Certification Form (Page 3 of 4) in pdf

INSTRUCTIONS

Completing the Certification Form

Compliance with the Equal Employment Opportunity Plan (EEOP) Requirements

The federal regulations implementing the Omnibus Crime Control and Safe Streets Act (Safe Streets Act) of 1968, as

amended, require some recipients of financial assistance from the U.S. Department of Justice subject to the statute’s

administrative provisions to create, keep on file, submit to the Office for Civil Rights (OCR) at the Office of Justice

Programs (OJP) for review, and implement an Equal Employment Opportunity Plan (EEOP). See 28 C.F.R. pt. 42, subpt.

E. All awards from the Office of Community Oriented Policing Services (COPS) are subject to the EEOP requirements;

many awards from OJP, including awards from the Bureau of Justice Assistance (BJA), the Office of Juvenile Justice and

Delinquency Prevention (OJJDP), and the Office for Victims of Crime (OVC) are subject to the EEOP requirements; and

many awards from the Office on Violence Against Women (OVW) are also subject to the EEOP requirements. If you

have any questions as to whether your award from the U.S. Department of Justice is subject to the Safe Streets Act’s

EEOP requirements, please consult your grant award document, your program manager, or the OCR.

Recipients should complete either Section A or Section B or Section C, not all three. If recipient completes Section

A or C and sub-grants a single award over $500,000, in addition, please complete Section D.

Section A

The regulations exempt some recipients from all of the EEOP requirements. Your organization may claim an exemption

from all of the EEOP requirements if it meets any of the following criteria: it is a nonprofit organization, an educational

institution, a medical institution, or an Indian tribe; or it received an award under $25,000; or it has less than fifty

employees. To claim the complete exemption from the EEOP requirements, complete Section A.

Section B

Although the regulations require some recipients to create, maintain on file, and implement an EEOP, the regulations

allow some recipients to forego submitting the EEOP to the OCR for review. Recipients that (1) are a unit of state or local

government, an agency of state or local government, or a private business; and (2) have fifty or more employees; and (3)

have received a single grant award of $25,000 or more, but less than $500,000, may claim the limited exemption from the

submission requirement by completing Section B. In completing Section B, the recipient should note that the EEOP on

file has been prepared within twenty-four months of the date of the most recent grant award.

Section C

Recipients that (1) are a unit of state or local government, an agency of state or local government, or a private business,

and (2) have fifty or more employees, and (3) have received a single grant award of $500,000 or more, must prepare,

maintain on file, submit to the OCR for review, and implement an EEOP. Recipients that have submitted an EEOP

Utilization Report (or in the process of submitting one) to the OCR, should complete Section C.

Section D

Recipients that (1) receive a single award over $500,000; and (2) subaward a single award of $500,000 or more must

provide a list; including, name, address and DUNS # of each such sub-recipient by completing Section D.

Submission Process

Recipients should download the online Certification Form, complete required sections, have the appropriate official sign

it, electronically scan the signed document, and then send the signed document to the following e-mail address:

EEOPForms@usdoj.gov. The document must have the following title: EEOP Certification. If you have questions about

completing or submitting the Certification Form, please contact the Office for Civil Rights, Office of Justice Programs,

810 7th Street, NW, Washington, DC 20531 (Telephone: (202) 307-0690 and TTY: (202) 307-2027).

OMB Approval No. 1121-0340 Expiration Date: 12/31/15

Certification Form Page 3