Form 1122-0014 Semi Annual Progress Report for STOP Violence Against In

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U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
STOP Violence Against Indian Women
Discretionary Grant Program
Brief Instructions: This form must be completed for each STOP Violence Against Indian Women Discretionary
(STOP VAIW) grant received. The grant administrator or coordinator must ensure that the form is completed fully
with regard to all grant activities. 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 the activities supported under this grant during the current reporting period. Sections B, F, and subsections A1 and C2 of this form
must be completed by all grantees. In sections D, E, and subsections A2, C1, C3, C4, C5, and C6, grantees must
answer an initial question about whether they supported certain activities during the current reporting period. If
the response is yes, then the grantee 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, C4, C5, C6, and E1-E5); or, 2)
if you are a law enforcement agency receiving funds to pay for staff who provide training to other law enforcement
officers, you would complete A1, A2, B, C1, C2, and F (and answer ‘no’ in C3, C4, C5, C6, D and E1-E5).
Throughout this form, the term “STOP VAIW funds” includes the 25% non-federal match. Grantees must report on
activities supported through the STOP VAIW federal funds and the non-federal portion of the budget identified as
the organization’s 25% match. All information should reflect activities for the current reporting period only. The activities of volunteers or interns may be reported if they are coordinated or supervised by STOP VAIW grant-funded
staff or if STOP VAIW 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 B:
Section C:
C1:
C2:
C3:
C4:
C5:
C6:
C7:
Section D:
Section E:
E1:
E2:
E3:
E4:
E5:
Section F:
Appendix A

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

Page Number
11
33
44
44
66
77
99
11
10
12
11
12
13
14
13
18
17
17
18
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23
23
24
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25
25
26

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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 STOP VAIW grant)

5.

Point of contact
(person responsible for the day-to-day administration or coordination of the grant):
First Name
MI
Last Name
Name
Address
Address
State
Facsimile
Facsimile

City
Telephone
Telephone
E-mail
E-mail

Zip Code

6.

What tribal population(s) is(are) served by this grant?

7.

What percentage of your STOP VAIW Program funds were directed to each of these areas?
(Report the area[s] addressed by your STOP VAIW 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. See pages 2-3 of the separate instructions for complete definitions.)
Throughout this form, the term sexual assault includes both assaults committed by offenders who are
strangers to the victim/survivor and assaults committed by offenders who are known to, related by blood
or marriage to, or in a dating relationship with the victim. The term domestic violence applies to any pattern
of coercive behavior that is used by one person to gain power and control over a current or former intimate
partner. Domestic violence includes dating violence, which is violence committed by a person who is or has
been in a social relationship of a romantic or intimate nature with the victim. Stalking is defined as a course
of conduct directed at a specific person that places that person in reasonable fear of the death of, or serious
bodily injury to, herself or himself, a member of her/his immediate family, or her/his spouse or intimate
partner.
Percentage of grant funds

Sexual assault

%

Domestic violence

%

Stalking

%

TOTAL

100% 0 %

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Staff Information

A2

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

Yes—answer question 8
No—skip to Section B
8.

Staff
(Report the total number of full-time equivalent (FTE) staff funded by the STOP VAIW 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 repor ting
period, report the average. Round to the second decimal. See separate instructions for examples of how to
calculate FTEs for part-time staff and contractors.)
Staff

Grant-funded staff

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

0.00

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9.

PURPOSE AREAS

B

All grantees must complete this section.

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

Purpose areas
Training tribal law enforcement officers, judges, other court personnel, and prosecutors to
more effectively identify and respond to violent crimes against Indian women, including the
crimes of domestic violence, sexual assault, and dating violence.
Developing, training, or expanding units of tribal law enforcement officers, judges, other court
personnel, and prosecutors specifically targeting violent crimes against women, including the
crimes of sexual assault and domestic violence.
Developing and implementing more effective police, court, and prosecution policies, protocols,
orders, and services specifically devoted to preventing, identifying, and responding to violent
crimes against Indian women, including sexual assault and domestic violence.
Developing, installing, or expanding data collection and communication systems, including
computerized systems linking police, prosecutors, and courts for the purpose of identifying and
tracking arrests, protection orders, protection order violations, prosecutions, and convictions
for violent crimes against women, including sexual assault and domestic violence
Developing, enlarging, or strengthening victim services programs, including: sexual assault,
domestic violence, and dating violence programs, developing or improving the delivery of victim
services to underserved populations; providing specialized domestic violence court advocates
in courts where a significant number of protection orders are filed, and increasing reporting
and reducing attrition rates for cases involving violent crimes against Indian women, including
crimes of sexual assault and domestic violence.
Developing, enlarging, or strengthening programs to address stalking.
Developing, enlarging, or strengthening programs addressing the needs and circumstances of
Indian tribes dealing with violent crimes against women, including the crimes of sexual assault
and domestic violence.
Training sexual assault forensic medical personnel examiners in evidence collection and preservation, analysis, prevention, and providing expert testimony and treatment of trauma related
to sexual assault.
Supporting formal and informal multidisciplinary, cross jurisdictional efforts to coordinate the
response of law enforcement agencies, prosecutors, courts, victim services agencies, and
other agencies and departments to violent crimes against women, including sexual assault,
domestic violence, and dating violence.
Developing, enlarging, or strengthening programs to assist law enforcement, prosecutors,
courts, and others to address the needs and circumstances of older and disabled victims
of domestic violence or sexual assault, including recognizing, investigating, and prosecuting
instances of such assault or violence and targeting outreach and support, counseling, and
other victim services to such older and disabled individuals.
Providing assistance to victims of domestic violence and sexual assault in immigration
matters.

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C1

FUNCTION AREAS
Training

Were your STOP VAIW funds used for training during the current reporting period?
Check yes if STOP VAIW-funded staff provided training, or if STOP VAIW funds directly supported the training.

Yes—answer questions 10-12
No—skip to C2
10. Training events
(Report the total number of training events provided during the current reporting period that were either
provided by STOP VAIW-funded staff or directly supported by STOP VAIW funds. Staff development training
provided to STOP VAIW-funded staff should not be counted.)
Total number of training events provided

11. Number of people trained
(Report the number of people trained during the current reporting period by STOP VAIW Program-funded staff
or training supported by STOP VAIW funds. Use the category that is most descriptive of the people who attended the training event. STOP VAIW Program-funded staff attending staff development training should not
be counted.)
People trained
Tribal
Non-tribal
Attorneys/law students
Batterer Intervention Program staff
Coalition staff (sexual assault)
Coalition staff (domestic violence)
Coalition staff (dual, sexual assault, and domestic violence)
Community advocacy organization staff
Correction personnel (probation, parole, and correctional facility staff)
Court personnel (judges, clerks)
Disability organization staff (non-governmental)
Elder organization staff (non-governmental)
Faith-based organization staff
Federal law enforcement officers
Government agency staff (vocational rehabilitation, food stamps, TANF)
Health professionals (doctors, nurses)
Immigrant organization staff
Law enforcement officers
Legal services staff
Mental health professionals
Multidisciplinary group (various disciplines at same training)
Prosecutors
Sexual assault forensic examiners
Social service organization staff
Spiritual leaders
Supervised visitation and exchange center staff
Tribal council members
Tribal elders
Tribal government/Tribal government agency staff
Victim advocate (sexual assault)
Victim advocate (domestic violence)
Victim advocate ( dual, sexual assault, and domestic violence)
Victim-witness specialists
Volunteers
Other (specify):
TOTAL

0

0

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

Sexual assault, domestic violence, and stalking
Advocacy for Native women
Child witnesses
Confidentiality
Cultural issues specific to American Indians
Dating violence overview, dynamics,
and services
Domestic violence overview, dynamics,
and services
Dynamics and history of violence against
Native American women
Federal response to sexual assault and
domestic violence (IHS, DHHS)
Indian Child Welfare Act
Mandatory reporting requirements
Safety planning for victims
Sexual assault overview, dynamics, and
services
Stalking overview, dynamics, and services
Supervised visitation and exchange
Tribal strategies to address sexual assault
or domestic violence
Other (specify):
Other underserved populations
Issues specific to victims/survivors who:
live in rural areas
are Asian
are black or African American
have disabilities
are elderly
are Hispanic or Latino
are homeless or living in poverty
are institutionalized or isolated
are immigrants, refugees, or asylum
seekers
are lesbian, gay, bisexual, transgender,
or intersex
are Native Hawaiian or other Pacific
Islander
have mental health problems
have substance abuse problems
Other (specify):

Justice system
Civil court procedures
Criminal court procedures
Domestic violence statues/codes
Federal Response to sexual assault and
domestic violence (BIA, FBI, USAO)
Firearms and domestic violence
Identification and arrest of predominant
aggressor
Immigration statutes
Judicial response
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):
Community response
Coordinated community response
Response teams (DART, DVRT, SART)
Technology
Volunteer training
Other (specify):

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C2

Coordinated Community Response
All grantees must complete this section.

13. Coordinated community response activities
(Check the appropriate boxes to indicate the agencies or organizations, even if they are not partners with
which you have a memorandum of understanding [MOU], 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 STOP VAIW grant.)
Agencies or groups

Victim/survivor referrals,
consultations, technical assistance
Daily

Weekly

Monthly

Meetings
Weekly

MOU
Partner

Monthly Quarterly

Batterer intervention program
Community advocacy
organization
Corrections (probation,
parole and correctional
facility staff)
Court (federal)
Court (state or local)
Court (tribal)
Domestic violence
organization (tribal)
Domestic violence
organization (non-tribal)
Faith-based organization
Health/mental health
organization (tribal)
Health/mental health
organization (non-tribal)
Law enforcement (federal)
Law enforcement (local or
state)
Law enforcement (tribal)
Legal services organization
(tribal)
Legal services organization
(non-tribal)
Prosecutor (federal)
Prosecutor (tribal)
Prosecutor (local or state)
Sexual assault organization
(tribal)
Sexual assault organization
(non-tribal)
Social service organization
(tribal)
Social service organization
(non-tribal)
Tribal council
Tribal elders
Other (specify):

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C3

Policies

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

Yes—answer question 14
No—skip to C4
14. Policies or protocols developed, revised, or implemented during the current reporting period.
(Check all that apply.)

Victim services
Appropriate services for victims/survivors who are American Indian or Alaska Native
Appropriate services for victims/survivors who are elderly and/or have disabilities
Appropriate services for victims/survivors from other underserved populations
Confidentiality
Mandatory training standards for staff and volunteers
Staff, board, and volunteers represent the diversity of your service area
Victim/survivor informed about Crime Victim’s Compensation and Victim Impact Statements
Other (specify):
Health care
Advocate response to emergency room
Appropriate services for victims/survivors who are American Indian or Alaska Native
Appropriate services for victims/survivors are who are elderly and/or have disabilities
Appropriate services for victims/survivors from other underserved populations
Forensic exams not billed to victim
Mandatory training on sexual assault, domestic violence, and/or stalking
Routine screening and referrals for sexual assault, domestic violence, and/or stalking
Other (specify):
Law enforcement
Appropriate response to victims/survivors who are American Indian or Alaska Native
Appropriate response to victims/survivors who are elderly and/or have disabilities
Appropriate response to victims/survivors from other underserved populations
Identifying primary aggressor/discouraging dual arrest
Immediate access to protection order information
Mandatory training on sexual assault, domestic violence, and/or stalking
No charge to victims for service of protection orders, warrants, or subpoenas
No victims polygraphed
Protection order enforcement (including full faith and credit)
Providing information to victims/survivors about victim services
Other (specify):

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Prosecution
Appropriate response to victims/survivors who are American Indian or Alaska Native
Appropriate response to victims/survivors who are elderly and/or have disabilities
Appropriate response to victims/survivors from other underserved populations
Child witness strategies
Evidence-based prosecution
Protection order enforcement (including full faith and credit)
Mandatory training on sexual assault, domestic violence, and/or stalking
No victims polygraphed
Victim witness notification
Other (specify):
Court
Accelerated trial schedules
Appropriate response for victims/survivors who are American Indian or Alaska Native
Appropriate response to victims/survivors who are elderly and/or have disabilities
Appropriate response to victims/survivors from other underserved populations
Full faith and credit for protection orders
Judicial monitoring of sexual assault and domestic violence and/or stalking offenders
Mandatory training on sexual assault, domestic violence, and/or stalking
Policy against mediation
Policy against mutual restraining orders
Procedures for courtroom security
Tribal codes
Other (specify):
Probation and parole
Appropriate response to victims/survivors who are American Indian or Alaska Native
Appropriate response to victims/survivors who are elderly and/or have disabilities
Appropriate response to victims/survivors from other underserved populations
Mandatory training on sexual assault, domestic violence, and/or stalking
Strategies to assist and protect victim/survivor during probation and parole
Victim notification
Other (specify):

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C4

Products and Codes

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Expiration Date: 10/31/2007

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

Yes—answer question 15
No—skip to C5
15. Use of STOP VAIW funds for product or code development, substantial revision, and/or distribution
(Report the number of products or codes developed, substantially revised, and/or distributed with STOP VAIW
funds during the current reporting period. Report the number of new products or codes developed or subtantially revised during the current reporting period; the title/topic; the intended audience for each product or
codes developed, revised, and/or distributed; and the number of products or codes used or distributed. If a
product or code was created in or translated into a language other than English, including Braille, indicate
the lanugage. Report on products or codes that were newly developed during the current reporting period
whether or not they were used or distributed, and on products or codes 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

Training
Curricula

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Products

Number
developed
or revised

Title/topic

Intended
audience

Number
used or
distributed

Other
languages

Training
materials

Tribal
codes

Other
(specify):

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C5

Data Collection and Communication Systems

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

Yes—answer questions 16-17
No—skip to C6.
16. Use of STOP VAIW funds for data collection and/or communication systems
(Check all that apply.)

Develop new data collection/communication systems
Expand existing data collection/communication systems
Install data collection/communication systems
Link existing data collection/communication systems
Manage data collection and communication
Purchase computers and other equipment
Share information with other community partners
17. 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
Calls to police
Case management
Compliance with court-ordered sanctions
Convictions
Court docket management
Evaluation/outcome measures
Incident reports
Information sharing
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 VAIW funds used for specialized units during the current reporting period?
Check yes if any STOP VAIW-funded staff were part of a specialized unit in any of the categories listed below,
or if STOP VAIW 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 sexual assault, domestic violence and stalking cases. A specialized unit may consist
of one person, even if that person is partially funded by your STOP VAIW grant.)

Yes—answer question 18
No—skip to C7
18. Use of STOP VAIW funds for specialized units
(Check all that apply.)
Tribal
law enforcement

Tribal
prosecution

Tribal
court

Tribal
probation

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

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C7

System Improvement

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

Yes—answer question 19
No—skip to Section D
19. Use of STOP VAIW funds for system improvement
(Check all that apply.)
Victim services

Law enforcement

Prosecution Court

Probation or parole

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

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VICTIM SERVICES

D

Were your STOP VAIW funds used to provide victim services to victims/survivors during the current
reporting period?
Check yes if STOP VAIW-funded staff provided victim services or if STOP VAIW funds were used to support
victim/survivor services during the current reporting period. Report all victim services provided with STOP
VAIW funds, whether by legal services, a victim services agency, or by staff providing 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 20-26
No—skip to Section E
20. Number of victims/survivors served, partially served, and victims seeking services who were not
served
Do not attempt to answer this question without referring to the separate set of instructions for further explanation and examples of how to distinguish among these categories. (Report the following, to the best of your
ability, as an unduplicated count for each category during the current reporting period. This means that each
victim/survivor who sought or received services during this reporting period should be counted only once and
in only one of the listed categories. For purposes of this question, victims/survivors are those against whom
the sexual assault, domestic violence, or stalking was directed.)
Sexual
assault

Domestic
violence

Stalking

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

21. Reasons that 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 eligibility or statutory requirements
Geographic or other isolation of victim/survivor
Hours of operation
Inadequate language capacity (including sign language)
Insufficient/lack of culturally appropriate services
Insufficient/lack of services for people with disabilities
Need not documented
Program reached capacity
Program rules not acceptable to victim/survivor
Services inappropriate or inadequate for victims/survivors with mental health problems
Services inappropriate or inadequate for victims/survivors with substance abuse problems
Services not appropriate for victim/survivor
Services not available for victim/survivor accompanied by male adolescents
Transportation problems
Other (specify):
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22. Demographics of victims/survivors served or partially served, and their offenders.
(Based on the victims/survivors reported in 20A and 20B, report the total numbers for all that apply.
Since victims/survivors may identify as more than one race/ethnicity and with more than one of the
“other demographics” options, the totals for these two categories may exceed the total number of victims/
survivors reported in 20A and 20B. However, the total number of victim/survivor’s reported in the “gender”
and “age” categories should equal the total number of victims/survivors reported in 20A and 20B.”)

Race/Ethnicity (victims/survivors may be counted
more than once within this category)
American Indian and/or Alaska Native

Number of victims/survivors

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

Number of victims/survivors

Female
Male
Unknown
TOTAL(should
(Shouldequal
equalthe sum0of
TOTAL
20A
and
, the
sum
of 20B)
20A and 20B)

Age

0

Number of victims/survivors

0-17
18-24
25-59
60 +
Unknown
TOTAL
20A
and
, the
sum
of 20B)
20A and 20B)
TOTAL(should
(Shouldequal
equal the sum0of
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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23. Victims/survivors’ relationship to offender
(For those victims/survivors reported in 20A and 20B, report the relationship of the victim/survivor to the offender. Count the relationship to each offender for victims/survivors victimized by more than one perpetrator.
The number of victims/survivors reported here may total more than the number reported in items 20A and
20B.)
Relationship to offender

Number of victims/survivors
Sexual assault Domestic violence Stalking

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

0

0

0

24. Victim services
(Report the number of victims/survivors from 20A and 20B who received hotline assistance; crisis intervention;
hospital response; support group/counseling services; criminal justice advocacy/court accompaniment; civil legal advocacy/court accompaniment; civil legal assistance; victim witness notification; victim/survivor advocacy;
an/or transportation. Count a victim/survivor once for each type of service received in during the current reporting period. The total number of victims/survivors reported here may total more than the sum of 20A and 20B.)
Number of victims/
Type of service
survivors served
Hotline calls
(Crisis or information and referral calls received by an agency’s hotline or office telephone.)

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

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

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 legal issues including preparing paperwork for protection orders; accompanying a victim/survivor to a protection order hearing or other civil proceeding;
and all other advocacy within the civil justice system.)

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

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

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

Transportation
Other (specify):

. .

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25. Shelter services
(Report the total number of victims/survivors and accompanying family members who received emergency
shelter or transitional housing funded with STOP VAIW funds. Report the total number of bed days provided in
emergency shelter or transitional housing to victims/survivors and family members. Emergency shelter can
be safe houses or hotel motel accommodations. 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

Number of
bed days

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

Final protection orders

Number of protection orders requested
Number of protection orders granted

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E1

CRIMINAL JUSTICE SYSTEM
Tribal Law Enforcement

Were your STOP VAIW funds used for Tribal law enforcement activities during the current reporting
period?
Check yes if STOP VAIW funds directly supported law enforcement activities.

Yes—answer questions 27-28
No—skip to E2
27. Activities
(Report law enforcement activities on sexual assault, domestic violence, and stalking cases/incidents during
the current reporting period.)
Activity
Number

Calls for assistance
(Emergency calls made to law enforcement.)

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

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

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

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

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

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

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

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

Cases referred to tribal prosecutors
Cases referred to local or state law enforcement or prosecutors
Cases referred to federal law enforcement or prosecutors
(Not including federal firearms charges)

Referrals of federal firearms charges to federal prosecutors
28. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which STOP
VAIW-funded law enforcement staff provided assistance to victims/survivors during the current reporting
period.)
Temporary protection orders
Final protection orders
Number of protection orders requested
Number of protection orders granted
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Tribal Prosecution

E2

Were your STOP VAIW funds used for tribal prosecution during the current reporting period?
Check yes if STOP VAIW funds directly supported prosecution activities.

Yes—answer questions 29-32
No—skip to E3
29. Number of sexual assault, domestic violence, and/or stalking cases received, charged, not
charged, or transferred
(Report the number of sexual assault, domestic violence, and/or stalking cases in which formal charges
were filed; decisions were made not to bring charges; or cases were not charged due to jurisdictional
limitations [e.g., no tribal ordinance, PL 280, no tribal court].)
a. Number of case referrals received
b. Number of cases in which charges were filed
c.

Number of cases in which an affirmative decision was made not to file charges
(except for jurisdictional reasons)

d. Number of cases not charged due to jurisdictional limitations
d1. Cases referred to federal entity for prosecution
d2. Cases referred to state entity for prosecution

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

Number of pending charges
from last reporting period

Number of new charges

Sexual assault
Domestic violence
Stalking
Violation of protection order
Violation of bail
Violation of probation
Violation of other court order
Other (specify):

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

Type of offense

Request Lack of
Plea
of victim evidence bargain Other

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

Number
acquitted

Sexual assault
Domestic violence
Stalking
Violation of
protection order
Violation of bail
Violation of
probation
Violation of other
court order
Other (specify):

32. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which STOP
VAIW-funded tribal prosecutors provided assistance to victims/survivors during the current reporting period.)
Temporary protection orders

Final protection orders

Number of protection orders requested
Number of protection orders granted

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Tribal Courts

E3

Were your STOP VAIW funds used for tribal courts during the current reporting period?
Check yes if STOP VAIW funds directly supported court activities.

Yes—answer questions 33-37
No—skip to E4
33. Number of criminal charges
(Report the total number of sexual assault, domestic violence, and stalking charges pending from the previous reporting period and new charges filed during the current reporting period. If you have not previously filed
a semi-annual report, include all pending charges at the beginning of the current reporting period as
“charges pending.”)
Your code or statute does not have to name the offense sexual assault, domestic violence, or stalking for it
to be counted here. Your code may use other names for these types of offenses, such as sexual battery or
harassment. Similarly, domestic violence offenses include any assaults, battery, vandalism, or other offenses that occurred in a domestic violence incident.

Type of offense

Charges pending from
last reporting period

New charges filed during
the current reporting period

Sexual assault
Domestic violence
Stalking
Violation of protection order
Violation of bail
Violation of probation
Violation of other court order
0

0

TOTAL

34. Disposition of criminal charges
(Report the disposition of sexual assault, domestic violence, and stalking charges during the current
reporting period.)
Type of offense

Number
dismissed

Number of
deferred adjudications

Number
convicted

Number
acquitted

Sexual assault
Domestic violence
Stalking
Violation of protection order
Violations of bail
Violation of probation or parole
Violation of other court order
TOTAL

0

0

0

0

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35. Judicial monitoring
(Report the number of sexual assault, domestic violence and 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. Also report the total number of review hearings conducted.)
Number of offenders reviewed

Number of review hearings conducted

TOTAL

36. Dispositions of violations reviewed
(Based on the cases reported in question 35 [judicial monitoring], report the total number of sexual assault,
domestic violence, and stalking cases in which there were dispositions of violations, during the current reporting period. The violation does not have to have occurred during this reporting period, only the disposition.
A case may be counted more than once if there were multiple violations.)
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
Other condition of
probation or parole
TOTAL

0

0

0

0

0

0

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

Final protection orders

Number of protection orders requested
Number of protection orders granted

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Tribal Probation

E4

Were your STOP VAIW funds used for probation during the current reporting period?
Check yes if STOP VAIW funds directly supported probation activities.
Yes—answer questions
question 38-40
Yes—answer
38-40
No—skip to
No—skip
to E5
Section F

38. Number of cases
(Report the total number of continuing and new cases involving offenders charged with sexual assault, domestic violence, and/or stalking. This is an unduplicated count. If you have not previously filed a semi-annual
report, include all pending cases at the beginning of the current reporting period as “number of continuing
cases.”)
Misdemeanor and felony domestic violence offenses include any assaults, battery, vandalism, or other offenses that occurred in a domestic violence incident. Your tribal law does not have to name the offense
“domestic violence” for it to be counted here. Similarly, sexual assault and stalking offenses should be
counted, even if your tribal law uses another name for these types of offenses, such as “sexual battery”
or “harassment.”
Number of
continuing cases

Number of
new cases

Completed probation
Without
violations

With
violations

Total unduplicated count
of cases (offenders)

39. Monitoring activities
(For new and continuing cases reported in question 38, report the number of the monitoring activities engaged in during the current reporting period.)
Activity

Number of offenders

Total contacts

Number of offenders

Total contacts

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

40. Disposition of probation violations
(Report the total number of sexual assault, domestic 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/
Violation
No action
Fine
Conditions Partial reProbation
written
taken
added
vocation of revoked/
warning
probation incarcerated
Protection order
New criminal behavior
Failure to attend mandated
offender treatment program
Other condition of
probation or parole
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E5

Batterer Intervention Program (BIP)

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

Yes—answer questions 41-43
No—skip to Section F
41. Offenders in program
(Report the number of continuing and new offenders in your BIP 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
42. Outcomes
(Report the total number of domestic violence offenders in your program who successfully completed the
program, who were terminated from the program, and 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):

43. 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, 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

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F

NARRATIVE

All grantees must answer question 44.
Please limit your response to four pages for this question.
44. Report on the status of your STOP VAIW grant goals and objectives as of the end of the current
reporting period.
(Using Appendix A as a guide, 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.)
To answer this question go to

Page 26.

All grantees must answer questions 45 and 46 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.
Please limit your response to two pages for each question.

45. What do you see as the most significant areas of remaining need, with regard to increasing
victim/survivor safety and offender accountability?
(Consider geographic regions, service delivery systems, types of victims/survivors, jurisdictional issues,
and challenges and barriers unique to your service area.)
To answer this question go to Page 29.

46. What has the STOP VAIW Program funding allowed you to do that you could not do prior to
receiving this funding?
(For example, expand services to victims/survivors, increase coordination between tribal and local law
enforcement, etc.)
To answer this question go to

Page 31.

Questions 47 and 48 are optional.
Please limit your response to two pages for each question.
47. Non-tribal criminal justice dispositions.
(If you have information about the dispositions of sexual assault, domestic violence, and/or stalking offenses that occurred in Indian country and were referred to local, state, or federal law enforcement or
prosecutors, please report that information here. If available, include information on whether the offenders
and victims were tribal members.)
To answer this question go to Page 33.

48. Provide additional information regarding the effectiveness of your grant-funded program.
(If you have other data or information regarding your program that would more fully or accurately reflect the
effectiveness of your STOP VAIW-funded program than the data you have been asked to provide on this form,
answer this question. Refer to separate instructions for a fuller explanation and examples.)
To answer this question go to

Page 35.

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

OMB Clearance No.: 1122-0014
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Report on the status of your STOP VAIW grant goals and objectives as of the end of the current reporting period - Question #44.
Goals/Objectives

Back to Instructions

Status

Back to Instructions

Status

Key Activities

Comments

Goals/Objectives

Key Activities

Comments

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APPENDIX A

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

Report on the status of your STOP VAIW grant goals and objectives as of the end of the current reporting period
- Question #44 (Cont.1).

Back to Instructions

Status

Back to Instructions

Status

Goals/Objectives

Key Activities

Comments

Goals/Objectives

Key Activities

Comments

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APPENDIX A

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

Report on the status of your STOP VAIW grant goals and objectives as of the end of the current reporting period
- Question #44 (Cont.2).
Goals/Objectives

Back to Instructions

Status

Back to Instructions

Status

Key Activities

Comments

Goals/Objectives

Key Activities

Comments

STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 28 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

What do you see as the most significant areas of remaining need, with regard to increasing victim/survivor safety and
offender accountability? - Question #45.

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 29 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

What do you see as the most significant areas of remaining need, with regard to increasing victim/survivor safety and
offender accountability? - Question #45 (cont.).

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 30 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

What has the STOP VAIW Program funding allowed you to do that you could not do prior to receiving this funding?
- Question #46.

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 31 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

What has the STOP VAIW Program funding allowed you to do that you could not do prior to receiving this funding?
- Question #46 (cont.).

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 32 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

Non-tribal criminal justice dispositions.
(If you have information about the dispositions of sexual assault, domestic violence, and/or stalking offenses that occurred in
Indian country and were referred to local, state, or federal law enforcement or prosecutors, please report that information here.
If available, include information on whether the offenders and victims were tribal members.) - Question #47.

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 33 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

Non-tribal criminal justice dispositions.
(If you have information about the dispositions of sexual assault, domestic violence, and/or stalking offenses that occurred in
Indian country and were referred to local, state, or federal law enforcement or prosecutors, please report that information here.
If available, include information on whether the offenders and victims were tribal members.) - Question #47 (Cont.).

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 34 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

Provide additional information regarding the effectiveness of your grant-funded program.
(If you have other data or information regarding your program that would more fully or accurately reflect the effectiveness of
your STOP VAIW-funded program than the data you have been asked to provide on this form, answer this question. Refer to
separate instructions for a fuller explanation and examples.) - Question #48.

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 35 • Office on Violence Against Women

OMB Clearance No.: 1122-0014
Expiration Date: 10/31/2007

Provide additional information regarding the effectiveness of your grant-funded program.
(If you have other data or information regarding your program that would more fully or accurately reflect the effectiveness of
your STOP VAIW-funded program than the data you have been asked to provide on this form, answer this question. Refer to
separate instructions for a fuller explanation and examples.) - Question #48 (Cont.).

Back to Instructions
STOP Violence Against Indian Women Discretionary Grants Program Semi-annual Progress Report • 36 • Office on Violence Against Women

Validate