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1 <br /> 1 <br /> 0` i <br /> t <br /> Washington State STOP Formula Grant Program Renewal Application for FFY 2019 <br /> CONSULTATION WITH VICTIM SERVICES PROVIDERS <br /> (Criminal Justice Applicants Only) <br /> i <br /> Criminal justice applicants are required to consult with their local sexual assault and domestic violence victim i <br /> service providers on their application activities.Criminal justice applicants should consult with their Community l <br /> Sexual Assault Program (CSAP) and the Department of Social and Health Services(DSHS)Shelter Funded <br /> Domestic Violence Agency.Tribal criminal justice agencies may instead consult with their Tribal Victim Services <br /> Program.This requirement is to ensure that proposed activities by criminal justice agencies are designed to i <br /> promote the safety and economic independence of victims of domestic violence,sexual assault,stalking,and <br /> i <br /> dating violence. i <br /> a <br /> As verification of this requirement, criminal justice agencies must discuss their STOP Grant activities with the x <br /> appropriate victim services agencies and ask the authorized official to sign this form.In counties where the CSAP <br /> is separate from the DSHS shelter-funded domestic violence agency,the applicant can print two copies of this <br /> form to enable both Executive Directors to respond and sign. <br /> f.s <br /> Note for Victim Services Providers 1 <br /> Please answer and sign below and then return this page to the criminal justice applicant to be included in their c <br /> application to OCVA. g <br /> 1. Since your participation in the development of the initial application,do you still agree that the proposed ei <br /> criminal justice activities promote the safety and economic independence of domestic violence,sexual I <br /> assault,dating violence or stalking victims(age 11 and older) in your jurisdiction? 1 <br /> © Yes ❑ No 6 <br /> Community Sexual Assault Program Name Provi•- ,e Interv- tion Center for Assault and Abuse <br /> ____:___:"..•00_ <br /> / a <br /> Sign. re of CSAP Authorized Official <br /> u. <br /> i <br /> DSHS Shelter Funded Domestic Violence Agency Name <br /> Signature of DSHS Shelter Authorized Official . i <br /> Tribal Victim Services Program Name ti <br /> 1 <br /> I <br /> Signature of Tribal Victim Services Program Authorized Official �II <br /> 5[ <br /> Victim Services Providers:If you answered "no"to the above question,please provide details regarding the j <br /> process and steps necessary to address concerns with the application. <br /> 19 <br /> 77 <br />