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FY25 Population Certification Form

Instructions: Interested applicants must complete this electronic form by 11:59 p.m., Alaska time, on January 17, 2025, to signal their intent to participate in the FY 2025 Tribal Victim Services Set-Aside (TVSSA) Program. OVC will use this information to determine each applicant’s eligibility to receive Set-Aside funding. OVC will also apply a population-based administrative formula to calculate the maximum award amounts for each applicant. OVC cannot accept Population Certifications after the submission deadline. Applicants will receive an email confirming receipt of their Certification form. 

If you need assistance completing the form or are concerned about making the deadline, please email the OVC TVSSA team at: [email protected].  
 
Important Notes:

Please complete each question on this web form. Your answers make it possible for OVC to assess your eligibility for TVSSA funds accurately.

This form will not save data and may time out. You may edit the form for as long as you have the window open in your browser.

After completing your information, hit the "submit" button at the bottom of the form to send this Population Certification to OVC for review. Once submitted, you will receive a confirmation email with your data to review. Instructions for how to fix any errors will be included in the email.

Background Information
Use the legal entity name of your Tribe or organization as it appears in SAM.gov if applicable.
Has the applicant Tribe/Organization received TVSSA funding in a previous Fiscal Year?
This is the person filling out the form.
This is someone who can answer questions about the form for the primary contact if they are unavailable.
 
Applicant Type

Please Note: If you are applying for funding on behalf of at least one other Federally recognized Tribe you must choose “Tribal Consortium” or “Authorized Designee” as your applicant type, so that you can attach the required Tribal resolution(s).

An authorized designee or consortium applicant must submit documentation with this form demonstrating it has the requisite legal authority to submit this form on behalf of a Federally recognized Tribe(s). See Tribal Authorizing Resolution in the OJP Grant Application Resource Guide.

Upload Resolution or Equivalent Documentation

  • Upload a resolution (or a legal equivalent) for each Federally recognized Tribe that would receive services or assistance under a potential award. If you have more than one file, create a zipped folder (if you’ve never done this before, you can search for instructions specific to your computer in your web browser).
  • Uploads are limited to 256 MBs, if your file exceeds that size, email [email protected] to make arrangements to submit documentation.

One file only.
50 MB limit (all files must total 50 MB or less).
Allowed types: pdf, doc, docx, jpg, zip.
Population Data
You will be asked to submit your population tier, total population, and the source of the population data in this section.

Application-Defined Population Data: OVC generally will defer to the population information an applicant includes in its certification. If an applicant fails to specify a tier, OVC will place the applicant in Tier 1. If an applicant specifies a tier but does not include the total population, OVC will place the tribe in the specified tier.

However, for purposes of running the formula to calculate each tier’s funding allotment, OVC will account for missing population numbers by creating a proxy population number using the average population numbers of other tribes within the same tier.

Recordkeeping: An applicant must keep documentation supporting their population certification. Consortia or authorized designee applicants must also maintain documentation (e.g., tribal resolutions, communications from tribal enrollment/leadership officials, and/or consortium bylaws) demonstrating its authority to certify on behalf of each tribe(s) whose populations are included on their form. This documentation is subject to review and audit.
Please select the Name of the Tribe from the drop-down list. If you are certifying a population that is not a federally recognized Tribe, choose “other” in the drop-down menu and add details in the “Population Source” field. This dropdown list is in alphabetical order, grouped by the lower 48 states, followed by Alaska Native communities.
Enter numbers only, with no commas or special characters.
Select your tier from the drop-down menu.
Enter the state listed in the Tribe’s SAM.gov registration.
Specify the source(s) of the total population used to complete this form. (e.g., 2020 U.S. Census, Tribal membership rolls/enrollment data).
This button allows you to add the data for another Tribe.
Certification

By entering my information below, and by submitting this certification on behalf of the applicant named above, and in support of its application, I certify to the Office for Victims of Crime (OVC), U.S. Department of Justice, under penalty of perjury, that—

(1) all of the information provided in the Population Certification (including the population data) is true and correct;

(2) I have the authority to make this certification on behalf of the applicant (that is, the entity applying directly to OVC);

(3) the applicant has the authority to apply for this grant program, and provide the population data provided herein, on behalf of each tribe for which the applicant applies;

(4) the applicant will keep on file (see 2 C.F.R. 200.333, generally requiring retention of records for 3 years after grant closeout), and available for inspection or audit, documentation substantiating the population data provided herein (e.g., data sets used, or correspondence from the relevant tribal enrollment official(s) and tribal chair(s), resolution(s), etc. providing or confirming such data);

(5) I understand that OVC will rely on this certification as a material representation in any decision to make an award to the applicant entity; and

(6) in the event that, during pre-application review, OVC becomes aware of a reason to question the population data certified herein for the tribe(s), or the certifying authority, the applicant understands and agrees that OVC may (without further notice prior to the OVC action) deny this application (or, for consortia applicants, that tribe’s allocation), or use alternative data for that tribe(s) for the FY23 formula calculation.

(7) I understand and acknowledge that a materially false, fictitious, or fraudulent statement (or concealment or omission of a material fact) in this certification may be the subject of criminal prosecution, civil penalty, and/or administrative remedies (see 18 U.S.C. §§ 1001, 1621; 34 U.S.C. §§ 10271-10273; 31 U.S.C. §§ 3729-3730, 3801-3812).

Follow-up Information
Application Submission Type

If you are determined to be eligible for TVSSA funding, you will be offered three options for completing the narrative section of your application. Please indicate your preferred option:

Are you interested in funding a construction project with FY 2025 TVSSA funds?
Date Created: October 7, 2024