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ATTACHMENT C <br />ACKNOWLEDGEMENT OF NOTICE OF STATUTORY REQUIREMENT TO COMPLY WITH THE CONFIDENTIALITY <br />AND PRIVACY PROVISIONS OF THE VIOLENCE AGAINST WOMEN ACT, AS AMENDED <br />(Non -Profit Victim Services Providers Only) <br />Under section 40002(b)(2) of the Violence Against Women Act, as amended (42 U.S.C. 13925(b)(2)), grantees and <br />subgrantees with funding from the Office on Violence Against Women are required to meet the following terms <br />with regard to nondisclosure of confidential or private information and to document their compliance. By <br />signature on this form, applicant for the STOP Grant acknowledges that they have notice that, if awarded funds, <br />they will be required to comply with this provision, and will mandate that subgrantees, if any, comply with this <br />provision, and will create and maintain documentation of compliance, such as policies and procedures for release <br />of victim information, and will mandate that subgrantees, if any, will do so as well. <br />(A) In general <br />In order to ensure the safety of adult, youth, and child victims of domestic violence, dating violence, sexual assault, <br />or stalking, and their families, grantees and subgrantees under this subchapter shall protect the confidentiality <br />and privacy of persons receiving services. <br />(B) Nondisclosure <br />Subject to subparagraphs (C) and (D), grantees and subgrantees shall not -- <br />(i) disclose, reveal, or release any personally identifying information or individual information collected in <br />connection with services requested, utilized, or denied through grantees' and subgrantees' programs, regardless <br />of whether the information has been encoded, encrypted, hashed, or otherwise protected; or <br />(ii) disclose, reveal, or release individual client information without the informed, written, reasonably time -limited <br />consent of the person (or in the case of an unemancipated minor, the minor and the parent or guardian or in the <br />case of legal incapacity, a court -appointed guardian) about whom information is sought, whether for this program <br />or any other Federal, State, or Tribal grant program, except that consent for release may not be given by the <br />abuser of the minor, incapacitated person, or the abuser of the other parent of the minor. <br />If a minor or a person with a legally appointed guardian is permitted by law to receive services without the parent's <br />or guardian's consent, the minor or person with a guardian may release information without additional consent. <br />(C) Release <br />If release of information described in subparagraph (B) is compelled by statutory or court mandate -- <br />(i) grantees and subgrantees shall make reasonable attempts to provide notice to victims affected by the <br />disclosure of information; and <br />(ii) grantees and subgrantees shall take steps necessary to protect the privacy and safety of the persons affected <br />by the release of the information. <br />(D) Information sharing <br />(i) Grantees and subgrantees may share -- <br />(1) nonpersonally identifying data in the aggregate regarding services to their clients and nonpersonally <br />identifying demographic information in order to comply with Federal, State, Tribal or territorial reporting, <br />evaluation, or data collection requirements; <br />Washington State STOP Formula Grant Program Renewal Application for FFY 2022 17 <br />