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Letter from the State of Hawaii Department of the Attorney General stating the Grantee is a non-profit organization operating within the State of Hawaii.
DEPARTMENT OF THE ATTORNEY GENERAL Crime Prevention and Justice Assistance Division

CERTIFICATION OF NON-PROFIT STATUS AND

STATEMENT REGARDING PUBLICATION OF FINANCIAL STATEMENTS

The Department of Justice, Office of Justice Programs, Office for Victims of Crime (OVC) requires non-profit organizations that receive Victims of Crime Act (VOCA) Assistance funding to certify their non-profit status. (42 U. S. C. Chapter 112)

The undersigned certifies, to the best of his or her knowledge and belief, that:

1. As of the date of this Certification and Statement, the (name of Grantee) is a non-profit organization, as defined by the State of Hawaii Department of Taxation.

2. The __________________ (name of Grantee) has the following documentation on file that can be made available upon audit. (Please check one of the following documents.)

□ Grantee’s 501(c)(3) designation letter.

□ Letter from the State of Hawaii Department of Taxation stating the Grantee is a non-profit organization operating within the State of Hawaii.

□ Letter from the State of Hawaii Department of the Attorney General stating the Grantee is a non-profit organization operating within the State of Hawaii.

□ Grantee’s State of Hawaii certificate of incorporation that substantiates its non-profit status.

□ For local non-profit affiliates of state/territory or national non-profits: One of the above four documents (check one of the above boxes to identify) and a statement issued by the state/territory or national parent organization that the Grantee is a local non-profit affiliate.

Non-profit organizations that receive VOCA Assistance funding must make its financial statements available online on a publically available website. An organization that has Federal 501(c)(3) tax status will be considered to be in compliance with this requirement, with no further action needed, to the extent that such organization files IRS Form 990 or similar tax document (e.g., 990-EZ), as several sources already provide searchable online databases of such statements. The undersigned certifies, to the best of his or her knowledge and belief, that:

As of the date of this Certification and Statement, the Grantee is in compliance with the requirement regarding the publication of financial statements as follows. (Please check one of the following statements.)

□ Grantee’s financial statements are available online at the following website:

URL: _____________________________________________________

□ Grantee has Federal 501(c)(3) tax status and has filed IRS Form 990 or similar tax document (e.g., 990-EZ).





SUBMITTED BY:

Signature: Date:

Name: Title: (Head of Grantee Agency or Designee)

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