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

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DRAFT
OFFICE ON VIOLENCE AGAINST WOMEN
ANNUAL STOP ADMINISTRATORS REPORT
STOP VIOLENCE AGAINST WOMEN FORMULA GRANT PROGRAM
1. DATE OF REPORT
2. CURRENT REPORTING PERIOD JANUARY 1– DECEMBER 31 ______ (Year)
3. STOP ADMINISTRATOR NAME
4. AGENCY
5. ADDRESS
CITY

_____________

STATE ____

TELEPHONE

ZIP CODE _________

FACSIMILE

EMAIL __________________________________________________________________
6A. STOP PROGRAM FUNDS AWARDED TO SUBGRANTEES AND AMOUNT OF FUNDS RETURNED DURING CURRENT REPORTING PERIOD (For all

federal fiscal years from which you made awards to subgrantees or from which unused funds were returned by subgrantees during
the current reporting period, provide the following: the federal grant number, the amount of funds that were returned unused by
subgrantees during the current reporting period if applicable, the amount awarded to subgrantees during the current reporting
period, and the percentage of the total amount awarded that was returned. Provide this information for all awards made during the
current reporting period, whether those awards were made from the current FFY allocation, from unobligated funds from another FFY,
or from funds returned unused by subgrantees. Do not report on funds awarded or returned unused during previous reporting
periods.)

FEDERAL GRANT #

AMOUNT OF GRANT FUNDS
RETURNED UNUSED BY
SUBGRANTEES

AMOUNT AWARDED TO
SUBGRANTEES DURING
CURRENT REPORTING
PERIOD

PERCENTAGE OF TOTAL
RETURNED

FFY 2005
FFY 2006
FFY 2007
FFY 2008
FFY 2009
TOTAL

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6B. STOP PROGRAM FUNDS RETURNED BY SUBGRANTEES

(If any of the FFY allocation was returned unused by subgrantees during the current reporting period, provide the category(ies)—e.g.,
victim services, law enforcement, prosecution, etc.—from which those funds were returned and the amount returned from each
category for the corresponding FFY.)
FFY 2005 FFY 2006 FFY 2007 FFY 2008 FFY 2009

AREA

AMOUNT

AMOUNT

AMOUNT

AMOUNT

AMOUNT

COURTS
LAW ENFORCEMENT
PROSECUTION
VICTIM SERVICES
DISCRETIONARY
TOTAL
7. ALLOCATION CATEGORIES (For every federal fiscal year from which awards were made during the current reporting period, indicate

the number of awards made to subgrantees, and the amounts awarded, to each of the allocation categories. Also indicate the
amount(s) allocated for administrative costs during the current reporting period. For discretionary awards, report the number of
awards and the allocation categories to which the awards were made. Only use the discretionary category to report on awards that
cannot be assigned to the other categories.)
FFY 2005
AREA

NUMBER

FFY 2006

% TOTAL
AMOUNT AMOUNT
AWARDED

NUMBER

AMOUNT

FFY 2007
% TOTAL
AMOUNT
AWARDED

NUMBER

AMOUNT

% TOTAL
AMOUNT
AWARDED

COURTS
LAW ENFORCEMENT
PROSECUTION
VICTIM SERVICES
DISCRETIONARY
ADMINISTRATIVE COSTS
TOTAL
FFY 2008
AREA

NUMBER

FFY 2009

% TOTAL
AMOUNT AMOUNT
AWARDED

NUMBER

AMOUNT

% TOTAL
AMOUNT
AWARDED

COURTS
LAW ENFORCEMENT
PROSECUTION
VICTIM SERVICES
DISCRETIONARY
ADMINISTRATIVE COSTS
TOTAL

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7A. USE OF DISCRETIONARY FUNDS (For any discretionary awards that you did not assign to the existing categories of courts, law
enforcement, prosecution, or victim services, describe below how those funds were used. Please include award amounts.)

7B. USE OF ADMINISTRATIVE FUNDS (If you reported administrative costs in question 7, please provide a detailed description of the

amount and description of administrative costs. Please include all personnel costs, membership dues, association fees, training, travel
costs for subgrantee monitoring, etc.)

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8A. CULTURALLY SPECIFIC VICTIM SERVICES AWARDS (Of the awards you reported in question 7 for victim services, indicate, for those

awards that represent the 10 percent set-aside for culturally specific community-based organizations, the numbers of awards, the total
amount awarded, and the percentage of the overall victim services allocation that amount represents. Also, indicate on your list of
active subgrants which of the victim services awards were made to these organizations.)
Culturally specific victim services awards
Number of subgrants awarded Total amount awarded
Percentage of victim service allocation
FFY 2007
FFY 2008
FFY 2009
FFY 2010
FFY 2011

8B. CULTURALLY SPECIFIC VICTIM SERVICES AWARDS LESS THAN 10% (If your culturally specific victim service awards do not represent
10% of your victim service allocation, please explain why and detail what efforts are being made to increase representation of
culturally specific victim service providers in your subgrantee population.)

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9. PERCENTAGE OF ALLOCATIONS BY TYPE OF VICTIMIZATION (Based on total money awarded during the current reporting period, provide

your best estimate of the percentage of funding awarded to each of the following types of victimizations. The total should equal 100%.)
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/dating 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 or dating partner. Stalking is defined as a course of conduct directed at a specific
person that would cause a reasonable person to fear for his or her safety or the safety of others, or suffer substantial emotional
distress.
TYPE OF VICTIMIZATION
Sexual assault
Domestic violence/dating violence
Stalking
TOTAL (must equal 100%)

% STOP FUNDS
%
%
%
100%

10. LISTING OF ACTIVE SUBGRANTS (In a separate attachment to this report, please provide the following information on all subgrants that

were active during the current reporting period: subgrant #; date of award; amount of award; name of subgrantee agency; contact
person, address, telephone number; and subgrant period [beginning and ending dates]. Provide the amount of each subgrant by
allocation category[ies]—e.g., victim services, law enforcement, courts—for those grants awarded during the current reporting period.
If a subgrant addressed more than one allocation category, indicate this by reporting the appropriate portion of the total award focused
on each category. Indicate if a victim services subgrant was made to a culturally specific community-based organization. If you wish,
you may use Appendix A and Appendix B as guides for presenting this information.)

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NARRATIVE

All STOP administrators must answer questions 11-13.
Please limit your response to the space provided (20,000 characters, approximately five pages).
11. REPORT ON THE STATUS OF YOUR STOP IMPLEMENTATION PLAN(S), AS OF THE END OF THE CURRENT REPORTING PERIOD. Using the
implementation plan(s) you submitted to your program specialist as a reference point, report on the
distribution of funds across law enforcement, prosecution, courts and victims services; the extent to which
you were able to support the type of programs identified in your plan(s); whether you achieved equitable
distribution of your funds in terms of geographic diversity and the availability of victim services. Describe
your successes and challenges and provide any additional explanation you feel is necessary to understand
what you have or have not accomplished relative to your implementation plan(s). If you have not
accomplished objectives that should have been accomplished during the current reporting period, please
provide an explanation.

Please limit your response to the space provided (8,000 characters) for each question

12. REPORT ON YOUR STATE OR TERRITORY’S EFFORTS TO RECOGNIZE AND ADDRESS THE NEEDS OF UNDERSERVED POPULATIONS DURING THE CURRENT
REPORTING PERIOD. INCLUDE INFORMATION REGARDING CULTURALLY SPECIFIC VICTIM SERVICES IF NOT ALREADY PROVIDED IN YOUR RESPONSE TO
QUESTION 8B .
Underserved populations are those groups underserved because of geographic location (such as rural
isolation), race or ethnicity, or special needs (such as language barriers, disabilities, immigration status, or
age), and any other population determined to be underserved by the planning process in consultation with
the U.S. Attorney General.

13. WHAT DO YOU SEE AS THE MOST SIGNIFICANT AREAS OF REMAINING NEED IN YOUR STATE OR TERRITORY, WITH REGARD TO INCREASING
VICTIM/SURVIVOR SAFETY AND OFFENDER ACCOUNTABILITY? Consider geographic regions, underserved populations,
service delivery systems, types of victimization, and challenges and barriers unique to your state or
territory. Please include any areas where you might wish to receive OVW-funded technical assistance.

Questions 14-17 are optional
Please limit your response to the space provided (8,000 characters) for each question
14. DESCRIBE ANY PROBLEMS OR BARRIERS YOUR STATE OR TERRITORY HAS HAD IN ITS EFFORTS TO ALLOCATE THE REQUIRED PERCENTAGES OF FUNDS TO
THE CATEGORIES OF VICTIM SERVICES, LAW ENFORCEMENT, PROSECUTION, OR THE COURTS. If appropriate, describe any such barriers,
what you have done to address these barriers, and any technical assistance needs you have in this area.
15. WHAT HAS STOP PROGRAM FUNDING ALLOWED YOUR STATE OR TERRITORY TO DO THAT IT COULD NOT DO WITHOUT THIS FUNDING? Describe
changes that occurred because of STOP Program funding. Consider expansion of services; coordination
and collaboration between agencies; development of technology tracking systems; specialized units; etc.
16. PROVIDE INFORMATION REGARDING STOP-FUNDED MODEL PROJECTS AND/OR PROMISING PRACTICES THAT ARE EXAMPLES OF WHAT HAS BEEN
ACCOMPLISHED WITH STOP FUNDING IN YOUR STATE OR TERRITORY. Describe and identify the funded projects and the reasons
you believe they are exemplary.

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17. PROVIDE ANY ADDITIONAL INFORMATION THAT YOU WOULD LIKE US TO KNOW ABOUT YOUR USE OF STOP PROGRAM FUNDS AND/OR THE
EFFECTIVENESS OF THAT FUNDING. 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 and statewide collaboration; the removal or reduction of barriers and challenges for
victims/survivors; 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 sixty 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, 800
K Street, NW, Washington, DC 20531

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APPENDIX A

Information on subgrants awarded during current reporting period

(List the subgrant numbers, award dates, award amounts by allocation category(ies), agency names and
contact information, subgrant periods [beginning and ending dates], and indicate if the agency is a
culturally specific community agency receiving a victim services subgrant.)
CULTURALLY
NAME OF AGENCY (INCLUDE
CONTACT PERSON, ADDRESS, PHONE)

OTHER

COURTS

AWARD

PROSECUTION

DATE OF

LAW ENFORCEMENT

SUBGRANT #

VICTIM SERVICES

STOP AWARD AMOUNT BY
ALLOCATION CATEGORY(IES)
SUBGRANT
PERIOD

SPECIFIC
COMMUNITY
AGENCY
RECEIVING A
VICTIM SERVICES
SUBGRANT

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APPENDIX B
Information on active subgrants awarded prior to the current reporting period

(For all subgrants awarded prior to the current reporting period that were active during the current
reporting period, list the subgrant numbers, award dates, award amounts, agency names and contact
information, and subgrant periods [i.e., beginning and ending dates].)
CULTURALLY
SUBGRANT #

DATE OF
AWARD

STOP
AWARD
AMOUNT

NAME OF AGENCY (INCLUDE
CONTACT PERSON, ADDRESS, PHONE)

SUBGRANT PERIOD

SPECIFIC
COMMUNITY
AGENCY RECEIVING
A VICTIM SERVICES
SUBGRANT

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