Form 1122-0003 STOP Sugbrantee Form

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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 subgrantees. In sections D, E, and subsections A2, C1,
and 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, 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 instructions, which contain detailed definitions and
examples illustrating how questions should be answered.

SECTION
Section A:
A1:
A2:
Section B:
Section C:
C1:
C2:
C3:
C4:
C5:
C6:
C7:
Section D:
Section E:
E1:
E2:
E3:
E4:
E5:
Section F:

General Information
Grant Information
Staff 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
Batterer Intervention Program (BIP)
Narrative

Page Number
1
1
3
4
5
5
8
10
13
14
15
16
17
24
24
27
32
36
39
40

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A1

GENERAL INFORMATION
Grant Information

All subgrantees must complete this subsection.

(format date with 6 digits - 01/31/07)

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 the one answer that best describes the organization receiving the STOP Program subgrant.)

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

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):

5a.

Is this a faith-based organization?
Yes
No

5b.

Is this a culturally-specific community-based organization?
Yes
No

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6.

Point of contact
(person responsible for the day-to-day coordination of the subgrant)
First name

MI

Last name

Agency/organization name
Address
City

State

Telephone

Zip code

Facsimile

E-mail

7.

Does this subgrant specifically address tribal populations?

(Check yes if your STOP Program subgrant focuses on tribal populations and indicate which tribes or nations you
served or intend to serve.)

Yes
8.

No

If yes, which tribes/nations:

What percentage of your STOP Program subgrant was directed to each of these areas?

(Report the area[s] addressed by your STOP Program subgrant during the current reporting period and estimate
the approximate percentage 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/survivor. 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 engaging in 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. (See separate instructions for more complete definitions.)
Percentage of subgrant funds

Sexual assault
Domestic violence/dating violence
Stalking
TOTAL (must equal 100 percent)

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 subgrant during the current reporting period. Report staff by the function(s) performed, not by title or location. Include employees who
are part-time and/or only partially funded with these subgrant funds as well as consultants/contractors. Include
employees who are funded with any required grant match. Report grant-funded overtime. If an employee or contractor was employed or utilized for only a portion of the reporting period, prorate appropriately. For example, if
you hired a full-time advocate in October who was 100% funded with STOP Program funds, you would report that
as .25 FTE. Report all FTEs in decimals, not percentages. One FTE is equal to 2,080 hours—40 hours per week x
52 weeks. See separate instructions for examples of how to calculate FTEs.)

Staff
Administrator (fiscal manager, executive director)

FTE(s)

Attorney (does not include prosecutor)
Counselor
Court personnel
Information technology staff
Investigator (prosecution-based)
Law enforcement officer
Legal advocate (does not include attorney or paralegal)
Paralegal
Probation officer/offender monitor
Program coordinator (training coordinator, volunteer coordinator, hotline
coordinator, victim services coordinator)
Prosecutor
Sexual assault nurse examiner/sexual assault forensic examiner (SAFE/SANE)
Support staff (administrative assistant, bookkeeper, accountant)
Trainer
Translator/interpreter
Victim advocate (non-governmental, includes domestic violence, sexual assault,
and dual)
Victim assistant (governmental, includes victim-witness specialist/coordinator)
Other (specify):
TOTAL

0.00

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B

PURPOSE AREAS

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
Purpose areas
that apply
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 services 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.
Maintaining core victim services and criminal justice initiatives, while supporting complementary new initiatives and emergency services for victims and their families.
Supporting the placement of special victim assistants (to be known as “Jessica Gonzales Victim Assistants”)
in local law enforcement agencies to serve as liaisons between victims of domestic violence, dating violence, sexual assault, and stalking and personnel in local law enforcement agencies in order to improve the
enforcement of protection orders.
To provide funding to law enforcement agencies, nonprofit nongovernmental victim services providers, and
State, tribal, territorial, and local governments, (which funding stream shall be known as the Crystal Judson
Domestic Violence Protocol Program) to promote
• The development and implementation of training for local victim domestic violence service providers,
and to fund victim services personnel, to be known as “Crystal Judson Victim Advocates,” to provide supportive services and advocacy for victims of domestic violence committed by law enforcement personnel;
• The development (in collaboration with State, Tribal, territorial and local victim services providers and domestic violence coalitions) and implementation of protocols within law enforcement agencies to ensure consistent and effective responses to the commission of domestic violence by personnel within such agencies.

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C1

FUNCTION AREAS
Training

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Were your STOP Program funds used for training during the current reporting period?

Check yes if STOP Program-funded staff provided training or if subgrant funds were used to directly support training.

Yes—answer questions 11-14
No—skip to C2
11. Training events provided

(Report the total number of training events provided during the current reporting period that were either provided
by STOP Program-funded staff or directly supported by STOP Program subgrant funds. Do not include training provided to STOP Program-funded staff. For purposes of this reporting form, training means providing information
on sexual assault, domestic violence, dating violence, and stalking that enables professionals to improve their response to victims/survivors as it relates to their role in the system.)
Total number of training events provided

12. Number of people trained

(Report the number of people trained during the current reporting period by STOP Program-funded staff or training supported by STOP Program funds. Use the category that is most descriptive of the people who attended the
training event. STOP Program-funded staff who attended training events should not be counted as people trained.
If you do not know how many people to report in specific categories, you may report the overall number in “Multidisciplinary,” but this category should be used only as a last resort. Do not include staff funded under your STOP
Program grant who attended staff development events.)
People trained

Advocacy organization staff (NAACP, AARP)
Attorneys/law students (does not include prosecutors)
Batterer intervention program staff
Correction personnel (probation, parole, and correctional facilities staff)
Court personnel (judges, clerks)
Disability organization staff (non-governmental)
Educators (teachers, administrators, etc.)
Elder organization staff (non-governmental)
Faith-based organization staff
Government agency staff (vocational rehabilitation, food stamps, TANF)
Health professionals (doctors, nurses—does not include SANEs or SAFEs)
Immigrant organization staff (non-governmental)
Law enforcement officers
Legal services staff (does not include attorneys)
Mental health professionals
Military command staff
Multidisciplinary (various disciplines at same training)
Prosecutors
Sex offender treatment providers
Sexual assault nurse examiners/sexual assault forensic examiners
Social service organization staff (non-governmental—food bank, homeless shelter)
Substance abuse organization staff
Supervised visitation and exchange center staff
Translators/interpreters
Tribal government/Tribal government agency staff
Victim advocates (non-governmental, includes sexual assault, domestic violence, and dual)
Victim assistants (governmental, includes victim-witness specialists/coordinators)
Volunteers
Other (specify):
TOTAL
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Number

0

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13. Training content areas

(Indicate all topics covered in training events provided with your STOP Program funds during the current
reporting period. Check all that apply.)

Sexual assault, domestic violence/dating violence,
and stalking
Advocate response
Child witnesses
Confidentiality
Dating violence overview, dynamics, and
services
Domestic violence overview, dynamics, and
services
Mandatory reporting requirements
Response to victims/survivors who have been
trafficked
Response to victims/survivors who are incarcerated
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
Identification and arrest of
predominant aggressor
Immigration
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:
are American Indian or Alaska Native
are Asian
are black or African American
are elderly
are Hispanic or Latino
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 disabilities
have limited English proficiency
have mental health issues
have substance abuse issues
live in rural areas
Other (specify):
Community response
Community response to sexual assault
Coordinated community response
Response teams (DART, DVRT, SART)
Technology
Other (specify):

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14. (Optional) Additional information

(Use the space below to discuss the effectiveness of training activities funded or supported by your STOP Program
subgrant and to provide any additional information you would like to share about your training activities beyond
what you have provided in the data above. Examples might include a reduction in dual arrest rates following
training provided on identifying the predominant aggressor, or improved system response to victims/survivors
with disabilities following a multidisciplinary training provided to advocates, law enforcement, and prosecution
agencies on issues specific to victims/survivors with disabilities.) (Maximum 2000 characters)

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C2

Coordinated Community Response
All subgrantees must complete this subsection.

15. Coordinated community response (CCR) 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. Do not report “task force” in the “Other” category. If
STOP Program-funded staff participated in a task force or work group, indicate that under “Meetings” by checking
the frequency of the meetings and the types of organizations participating.)
Agency/organization

Advocacy organization (NAACP,
AARP)
Batterer intervention program
Corrections (probation,
parole, and correctional
facility staff)
Court
Domestic violence organization
Educational institutions/organizations
Faith-based organization
Governmental agency (SSA,
TANF)
Health/mental health organization
Law enforcement
Legal organization (legal services, bar association, law school)
Prosecutor’s office
Sex offender management/sex
offender treatment provider
Sexual assault organization
Social service organization (nongovernmental)
Tribal government/Tribal
government agency
Other (specify):

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

Meetings
Weekly

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Monthly Quarterly

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16. (Optional) Additional information

(Use the space below to discuss the effectiveness of CCR activities funded or supported by your STOP Program
subgrant and to provide any additional information you would like to share about your CCR activities beyond what
you have provided in the data above. Examples might include an improved judicial response to victims/survivors
requesting protection orders, following meetings of a regional task force that included victim advocates, legal services attorneys, and judges; or improved information to victims/survivors regarding resources and greater coordination between the prosecutor’s office and the local victim services agency as a result of meetings between the
governmental and non-governmental advocates.) (Maximum 2000 characters)

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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 questions 17-18
No—skip to C4
17. Types of protocols and/or policies developed, substantially revised, or implemented during the current reporting period
(Check all that apply.)

Victim services
Policies to protect victims/survivors from Internet disclosure of identifying information
Appropriate response to underserved populations
Pro-arrest/mandatory arrest
Appropriate response to victims/survivors with
substance abuse issues and/or mental health diProcedures for anonymous, confidential, or
agnoses
Jane Doe reporting of sexual assault
Appropriate response to victims/survivors who are
Protection order enforcement (including full
elderly or have disabilities
faith and credit)
Confidentiality
Providing information to victims/survivors
about victim services
Mandatory training standards for staff and volunteers
Sexual assault response and protocols
Procedures for anonymous, confidential, or Jane
Other (specify):
Doe reporting of sexual assault
Staff, board, and/or volunteers represent the diver- Prosecution
sity of your service area
Appropriate response to underserved populaVictim/survivors informed about Crime Victims
tions
Compensation and Victim Impact Statements
Appropriate response to victims/survivors
Other (specify):
who are elderly or have disabilities
Mandatory training on sexual assault, domesLaw enforcement
tic violence, dating violence, and/or stalking
Appropriate response to underserved populations
No charge to victim/survivors for any costs
Appropriate response to victims/survivors who are
related to the prosecution of sexual assault,
elderly or have disabilities
domestic violence/dating violence, and/or
Identifying primary aggressor/discouraging dual
stalking
arrest
No victims/survivors polygraphed
Immediate access to protection order information
Policies to protect victims/survivors from InMandatory training on sexual assault, domestic
ternet disclosure of identifying information
violence, dating violence, and/or stalking
Protection order enforcement (including full
No charge to victims/survivors for service of profaith and credit)
tection orders, warrants, or subpoenas
Sexual assault response and protocols
No charge to sexual assault victims/survivors for
Vertical prosecution
any costs associated with forensic exam
Victim-witness notification
No charge to victims/survivors for any costs related
Other (specify):
to the investigation of sexual assault, domestic violence/dating violence, and/or stalking offenses
No victims/survivors polygraphed

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Courts
Health care
Accelerated trial schedules
Advocate response to emergency room
Appropriate response to underserved populations
Appropriate response for underserved populations
Appropriate response to victims/survivors who are
elderly or have disabilities
Appropriate response to victims/survivors to
avoid or eliminate re-traumatization
Dedicated domestic violence docket
Appropriate response to victims/survivors who
Full faith and credit for protection orders
are elderly or have disabilities
Immediate access to obtaining protection orders
Forensic exams not billed to victims/survivors
Judicial monitoring of sexual assault, domestic vioMandatory training on sexual assault, domeslence/dating violence, and/or stalking offenders
tic violence, dating violence, and/or stalking
Mandatory training on sexual assault, domestic vioRoutine screening and referrals for sexual aslence, dating violence, and/or stalking
sault, domestic violence, dating violence, and/
No charge to victims/survivors for any costs related
or stalking
to prosecution of a sexual assault, domestic vioOther (specify):
lence/dating violence, and/or stalking offense or to
obtaining a protection order
Policies to protect victims/survivors from Internet
disclosure of identifying information
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, dating violence, and/or stalking
Strategies to assist and protect victims/survivors
during probation and parole
Victim/survivor inclusion in offender supervision
planning process/sex offender management
Victim/survivor notification
Other (specify):

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18. (Optional) Additional information

(Use the space below to discuss the effectiveness of policies you have developed or implemented that were
funded or supported by your STOP Program subgrant and to provide any additional information you would like to
share about your activities related to the developing, revising, and implementing of policies beyond what you have
provided in the data above. An example might include a significant increase in victim/survivor contact with, and
input to the specialized probation officer/unit following the implementation of a policy on victim/survivor involvement.) (Maximum 2000 characters)

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C4

Products

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 19
No—skip to C5
19. 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. Do not report the
number of products printed or copied; only report the number developed or revised—in most cases that number
will be one for each product described —and/or the number used or distributed. See separate instructions for
examples of how to report under “developed or revised” and “used or distributed.”)
Number
Number
Intended
Other
developed
used or
Products
Title/topic
audience
languages
or revised
distributed

Brochures

Manuals

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 20-21
No—skip to C6
20. 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
21. 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/charges
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 unit, or dedicated staff of law enforcement officers, prosecutors, probation officers, judge, or
other court personnel responsible for handling sexual assault, domestic violence/dating violence, and/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 questions 22-23
No—skip to C7
22. 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):
23. Victimizations addressed by STOP Program-funded specialized units

(Check all victimizations addressed by your specialized unit during the current reporting period.)
Law enforcement

Prosecution

Court

Probation or parole

Sexual assault
Domestic violence/dating
violence
Stalking

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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 24
No—skip to section D
24. Use of STOP Program funds for system improvement
(Check all that apply for the current reporting period.)
Victim services

Law enforcement

Prosecution

Court

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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Probation or parole

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D

VICTIM SERVICES

Were your STOP Program funds used to provide 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/survivors served, and victim services provided with STOP Program funds, whether by a victim services agency or victim services within law enforcement, prosecution, or the court system in this section. Report criminal justice activities, such as 911 calls, cases
investigated, and cases prosecuted, in section E only.

Yes—answer questions 25-32
No—skip to section E
25. Number of primary 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 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
was seeking or who received services during the current reporting period should be counted only once in that
reporting period. For purposes of this question, victims/survivors are those against whom the sexual assault, domestic violence, dating 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. Do not report secondary
victims here.)
Domestic
Sexual
violence/ Stalking
Primary victims/survivors
TOTAL
assault
dating
violence

A. Served: Victims/survivors who received the service(s) they requested, if those services were funded by your STOP Program subgrant

0

B. Partially served: Victims/survivors who received some service(s),
but not all of the services they requested, if those services were
funded by your STOP Program subgrant

0

TOTAL SERVED and PARTIALLY SERVED (25A + 25B)

0

0

0

0

C. Victims/survivors seeking services who were not served: Victims/
survivors who sought services and did not receive the service(s)
they were seeking, if those services were funded by your STOP Program subgrant

0

26. Number of secondary victims served

Please do not answer this question without referring to the separate instructions for further explanation and for
examples of how and when to report secondary victims. (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 secondary victim
who received services during the current reporting period should be counted only once and in only one of the
listed categories, which should correspond to the category of victimization of the primary victim/survivor. For
purposes of this question, secondary victims are those who are indirectly affected by the domestic violence/dating violence, sexual assault, and/or stalking—i.e., children, siblings, spouses or intimate partners, grandparents,
other affected relatives, friends, neighbors, etc.)
Secondary victims

Sexual assault
Law enforcement

Domestic violence/
dating violence
Prosecution

Stalking

Court

Secondary victims who received service(s)
funded by your STOP Program subgrant

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TOTAL

Probation or parole
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27. Reasons that primary victims/survivors seeking services were not served or were partially served
(Check all that apply.)

Reasons not served or partially served

Conflict of interest
Did not meet statutory requirements
Hours of operation
Insufficient/lack of culturally appropriate services
Insufficient/lack of language capacity (including sign language)
Insufficient/lack of services for people with disabilities
Lack of child care
Program reached capacity
Program rules not acceptable to victim/survivor
Program unable to provide service due to limited resources/priority-setting
Services inappropriate or inadequate for victims/survivors with mental health issues
Services inappropriate or inadequate for victims/survivors with substance abuse issues
Services not appropriate for victim/survivor
Services not available for victims/survivors accompanied by male adolescents
Transportation
Other (specify):

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28. Demographics of primary victims/survivors served or partially served

(Based on the primary victims/survivors reported in 25A and 25B, report the total numbers for all that apply.
Because victims/survivors may identify in more than one category of race/ethnicity, the total for “Race/ethnicity” may exceed the total number of victims/survivors reported in 25A and 25B. However, the total number of
victims/survivors reported under “Race/ethnicity” should not be less than the total number of victims/survivors
reported in 25A and 25B. The total number of victims/survivors reported under “Gender” and the total number
reported under “Age” should equal the total number of victims/survivors reported in 25A and 25B. Those victims/
survivors for whom gender, age, and/or race/ethnicity are not known should be reported in the “Unknown” category. Do not report demographics for secondary victims.)

Race/ethnicity (Victims/survivors should not be counted
more than once in either the category “American Indian and
Alaska Native” or in the category “Native Hawaiian and other
Pacific Islander.”)

Number of victims/survivors

American Indian and Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian and other Pacific Islander
White
Unknown
TOTAL RACE/ETHNICITY (should not be less than the sum of
25A and 25B,

0

0)

Number of victims/survivors

Gender
Female
Male
Unknown
TOTAL GENDER (should equal to the sum of 25A and 25B,

0)

Age
0-12

0

Number of victims/survivors

13-17
18-24
25-59
60+
Unknown
TOTAL AGE (should equal to the sum of 25A and 25B,

0)

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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29. Victims/survivors’ relationships to offender by victimization

(For those primary victims/survivors reported as served and partially served in 25A and 25B, report the victim/
survivor’s relationship 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.
0;
The total number of relationships in the sexual assault column must be at least
the total number in the domestic violence/dating violence column must be at least
0;
and the total number in the stalking column must be at least
0 ;
Do not report relationships to offender for secondary victims.)
Number of victim/survivor relationships by victimization
Victim/survivor’s relationship to offender
Sexual assault Domestic violence/dating violence Stalking
Current or former spouse or intimate partner
Other family or household member
Dating relationship
Acquaintance (neighbor, employee, co-worker,
student, schoolmate, etc.)
Stranger
Relationship unknown
TOTAL

0

0

30A. Victim services

(Report the number of primary victims/survivors from 25A and 25B who received STOP Program-funded services.
Count each victim/survivor only once for each type of service that victim received during the current reporting period; do not report the number of times that service was provided to the victim. The total for each type of service
should not be higher than the total of 25A and 25B,
0 . Shelter services should be reported in Question 30B. Do not report secondary victims receiving services in this question.)
Number of victims/
Type of service
survivors served
Civil legal advocacy/court accompaniment (Assisting a victim/survivor with civil legal
issues, including preparing paperwork for a protection order and accompanying victim/
survivor to a protection order hearing, administrative hearing, or other civil court proceeding. Does not include advocacy by attorneys and/or paralegals.)
Civil legal assistance (Civil legal services provided by an attorney and/or a paralegal.)
Counseling services/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 notifying the victim/survivor of case status, hearing dates,
plea agreements, and sentencing terms; 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.)
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 crisis intervention that
occurs in person and/or over the telephone.)
Forensic exam (Exam conducted by a sexual assault nurse examiner or by a sexual assault forensic examiner)
Hospital/clinic/other medical response (Accompanying a victim survivor to or meeting a
victim/survivor at a hospital, clinic, or medical office)
Language services (Interpretation, translation)
Transportation
Victim/survivor advocacy (Actions designed to assist the victim/survivor in obtaining support, resources, or services, including employment, housing, shelter services,
health care, victim’s compensation, etc.)
Other (specify):
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30B. Shelter services

(Report the number of victims/survivors and accompanying family members who received emergency shelter
and/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 nights provided in emergency shelter and/or transitional housing
to victims/survivors and family members. The number of bed nights is computed by multiplying the number of
victims and family members by the number of nights they stayed in the shelter. The number of bed nights will
typically be significantly higher than the number of victims and family members. For example, one victim and her
three children all stayed in the shelter for 10 nights. The number of bed nights would be 4 x 10, or 40.)
Shelter service

Emergency shelter

Number of victims/
survivors

Number of
family members

Number of
bed nights

Transitional housing
30C. Hotline calls
(Report the number of hotline calls received from primary victims, and the total number of hotline calls received,
on phone lines paid for with STOP Program funds or answered by STOP Program-funded staff, during the current
reporting period. Primary victims whose calls are reported here should not be reported as victims served in question 25 unless they also received at least one of the services listed in question 30A Victim Services or question
30B Shelter Services. Victims/survivors who receive services such as crisis intervention or victim advocacy over
the telephone, in addition to basic hotline information and/or referrals, should also be reported in question 30A.
Hotline calls that include victim advocacy or crisis intervention services are those that require more time than the
average call and involve a more intensive focus on the immediate needs and situation of the victim. For examples
of when to report only the hotline call and when to report both the hotline call and a service or services in question 30A, see separate instructions.)
Number of calls from
victims/survivors

Total number of
calls

Hotline calls (Crisis or information and referral calls
received by an agency’s hotline or office telephone)
30D. Victim-witness notification/outreach to victims/survivors

(Report the number of unsolicited letters, phone calls, or visits to victims/survivores of specific incidents of sexual
assault, domestic violence, dating violence, and stalking identified in police reports or court documents, informing them of services and/or providing information about the criminal justice system. Victims/survivors who are
the recipients of these notification/outreach activities should not be reported as victims/survivors served in question 25 unless they also received at least one of the services reported in question 30A Victim Services or question
30B Shelter Services. Victims/survivors who receive services such as criminal justice advocacy over the telephone should be reported in question 30A.)
Number of notification/outreach activities to
victims/survivors

Victim-witness notification/outreach to victims/
survivors (unsolicited letters, phone calls, or visits)

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31. 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.
These orders may also be referred to as protection from abuse, protection from harassment or anti-harassment
orders, restraining orders , or no-contact or stay-away orders.)

Sexual assault protection orders

Temporary orders

Final orders

Temporary orders

Final orders

Temporary orders

Final orders

Number requested
Number granted
Domestic violence/dating
violence protection orders
Number requested
Number granted
Stalking protection orders
Number requested
Number granted

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32. (Optional) Additional information

(Use the space below to discuss the effectiveness of victim services funded or supported by your STOP Program
subgrant and to provide any additional information you would like to share about your victim services activities beyond what you have provided in the data above. An example might include that your agency, as a result of STOP
Program-funding, was able to provide medical accompaniment to an increased percentage of sexual assault survivors. This resulted in a higher percentage of victims/survivors seeking additional support services.) (Maximum
2000 characters)

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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 subgrant funded law enforcement activities. If STOP funds supported only a victim-witness assistant or victim advocate located in a law enforcement agency, then only Section D Victim Services
should be completed.

Yes--answer questions 33-36. Provide information only for STOP Program-funded law enforcement
activities engaged in during the current reporting period.
No—skip to E2.
33. Activities

(Report the number of STOP Program-funded activities related to sexual assault, domestic violence/dating violence, and/or stalking cases/incidents for the current reporting period. If an activity relates to a case/incident

involving more than one type of crime, the activity should be counted only once under the primary victimization.)

Activity

Sexual assault

Domestic violence/
dating violence

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)
Forensic medical evidence (All cases in
which rape kits were processed)
Arrests (All arrests made by law enforcement, except dual arrests)
Dual arrests (Responses by law enforcement in which the 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 directly
issued by law enforcement in jurisdictions
where law enforcement officers are so
authorized)
Referrals of cases to prosecutor
Referrals of federal firearms charges to
federal prosecutor
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34. Victim/survivor referrals to victim services

(Report the total number of victim/survivor referrals to victim services during the current reporting period. “Governmental” refers to victim services provided by victim assistants or victim-witness specialists/coordinators employed by criminal justice agencies, such as law enforcement, prosecution, courts, or probation that are targeted
to victims/survivors of domestic violence, dating violence, sexual assault, and/or stalking. “Non-governmental” refers to services provided by non-profit community-based agencies to victims/survivors of domestic violence,
dating violence, sexual assault, and/or stalking.)

Governmental victim
services

Non-governmental victim
services

Number of victim/survivor referrals
35. 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.
These orders may also be referred to as restraining orders, anti-harassment orders, or no-contact or stay-away
orders.)

Sexual assault protection orders

Temporary orders

Final orders

Temporary orders

Final orders

Temporary orders

Final orders

Number requested
Number granted
Domestic violence/dating
violence protection orders
Number requested
Number granted
Stalking protection orders
Number requested
Number granted

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36. (Optional) Additional information
(Use the space below to discuss the effectiveness of law enforcement activities funded or supported by your
STOP Program subgrant and to provide any additional information you would like to share about these activities
beyond what you have provided in the data above. An example might include an increase in the number of cases
accepted for prosecution as the result of a STOP Program-funded specialized investigator focused on domestic
violence/dating violence, sexual assault, and stalking.) (Maximum 2000 characters)

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E2

Prosecution

Were your STOP Program funds used for prosecution during the current reporting period?

Check yes if your STOP Program subgrant funded prosecution activities. If STOP Program funds supported only a
victim assistant/victim-witness specialist or victim advocate located in a prosecution office, then only section D
Victim Services should be completed.

Yes--answer questions 37-43. Provide the information only for STOP Program-funded prosecution
activities engaged in during the current reporting period.
No—skip to E3.
37A. Number of cases received, accepted for prosecution, declined, or transferred

(Report the number of domestic violence/dating violence, sexual assault, or stalking-related case referrals received during the current reporting period--including cases already charged before reaching the prosecutor’s
office. Of those cases referred, report the number that were accepted and the number that were declined for
prosecution during the current reporting period. A case should be characterized by the most serious offense and
may include numerous charges or counts. In most instances, a case will refer to one victim, one offender, and
one incident. It is strongly suggested that you refer to the separate instructions for examples of how to count and
characterize cases.)
Misdemeanor and felony domestic violence cases may include any assaults, battery, vandalism, or other offenses
that occurred in a domestic violence incident. Your state law does not have to name an offense ‘‘domestic violence’’ for a case addressing that offense to be counted here. Similarly, cases addressing 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.’’
Received/accepted/declined/transferred

Domestic violence/
dating violence

Sexual assault

Stalking

a. Number of case referrals received
b. Number of cases accepted for prosecution
c. Number of cases declined
d. Transferred to higher or lower court that is
outside grant-funded jurisdiction

37B. Reasons for declining cases
(Of those cases reported in line c of question 37A as declined, report only the primary reason for the decision to
decline prosecution. Please see separate instructions for further explanation of the reasons and for examples of
how to apply them.)
Reason for declining

Domestic violence/
dating violence

Sexual assault

Insufficient evidence (returned for
further investigation)
Insufficient evidence/victim
unavailable (no further action
requested)
Request of victim/victim safety
Other (specify):

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38. Disposition of cases
(Report the dispositions of all cases resolved during the current reporting period.)

Domestic violence/
dating violence
ordinance
Misdemeanor
domestic violence/
dating violence
Felony domestic
violence/dating
violence
Domestic violence/
dating violence
homicide
Misdemeanor
sexual assault
Felony sexual assault
Sexual assault
homicide
Stalking ordinance
Misdemeanor
stalking
Felony stalking
Stalking homicide
Violation of bail
Violation of probation or parole
Violation of protection order
Violation of other
court order
Other (specify):

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Guilty of lesser
charge in lower
category

Guilty of lesser
charge in the
same category

Guilty as
charged

Number convicted
Plead to lesser
charge in lower
category

Number of
deferred
adjudications

Plead to lesser
charge in the
same category

Number
dismissed

Plead as
charged

Type of case

Number
acquitted

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39. (Optional) Other issues present in cases that reached disposition
(If possible, use the space below to discuss the extent to which cases that were characterized as domestic violence, dating violence, sexual assault, and/or stalking also included additional charges or elements of domestic
violence, dating violence, sexual assault, and/or stalking. For example, cases reported above as domestic violence felony cases may also have included counts of misdemeanor sexual assault, and cases reported as felony
sexual assaults may also have included stalking charges. The purpose of this question is to gather information
on how often multiple crimes were present in the cases reported. If detailed information is not available, feel free
to provide estimates based on your experience.) (Maximum 2000 characters)

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40. Tribal subgrantees
(Report the total number of sexual assault, domestic violence, dating 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

41. Victim/survivor referrals to victim services
(Report the total number victim/survivor referrals referred to victim services during the current reporting period.
“Governmental” refers to victim services provided by victim assistants or victim-witness specialists/coordinators
employed by criminal justice agencies, such as law enforcement, prosecution, courts, or probation that are targeted to victims/survivors of domestic violence, dating violence, sexual assault, and/or stalking. “Non-governmental” refers to services provided by non-profit community-based agencies to victim/survivors of domestic
violence, dating violence, sexual assault, and/or stalking.)
Governmental victim services

Non-governmental victim services

Number of victim/survivor referrals

42. 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. These orders may also be referred to as protection from abuse or protection from harassment orders, restraining orders, or no-contact or stay-away orders.)
Sexual assault protection orders

Temporary orders

Final orders

Temporary orders

Final orders

Temporary orders

Final orders

Number requested
Number granted

Domestic violence/dating violence
protection orders
Number requested
Number granted

Stalking protection orders
Number requested
Number granted

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43. (Optional) Additional information
(Use the space below to discuss the effectiveness of prosecution activities funded or supported by your STOP
Program subgrant and to provide any additional information you would like to share about those activities beyond
what you have provided in the data above. An example might include expedited prosecution of felony domestic
violence and sexual assault cases as a result of funding a specialized prosecutor to handle those cases.)
(Maximum 2000 characters)

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E3

Courts

Were your STOP Program funds used for courts during the current reporting period?

Check yes if your STOP Program subgrant funded court activities. If STOP funds supported only a victim advocate
located in a court, then only section D Victim Services should be completed.

Yes—answer questions 44-51. Provide the information only for STOP Program-funded court activities engaged in during the current reporting period.
No—skip to E4.
44. Number of criminal cases

(Report the total number of new sexual assault, domestic violence, dating violence, and/or stalking-related cases
filed during the current reporting period.)
Misdemeanor and felony domestic violence cases 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 cases should be counted under
the appropriate sexual assault or stalking offense listed below (e.g., felony sexual assault), even if your state law
uses another name for these types of offenses, such as “sexual battery” or “harassment.”

Type of case

New cases filed during the current reporting period

Misdemeanor sexual assault
Felony sexual assault
Homicide related to sexual assault, domestic violence/
dating violence, or stalking
Domestic violence/dating violence ordinance
Misdemeanor domestic violence/dating violence
Felony domestic violence/dating 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

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45. Disposition of criminal cases

(Report the disposition of any sexual assault, domestic violence/dating violence, or stalking cases resolved during
the current reporting period.)
Type of case

Number
Number of
dismissed deferred adjudications

Number
convicted

Number
acquitted

Misdemeanor sexual assault
Felony sexual assault
Homicide related to sexual assault, domestic
violence/dating violence, or stalking
Domestic violence/dating violence ordinance
Misdemeanor domestic violence/dating violence
Felony domestic violence/dating 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

0

0

46. Judicial monitoring

(Report the number of sexual assault, domestic violence, dating 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 individual review
hearings conducted. The number of review hearings is the number of individual hearings held for each offender,
even when that offender is reviewed during the same monitoring sessions as other offenders. For example, if
10 offenders were reviewed at the same three sessions during the reporting period, the number of offenders reviewed would be 10 and the number of review hearings conducted would be 10 multiplied by 3, or 30.)
Number of offenders reviewed

Number of individual review hearings conducted

TOTAL

47. Disposition of violations

(Report the number of sexual assault, domestic violence, dating violence, and/or 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/
Probation
No
Partial reViolation
Conditions
Fine
written
revoked/
action
vocation of
added
warning
taken
probation incarcerated
Protection order
New criminal behavior
Failure to attend batterer intervention program (BIP)
Failure to attend mandatedoffender treatment (does not
include BIP)
Other conditions of probation
or parole
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STOP Violence Against Women Formula Grants

0

• Office on 0
Violence Against Women

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0

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48. Victims/survivor referrals to victim services

(Report the total number victim/survivor referrals to victim services during the current reporting period. “Governmental” refers to victim services provided by victim-assistants or victim-witness specialists/coordinators employed by criminal justice agencies, such as law enforcement, prosecution, courts, or probation that are targeted
to victims/survivors of domestic violence, dating violence, sexual assault, and/or stalking. “Non-governmental” refers to services provided by non-profit community-based agencies to victims/survivors of domestic violence,
dating violence, sexual assault, and/or stalking.)
Governmental victim services

Non-governmental victim services

Number of victim/survivor referrals

49. 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/dating violence, and stalking during the current reporting
period. These orders may be referred to as protection from abuse or protection from harassment or anti-harassment, or restraining orders. Include only civil orders.)
Sexual assault protection orders
Temporary orders
Final orders
Number requested
Number granted
Domestic violence/dating violence
protection orders

Temporary orders

Final orders

Temporary orders

Final orders

Number requested
Number granted
Stalking protection orders
Number requested
Number granted

50. Criminal protection orders

(Report the total number of criminal protection orders requested and the total number granted by the court to
victims/survivors of sexual assault, domestic violence/dating violence, and stalking during the current reporting
period. These orders may be referred to as no-contact or stay-away orders.)
Requested
Number of protection orders

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Granted

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51. (Optional) Additional information

(Use the space below to discuss the effectiveness of court activities funded or supported by your STOP Program
subgrant and to provide any additional information you would like to share about those activities beyond what you
have provided in the data above. An example might include an increased percentage of court-monitored offenders complying with mandated offender treatment and batterer intervention programs.)
(Maximum 2000 characters)

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E4

Probation and Parole

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

Yes--answer questions 52-56. Provide the information only for STOP Program-funded probation
and parole activities engaged in during the current reporting period.
No—skip to E5.
52. Number of offenders

(Report the total number of continuing and new offenders charged with sexual assault, domestic violence, dating
violence, and/or stalking. This is an unduplicated count. If you have not previously filed an annual report, include
all pending offenders at the beginning of the current reporting period as “number of continuing offenders.”)

Number of continuing Number of new
offenders
offenders

Number who
completed probation
Without violations

With violations

Unduplicated count of
domestic violence/dating
violence offenders
Unduplicated count of
sexual assault offenders
Unduplicated count of
stalking offenders
TOTAL

0

0

0

0

53. Monitoring activities
(For new and continuing cases reported in question 52, report the number of the monitoring activities engaged in
during the current reporting period. Report only those offenders who were monitored using the specific activity
under “Number of offenders.” Report the total number of contacts for all offenders for the specific activity under
“Total contacts.” For example, out of a total caseload of 150, a probation officer has face-to-face contact with
100 of those offenders during the reporting period. Multiplying those offenders by the number of face-to-face
meetings the officer had with each offender, the total contacts amount to 900. The number of offenders reported as having face-to-face meetings would be 100, and the number of total face-to-face contacts would be 900.)

Activity
Face-to-face meeting with offender

Number of offenders

Total contacts

Number of victims/
survivors

Total contacts

Telephone contact with offender
Unscheduled surveillance of offender
Activity
Outreach to victims/survivors

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54. Dispositions of violations
(Report the total number of sexual assault, domestic violence/dating violence, and/or 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/
Probation
No
Partial reViolation
Conditions
Fine
written
revoked/
action
vocation
of
added
warning
taken
probation incarcerated
Protection order
New criminal behavior
Failure to attend batterer intervention program (BIP)
Failure to attend mandatedoffender treatment (does not
include BIP)
Other conditions of probation
or parole
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TOTAL
STOP Violence Against Women Formula Grants

0

0

• Office on Violence Against Women

0

55. Victims/survivor referrals to victim services

(Report the total number victim/survivor referrals to victim services during the current reporting period. “Governmental” refers to victim services provided by victim-assistants or victim-witness specialists/coordinators
employed by criminal justice agencies, such as law enforcement, prosecution, courts, or probation. “Non-governmental” refers to services provided by non-profit community-based agencies to victims/survivors of domestic
violence, dating violence, sexual assault, and/or stalking.)
Governmental victim services

Non-governmental victim services

Number of victim/survivor referrals

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56. (Optional) Additional information

(Use the space below to discuss the effectiveness of probation activities funded or supported by your STOP Program subgrant and to provide any additional information you would like to share about those activities beyond
what you have provided in the data above. An example might include a decrease in caseload and higher number
of contacts with offenders as a result of funding a specialized domestic violence probation officer.)
(Maximum 2000 characters)

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E5

Batterer Intervention Program (BIP)

Were your STOP Program funds used for BIP during the current reporting period?

Check yes if STOP Program-funded staff or STOP Program funds directly supported BIP activities.

Yes--answer questions 57-59, providing information for grant-funded activities
No—skip to section F
57. 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 an 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

58. Outcomes

(Report the total number of domestic violence/dating 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):

59. Length of BIP in weeks

(Report the number of weeks batterers are expected to remain in the program in order to complete it. If your BIP
has more than one program length and/or curriculum, provide the length for each type of program.)
A

B

Number of weeks

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C

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F

NARRATIVE

All subgrantees must answer questions 60 and 61.
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED FOR EACH QUESTION.
60. What do you see as the most significant areas of remaining need, with regard to improving services
to victims/survivors of sexual assault, domestic violence, dating violence, and stalking, increasing
victim/survivor safety, and enhancing community response (including offender accountability for
both batterers and sex offenders)?

(Consider geographic regions, underserved populations, service delivery systems, types of victimization, and challenges and barriers unique to your jurisdiction.) Page 41.

61. 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 on arrests and prosecutions) Page 43.

Questions 62 and 63 are optional.
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED FOR EACH QUESTION.
62. Provide any additional information that you would like us to know about your STOP Program subgrant and/or the effectiveness of your grant.

(If you have any other data or information that you have not already reported in answer to previous questions that
demonstrate the effectiveness of your STOP Program-funded program please provide it below. Refer to separate
instructions for a fuller explanation and examples.) Page 45.

63. Provide any additional information that you would like us to know about the data submitted.

(If you have any information that could be helpful in understanding the data you have submitted in this report,
please answer this question. For example, if you submitted two different progress reports for the same reporting
period, you may explain how the data was apportioned to each report; or if your STOP Program funds supported
staff—e.g., victim advocates, law enforcement officers, etc.-- but did not report any corresponding victim services
or law enforcement activities, you may explain why; or if you did not use STOP Program funds to support either
staff or activities during the reporting period, please explain how program funds were used, if you have not already done so.) Page 47.

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, 800 K Street, NW, Washington, DC 20531.
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What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors
of sexual assault, domestic violence, dating violence, and stalking, increasing victim/survivor safety, and enhancing
community response (including offender accountability for both batterers and sex offenders)?
Question #60

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What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors
of sexual assault, domestic violence, dating violence, and stalking, increasing victim/survivor safety, and enhancing
community response (including offender accountability for both batterers and sex offenders)?
Question #60 (cont.)

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What has STOP Program funding allowed you to do that you could not do prior to receiving this funding?
Question #61

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What has STOP Program funding allowed you to do that you could not do prior to receiving this funding?
Question #61 (cont.)

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Provide any additional information that you would like us to know about your STOP Program subgrant and/or the effectiveness of your grant.
Question #62

STOP Program Annual Progress Report • 45 • Office on Violence Against Women

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Provide any additional information that you would like us to know about your STOP Program subgrant and/or the effectiveness of your grant.
Question #62 (cont.)

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Provide any additional information that you would like us to know about the data submitted.
Question #63

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Provide any additional information that you would like us to know about the data submitted.
Question #63 (cont.)

STOP Program Annual Progress Report • 48 • Office on Violence Against Women

Validate