
ExpirationDate:
Date:10/31/2007
Expiration

NARRATIVE

F

All grantees must answer question 53.
Please limit your response to four pages for this question.
53. Report on the status of your Rural Program grant goals and objectives as of the end of the current reporting period.
(Using Appendix A, report on the status of the goals and objectives for your grant as of the end of the current
reporting period, as they were identified in your grant proposal or as they have been added or revised. Indicate whether the activities related to your objectives for the current reporting period have been completed,
are in progress, are delayed, or have been revised. Comment on your successes and challenges, and provide
any additional explanation you feel is necessary for us to understand what you have or have not accomplished relative to your goals and objectives. If you have not accomplished objectives that should have been
accomplished during the current reporting period, you must provide an explanation.)
Page 32

All grantees must answer questions 54 and 55 on an annual basis. Submit this information on the
January to June reporting form only.
Please limit your response to two pages for each question.
54. What do you see as the most significant areas of remaining need, with regard to meeting the
needs of victims/survivors of domestic violence and their children, and offender accountability?
(Consider geographic regions, underserved populations, service delivery systems, types of victims/survivors, and/or challenges and barriers unique to your state or service area.)

Page 35

55. What has Rural Program funding allowed you to do that you could not do prior to receiving this
funding?
(For example, the money allowed us to expand our service areas; expand services offered to victims/survivors.)
Page 37

Question 56 is optional.
Please limit your response to two pages for this question.
56. Provide any additional information that you would like us to know about your Rural Program
grant and/or the effectiveness of your grant.
(If you have other data or information regarding your program that would more fully or accurately reflect the
effectiveness of your Rural Program grant than the data you’ve been asked to provide on this form, answer
this question. If you have not already done so elsewhere on this form, feel free to discuss any of the following: systems-level changes, community collaboration, the removal or reduction of barriers and challenges for
victims/survivors, promising practices, positive or negative unintended consequences.)
Page 39

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.

Rural
Domestic
Violence
ChildVictimization
Victimization
Enforcement
Grants
Semi-Annual
Progress
Report
• 30
on Violence
ViolenceAgainst
AgainstWomen
Women
Rural
Domestic
Violence
and and
Children
Enforcement
Grants
Program
Semi-annual
Progress
Report
• 31• • Office
Office on

APPENDIX A

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

Report on the status of your Rural Program grant goals and objectives as of the end of the current reporting period.
Question #53.
Goals/Objectives

Back to Instructions

Status

Key Activities

Comments

Goals/Objectives

Back to Instructions

Status

Key Activities

Comments

Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 32 • Office on Violence Against Women

APPENDIX A

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

Report on the status of your Rural Program grant goals and objectives as of the end of the current reporting
period Question #53 (Cont.1).

Back to Instructions

Status

Back to Instructions

Status

Goals/Objectives

Key Activities

Comments

Goals/Objectives

Key Activities

Comments

Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 34 • Office on Violence Against Women

APPENDIX A

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

Report on the status of your Rural Program grant goals and objectives as of the end of the current reporting
period Question #53 (Cont.2).
Goals/Objectives

Back to Instructions

Status

Back to Instructions

Status

Key Activities

Comments

Goals/Objectives

Key Activities

Comments

Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 34 • Office on Violence Against Women

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

What do you see as the most significant areas of remaining need, with regard to meeting the needs of
victims/survivors of domestic violence and their children, and offender accountability?
(Consider geographic regions, underserved populations, service delivery systems, types of victims/survivors, and/or challenges
and barriers unique to your state or service area.) - Question #54.

Back to Instructions
Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 35 • Office on Violence Against Women

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

What do you see as the most significant areas of remaining need, with regard to meeting the needs of
victims/survivors of domestic violence and their children, and offender accountability?
(Consider geographic regions, underserved populations, service delivery systems, types of victims/survivors, and/or challenges
and barriers unique to your state or service area.) - Question #54 (cont.)

Back to Instructions
Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 36 • Office on Violence Against Women

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

What has Rural Program funding allowed you to do that you could not do prior to receiving this funding?
(For example, the money allowed us to expand our service areas; expand services offered to victims/survivors. Question
#55.)

Back to Instructions
Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 37 • Office on Violence Against Women

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

What has Rural Program funding allowed you to do that you could not do prior to receiving this funding?
(For example, the money allowed us to expand our service areas; expand services offered to victims/survivors.) Question #55
(Cont.).

Back to Instructions
Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 38 • Office on Violence Against Women

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

Provide any additional information that you would like us to know about your Rural Program grant and/or the
effectiveness of your grant.
(If you have other data or information regarding your program that would more fully or accurately reflect the effectiveness of
your Rural Program grant than the data you've been asked to provide on this form, answer this question. If you have not
already done so elsewhere on this form, feel free to discuss any of the following: systems-level changes, community
collaboration, the removal or reduction of barriers and challenges for victims/survivors, promising practices, positive or
negative unintended consequences.)
- Question #56.

Back to Instructions
Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 39 • Office on Violence Against Women

OMB Clearance No.: 1122-0013
Expiration Date: 10/31/2007

Provide any additional information that you would like us to know about your Rural Program grant and/or the
effectiveness of your grant.
(If you have other data or information regarding your program that would more fully or accurately reflect the effectiveness of
your Rural Program grant than the data you've been asked to provide on this form, answer this question. If you have not
already done so elsewhere on this form, feel free to discuss any of the following: systems-level changes, community
collaboration, the removal or reduction of barriers and challenges for victims/survivors, promising practices, positive or
negative unintended consequences.)
- Question #56 (cont.).

Back to Instructions
Rural Domestic Violence and Children Victimization Enforcement Grants Program Semi-annual Progress Report • 40 • Office on Violence Against Women

Validate