Certifying Agency Reporting Form 2023

RCW 7.98.020 (6)(c) requires each certifying agency identified in RCW 7.98 to: "Keep written documentation regarding the number of victims who requested certifications, the number of certification forms that were signed, the number of certification forms that were denied, and the number of certification forms that were withdrawn, which must be reported to the Office of Crime Victims Advocacy on an annual basis."

 
 

This form is for July 1, 2022 through June 30, 2023. The data is due BY AUGUST 15, 2023

If no U&T Visas were received, please enter "0" and submit.

 
 
 

If yes, check the box.

 

Please select the city that your agency is located in. You can type ahead to filter the list.

 

Please enter the zip code that your agency is located in.

 

Please select the county that your agency is located in. You can type ahead to filter the list.

 
 
 
 
mm/dd/yyyy
 

Please enter the number of certification requests received during the reporting period,

 

Please enter the number of certification requests that were signed during the reporting period,

 

Please enter the number of certification requests that were denied during the reporting period,

 

Please enter the number of certification requests that were withdrawn during the reporting period,

 

This is not a required field. However, if your agency tracks the number of requests that are pending determination, please enter that information here.

 
 

If you have any additional comments on the information provided, please provide that here. Although not required, you could indicate the reasons for denied and/or withdrawn requests as an example.

 
 

Please enter your email address for any follow up questions.

 
 
 
 

Thank you for providing this information. It provide important data regarding U and T visa certifications in the state of Washington.