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ATTACHMENT G <br />CONSULTATION WITH VICTIM SERVICES PROVIDERS <br />(Criminal Justice Applicants Only) <br />Criminal justice applicants are required to consult with their local sexual assault and domestic violence victim <br />service providers on their application activities. Criminal justice applicants should consult with their Community <br />Sexual Assault Program (CSAP) and the Department of Social and Health Services (DSHS) Shelter Funded Domestic <br />Violence Agency. Tribal criminal justice agencies should consult with their Tribal Victim Services Program. This <br />requirement is to ensure that proposed activities by criminal justice agencies are designed to promote the safety <br />and economic independence of victims of domestic violence, sexual assault, stalking, and dating violence. <br />As verification of this requirement, criminal justice agencies must discuss their STOP Grant activities with the <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 />Note for Victim Services Providers <br />Please answer and sign below and then return this page to the criminal justice applicant to be included in their <br />renewal application to OCVA. <br />1. Do you agree that the proposed criminal justice activities promote the safety and economic independence <br />of domestic violence, sexual assault, dating violence or stalking victims (age 11 and older) in your <br />jurisdiction? <br />121 Yes ❑ No <br />Community Sexual Assault Program Name Providence Intervention Center for Assault and Abuse <br />Signature of CSAP Authorized Official <br />DSHS Shelter Funded Domestic Violence Agency Name Domestic Violence Services of Snohomish County <br />Signature of DSHS Shelter Authorized Official <br />Tribal Victim Services Program Name <br />Signature of Tribal Victim Services Program Authorized Official <br />Note to Victim Services Providers: If you answered "no" to the above question, please provide details regarding <br />the process and steps necessary to address concerns with the application. <br />Washington State STOP Formula Grant Program Renewal Application for FFY 2022 <br />25 <br />