Form 1122-0024 Semi-Annual Progress Report for the Tribal Sexual Assaul

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Expiration Date: 10/31/2013

U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
TRIBAL SEXUAL ASSAULT SERVICES PROGRAM
VIOLENCE AGAINST WOMEN GRANT PROGRAM
Brief Instructions: This form must be completed for each Tribal Sexual Assault Services Program (T-SASP)
grant received. The grant administrator or coordinator must ensure that the form is fully completed with
regard to all grant-funded 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 engaged in under this grant during the current reporting period. Sections B, D, and E and
subsections A1 and C1 of this form must be completed by all grantees. In subsections A2, C2, and C3
and section D, grantees must answer an initial question about whether they engaged in certain activities
during the current reporting period. If the response is yes, then the grantee must complete that section/
subsection. If the response is no, the rest of that section/subsection is skipped.
For example, if you are an agency providing victim services and policy development, you would complete
A1, A2, B, C1, C2, D, and E (and answer ‘no’ in C3 if you are not funded to develop or revise products).
The activities of volunteers or interns should be reported if they were coordinated or supervised by T-SASP
funded staff or if T-SASP funds substantially supported 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 A:

SECTION
General Information

A1:
A2:
Section B:
Section C:
C1:
C2:
C3:
Section D:
Section E:

Grant Information
Staff Information
Purpose Areas
Function Areas
Coordinated Community Response
Policies
Products
Victim Services
Narrative

Page Number
1
1
2
3
4
4
7
9
10
17

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A1

GENERAL INFORMATION
Grant Information

All grantees must complete this subsection.

(format date with 6 digits – 01/31/09)

1.

Date of report

2.

Current reporting period

3.

Grantee name

4.

Grant number
(List the federal grant number assigned to your T-SASP grant)

5.

Type of funded organization
(Check the one answer that best describes the organization receiving the T-SASP grant.)

✔

January 1-June 30

✔

July 1-December 31

(Year)

Tribal government
Tribal organization
Non-profit tribal organization

6.

Point of contact
(Person responsible for the day-to-day coordination of the grant)
First name

MI

Last name

Agency/organization name
Address
City

State

Telephone

Zip code

Facsimile

E-mail
7. What tribal populations(s) is(are) served by this grant?

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A2

Staff Information

Were your T-SASP grant funds used to fund staff positions during the current reporting period?
(Check yes if T-SASP 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 T-SASP grant 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 grant funds as well as
consultants/contractors. 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 T-SASP funds, you would report that as .50 FTE. Report all FTEs in
decimals, not percentages. One FTE is equal to 1,040 hours—40 hours per week x 26 weeks. See
separate instructions for examples of how to calculate and prorate FTEs.)
Staff

FTE(s)

Administrator (fiscal manager, executive director)
Counselor
Legal advocate (does not include attorney or paralegal)
Program coordinator (training coordinator, volunteer coordinator, hotline
coordinator, victim services coordinator)
Support staff (administrative assistant, bookkeeper, accountant)
Translator/interpreter
Tribal cultural specialist
Victim advocate
Other (specify):
TOTAL

0

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B

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PURPOSE AREAS

All grantees must complete this section.
9.

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

Purpose Areas
To establish programs and projects to assist victims of sexual assault
To maintain assistance for victims of sexual assault
To expand assistance for victims of sexual assault

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C1

FUNCTION AREAS
Coordinated Community Response

All grantees must complete this subsection.
10. Coordinated community-based response activities supported by T-SASP Program grant funds during
the current reporting period
(Check the appropriate boxes to indicate the agencies, organizations, or groups that you: provided
victim/survivor referrals to, received 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 a collaboration
for purposes of your T-SASP grant. If T-SASP 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.)
Agencies/organizations/
groups

Victims/survivor referrals,
consultations, technical
assistance
Daily

Weekly

Monthly

Meetings
Weekly

Collaborative
partners

Monthly Quarterly

Non-profit, non-governmental
Indian victim services program
Non-profit, tribal domestic
violence/dating violence or
sexual assault coalition
Women’s advisory committee
Community advocacy
organization
Corrections (probation, parole
and correctional facility staff)
Court (federal)
Court (local or state)
Court (tribal)
Educational institutions/youth
programs
Faith/spiritual-based
organization
Health/mental health
organization
Law enforcement (federal)
Law enforcement (local or
state)
Law enforcement (tribal)
Legal organization (legal
services, bar association, law
school)
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Agencies/organizations/
groups

Victims/survivor referrals,
consultations, technical
assistance
Daily

Weekly

Monthly

Meetings
Weekly

Collaborative
partners

Monthly Quarterly

Prosecutor (federal)
Prosecutor (local or state)
Prosecutor (tribal)
Social service organizaton
Tribal council
Tribal elders
Tribal government agency
Tribal housing authority
Other (specify):

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10a. (Optional) Additional information
(Use the space below to discuss the effectiveness of coordinated community response [CCR] activities
funded or supported by your T-SASP grant and to provide any additional information you would like
to share about your CCR activities beyond what you have provided in the data above and how these
activities increase the safety of American Indian/Alaska Native women.) (Maximum – 2000 characters)

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C2

Policies

Were your T-SASP funds used to develop, substantially revise, or implement policies or protocols during
the current reporting period?
(Check yes if T-SASP funded staff developed, substantially revised, or implemented polices or protocols,
or if T-SASP funds were used to directly support the development, revision, or implementation of
policies or protocols.)
Yes—answer questions 11-12
No—skip to C3
11. Types of protocols and/or policies developed, substantially revised, or implemented during the
current reporting period.
(Check all that apply.)
Advocate response to emergency room
Appropriate response to victims/survivors to avoid or eliminate re-traumatization
Appropriate response to victims/survivors with substance abuse issues and/or mental health
diagnoses
Appropriate response to victims/survivors who are D/deaf or hard of hearing
Appropriate response to victims/survivors who are elderly or have disabilities
Appropriate use of translators/interpreters
Confidentiality
Forensic exams not billed to victims/survivors
Mandatory training standards for staff and volunteers
Procedures for anonymous, confidential, or Jane Doe reporting of sexual assault
Routine screening and referrals for sexual assault
Victim/survivor informed about Crime Victims Compensation and Victim Impact Statements
Other (specify):

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12. (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 T-SASP grant and to provide any additional information you would like
to share about your activities relating to the developing, revising, or implementing of policies beyond
what you have provided in the data above. An example might include an increase in the number of
American Indian/Alaska Native victims/survivors who are D/deaf seeking services from your agency
following implementation of a protocol on interpretation that you helped to develop.) (Maximum 2,000
characters)

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C3

Products

Were your T-SASP funds used to develop, substantially revise, and/or distribute products during the
current reporting period?
Check yes if T-SASP funded staff developed revised and/or distributed products or if T-SASP funds
directly supported the development, revision, or distribution of products.
Yes—answer question 13
No—skip to section D
13. Use of T-SASP funds for product development, substantial revision, and/or distribution
(Report the number of products developed, substantially revised, and/or distributed with T-SASP 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.”)
Product

Number
developed
or revised

Title/topic

Intended
audience

Number
used or
distributed

Languages

Outreach
material
(brochures,
pamphlets,
information
packets,
posters,
television/
radio/other
media
spots, etc.)

Website

Other
(specify):

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D

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VICTIM SERVICES

All grantees must complete this section.

Count only victims/survivors served and victim services/activities provided by T-SASP funded staff or
supported with T-SASP funds.
14. Number of primary victims/survivors of sexual assault 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 services 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 was directed. Do not report secondary victims
here.)
Primary victims/survivors of sexual assault

TOTAL

A. Served: Victims/survivors who received the service(s) they requested, if
those services were funded by your T-SASP grant
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
T-SASP grant
TOTAL SERVED and PARTIALLY SERVED (14A + 14B)

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 T-SASP grant
15. 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. For purposes of this question, secondary victims are those who are collaterally affected
by the victimization—e.g., children, siblings, spouses, intimate partners, grandparents, other affected
relatives, friends, neighbors, etc.—except for the perpetrator of such victimization. Secondary victims
do not need to be connected with a primary victim who is receiving services.
Secondary victims

TOTAL

Secondary victims who received service(s) funded by your T-SASP grant

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16. 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 victims/survivors who are D/deaf or hard of hearing
Insufficient/lack of services for victims/survivors 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
Transportation
Other (specify):

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17. Demographics of primary victims/survivors served or partially served
(Based on the primary victims/survivors reported in 14A and 14B, 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 14A and 14B. However,
the total number of victims/survivors reported under Race/ethnicity should not be less than the total
number of victims/survivors reported in 14A and 14B. 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 14A and 14B. 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 or Alaska Native” or the category “Native Hawaiian or other Pacific Islander.”)
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Unknown
TOTAL RACE/ETHNICITY

Number of victims/survivors

0

(should not be less than 0, the sum of 14A and 14B.)

Gender
Female
Male
Unknown
TOTAL GENDER

Number of victims/survivors

0

(should equal 0, the sum of 14A and 14B.)

Age
0-6
7-12
13-17
18-24
25-59
60+
Unknown
TOTAL AGE

Number of victims/survivors

Other demographics
People with disabilities
People who are D/deaf or hard of hearing
People with limited English proficiency
People who live in rural areas

Number of victims/survivors

0

(should equal 0, the sum of 14A and 14B.)

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18. Victims/survivors’ relationships to offender
(For those primary victims/survivors reported as served and partially served in 14A and 14B,
report the victim/survivor’s relationship to the offender. If a victim/survivor was victimized by
more than one perpetrator, count the victim/survivor in all categories that apply. The total
number of relationships must be at least 0. Do not report relationships to offender for
secondary victims.)
Victim/survivor’s relationship to offender
Current or former spouse or intimate partner
Other family or household member (son/daughter, stepson/
stepdaughter, sibling, etc.)
Dating relationship
Acquaintance (neighbor, employee, co-worker, student, schoolmate,
etc.)
Stranger
Relationship unknown
TOTAL

Number of relationships

0

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19. Victim services
(Report the number of primary victims/survivors from 14A and 14B who received T-SASP 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 0, the total of 14A and 14B.
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.)
Counseling/support group (Short-term 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;
advocacy with probation/parole/corrections; supporting victims/survivors
through the sex offender management process; 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.)
Cultural advocacy (Activities such as sweat lodge, talking circles, wellness
gatherings, cultural ceremonies, etc.)
Employment counseling (Actions designed to assist a victim/survivor in
obtaining employment, e.g., coaching on career options, skills training, job
searches, resume-writing, marketing, job interviews, and preservation of
employment.)
Financial counseling (Actions designed to assist a victim/survivor with
issues related to improving credit, retiring debt, setting up bank accounts,
managing household finances, negotiating with lenders or landlords,
developing budgets, managing financial assets, making major purchases
such as a home or auto, filing tax returns.)
Hospital/clinic/other medical response (Accompanying a victim survivor to
or meeting a victim/survivor at a hospital, clinic, or medical office)
Job training (Providing training in specific employment-related skills to a
victim/survivor, e.g., on computer literacy.)
Language services (Interpretation, translation)
Material assistance (Providing victims/survivors with clothing, food, personal
items, etc.)
Transportation (Provision of transportation, either directly or through bus
passes, taxi fares, or other means of 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, school/education, etc.)
Other (specify):
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20. Hotline calls/information and referral
(Report the number of hotline calls and requests for information and referral received from primary
victims, and the total number of hotline calls received, on phone lines paid for with T-SASP funds or
answered by T-SASP funded staff, during the current reporting period. Primary victims whose calls
are reported here should not be reported as victims served in question 14 unless they also received
at least one of the services listed in question 19, Victim 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 19. 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 19, see separate instructions.)
Number of
calls/requests from
primary
victims/survivors

Total number of
calls/requests

Hotline calls (Crisis or information and referral
calls received by an agency’s hotline or office
telephone.)
Web-based information and referral
Walk-in information and referral
21. Outreach to victims/survivors
(Report the number of unsolicited letters, phone calls, or visits to victims/survivors of specific incidents
of sexual assault, informing them of services and/or providing information. Victims/survivors who
are the recipients of these outreach activities should not be reported as victims served in question 14
unless they also received at least one of the services reported in question 19 Victim services. Victims/
survivors who receive services such as advocacy over the telephone should be reported in question
19.)
Number of outreach
activities to
victims/survivors
Outreach to victims/survivors (Unsolicited letters,
phone calls, or visits.)

22.

Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for
which T-SASP 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.)
Protection orders

Temporary orders

Final orders

Number requested
Number granted

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23.

(Optional) Additional information
(Use the space below to discuss the effectiveness of victim services funded or supported by your
T-SASP grant 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 T-SASP funding, was able to provide culturally appropriate medical
accompaniment to an increased percentage of sexual assault survivors. This resulted in a higher
percentage of survivors from the population you serve also seeking additional support services.)

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E

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NARRATIVE

All grantees must answer question 24.
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED (8,000 CHARACTERS) FOR EACH QUESTION.
24. Report on the status of your T-SASP grant goals and objectives as of the end of the current
reporting period.
(Report succinctly 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 briefly on your successes
and challenges, and provide any additional explanation you feel is necessary for us to understand
what you have or have not accomplished relative to your goals and objectives. If you have not
accomplished objectives that should have been accomplished during the current reporting period, you
must provide an explanation.) Page 18.
All grantees must answer questions 25, 26 and 27 on an annual basis. Submit this information on the
January to June reporting form only.
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED (8,000 CHARACTERS) FOR EACH QUESTION.
25. What services or resources do you provide that are specifically tailored to reach the American
Indian and/or Alaska Native populations you serve? Page 21.
26. What do you see as the most significant areas of remaining need, with regard to improving
services to victims/survivors of sexual assault, increasing victims/survivors safety, and
enhancing community response (including offender accountability for sex offenders)?
(Consider geographic regions, service delivery systems, jurisdictional issues, and challenges and
barriers unique to your service area and the population you serve.) Page 23.
27. What has T-SASP funding allowed you to do that you could not do prior to receiving this funding?
(e.g., expand coordination and cross-referrals with sexual assault agencies in your community.) Page 25.
Questions 28 and 29 are optional.
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED (8,000 CHARACTERS) FOR EACH QUESTION.
28. Provide any additional information that you would like us to know about your T-SASP grant 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 T-SASP funded program please provide it below.
Refer to separate instructions for a fuller explanation and examples.) Page 27.
29. 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 you reported
staff—e.g., victim advocates—but did not report any corresponding victim services, you may explain why;
or if you did not use T-SASP 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 29.
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.

T-SASP Semi-annual Progress Report • 17 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

Back to Instructions.

Report on the status of your T-SASP grant goals and objectives for the current and objectives as of the end of
the current reporting period.
Question #24
Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

T-SASP Semi-annual Progress Report • 18 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

Back to Instructions.

Report on the status of your T-SASP grant goals and objectives for the current and objectives as of the end of
the current reporting period.
Question #24 (cont.)
Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

T-SASP Semi-annual Progress Report • 19 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

Back to Instructions.

Report on the status of your T-SASP grant goals and objectives for the current reporting period.
Question #24 (cont. 2)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

T-SASP Semi-annual Progress Report • 20• Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

What services or resources do you provide that are specifically tailored to reach the American Indian and/or
Alaska Native populations you serve?
Question #25

T-SASP Semi-annual Progress Report • 21 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

What services or resources do you provide that are specifically tailored to reach the American Indian and/or
Alaska Native populations you serve?
Question #25 (cont.)

T-SASP Semi-annual Progress Report • 22 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

What do you see as the most significant areas of remaining need, with regard to improving services to
victims/survivors of sexual assault, increasing victims/survivors safety, and enhancing community response
(including offender accountability for sex offenders)?
Question #26

T-SASP Semi-annual Progress Report • 23 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

What do you see as the most significant areas of remaining need, with regard to improving services to
victims/survivors of sexual assault, increasing victims/survivors safety, and enhancing community response
(including offender accountability for sex offenders)?
Question #26 (cont.)

T-SASP Semi-annual Progress Report • 24 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

What has T-SASP funding allowed you to do that you could not do prior to receiving this funding?
Question #27

T-SASP Semi-annual Progress Report • 25• Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

What has T-SASP funding allowed you to do that you could not do prior to receiving this funding?
Question #27 (cont.)

T-SASP Semi-annual Progress Report • 26 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

Provide any additional information that you would like us to know about your T-SASP grant and/or the
effectiveness of your grant.
Question #28

T-SASP Semi-annual Progress Report • 27 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

Provide any additional information that you would like us to know about your T-SASP grant and/or the
effectiveness of your grant.
Question #28 (cont.)

T-SASP Semi-annual Progress Report • 28 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

Provide any additional information that you would like us to know about the data submitted.
Question #29

T-SASP Semi-annual Progress Report • 29 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Back to Instructions.

OMB Clearance # 1122-0024
Expiration Date: 10/31/2013

Provide any additional information that you would like us to know about the data submitted.
Question #29 (cont.)

T-SASP Semi-annual Progress Report • 30 • Office on Violence Against Women
THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.

Validate

THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.