Title 030 | Chapter 010 | Regulation 020
PREVIOUS VERSION
The previous document that this document is based upon is available.
30 KAR 10:020.Application and certification.
Section 1.
Requirements for Application for Certification to Participate in the Safe at Home Program.(1)
Application for certification to participate in the Safe at Home Program shall be made to the Secretary of State by submitting a completed Application for Certification to Participate in Safe at Home Program, which shall contain:(a)
The applicant's full legal name;(b)
The applicant's date of birth;(c)
Any other names that may appear on the applicant's mail;(d)
The applicant's county of residence;(e)
The applicant's residential address;(f)
The applicant's phone number;(g)
The applicant's email address; and(h)
The applicant's dependent's legal names and identifying information (if applicable).(2)
The application shall include a sworn statement and acknowledge the following:(a)
I am an adult survivor of domestic violence, sexual assault, stalking, or human trafficking, or I am the parent of a child, or guardian of an adult individual, who is such a survivor, or I am a household member of such a survivor;(b)
I am not applying to participate in the Safe at Home Program to avoid prosecution of any kind. I confirm that I am not a sexually violent predator;(c)
I give permission to the Secretary of State's Office to verify my participation in the Safe at Home Program to state or local agencies when requested;(d)
I designate the Secretary of State as my agent for service of process and for the purpose of receipt of mail. If the Secretary of State accepts legal documents or certified mail addressed to me, it is as if I received them;(e)
I understand that my participation in the Safe at Home Program may be cancelled if :1.
I change my legal name and do not notify the Secretary of State's Office in writing prior to the change;2.
Mail forwarded by the Secretary of State's Office is returned as undeliverable by the United States Postal Service;3.
The Secretary of State accepts service of process on my behalf and I do not acknowledge it; or4.
My application contains false information;(f)
I understand that it is my responsibility to notify family, friends, businesses, and government agencies of my Safe at Home Program designated address. I recognize that if I share my confidential address, the Safe at Home Program cannot control its distribution;(g)
I realize that my mailing address may include an apartment number and that without this apartment number my mail may be delayed or may never reach me. I understand that the Safe at Home Program shall forward only first-class, legal, and certified mail, as well as packages of prescriptions;(h)
I understand that I am enrolled in the Safe at Home Program for a four (4) year term. At the end of this term, I realize that I am required to renew my enrollment or be cancelled from the program;(i)
I authorize the Safe at Home Program to notify the State Board of Elections to remove my physical and mailing address from voter registration documents that may be viewed by the public but maintain my physical address for the purpose of remaining registered and populated in the correct precinct.(j)
I realize that if I purchase or sell real estate, my information shall appear on public records;(k)
I understand that I am required to notify the Safe at Home Program if any of the information on my original application changes within fourteen (14) days;(l)
I understand that once I am enrolled in the Safe at Home Program, my actual address shall be confidential unless an agency has a bona fide statutory or administrative requirement for use of my address; and(m)
I understand that my children under the age of eighteen (18) may be enrolled with me as dependents and that individuals over the age of eighteen (18) are required to enroll separately. I realize that minors who turn eighteen (18) during participation in the program shall complete a renewal form at that time to continue Safe at Home Program participation.(3)
The Application for Certification to Participate in Safe at Home shall be:(a)
Notarized; and(b)
In English.Section 2.
Certification in the Safe at Home Program.(1)
The Secretary of State shall approve an Application for Certification to Participate in Safe at Home Program and certify the applicant as a program participant if the applicant and the Application for Certification to Participate in Safe at Home Program meet the requirements established in KRS 14.304 and this administrative regulation.(2)
The Secretary of State shall notify the applicant or filer whether the Application for Certification to Participate in Safe at Home Program was denied, or the applicant was certified as a program participant.(a)
If an Application for Certification to Participate in Safe at Home Program is denied, the Secretary of State shall inform the applicant or filer of the reason for the denial.(b)
If an applicant is certified as a program participant, the Secretary of State shall:1.
Assign to the program participant a participant number and designated address;2.
Issue to the program participant a Safe at Home Program Participant Card;3.
Provide information about the Safe at Home Program with instructions, frequently asked question and answers, and other information deemed necessary; and4.
Provide a general letter from the Secretary of State that the participant can provide to agencies.(3)
If an applicant is certified as a program participant, participation in the Safe at Home program shall be effective as of the date of the notification of certification.Section 3.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Application for Certification to Participate in Safe at Home Program", July 2023;(b)
"Address Confidentiality Program Participant Card", July 2023;(c)
"Safe at Home Program Participant Change of Information Form", July 2023;(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Secretary of State's Office, 700 Capital Avenue, State Capitol, Suite 152, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m., or may be obtained at sos.ky.gov.HISTORY: (50 Ky.R. 494, 1039; eff. 1-30-2024.)
FILED WITH LRC: October 10, 2023
CONTACT PERSON: Jennifer Scutchfield, Assistant Secretary of State, 700 Capital Avenue, State Capitol, Suite 152, Frankfort, Kentucky 40601, phone (502) 782-7417, fax (502) 564-5687, email jscutchfield@ky.gov.
30 KAR 10:020.Application and certification.
Section 1.
Requirements for Application for Certification to Participate in the Safe at Home Program.(1)
Application for certification to participate in the Safe at Home Program shall be made to the Secretary of State by submitting a completed Application for Certification to Participate in(a)
The applicant's full legal name;(b)
The applicant's date of birth;(c)
Any other names that may appear on the applicant's mail;(d)
The applicant's county of residence;(e)
The applicant's residential address;(f)
The applicant's phone number;(g)
The applicant's email address; and(h)
The applicant's dependent's legal names and identifying information (if applicable).(2)
The application shall(a)
I am an adult survivor of domestic violence, sexual assault, stalking, or human trafficking, or I am the parent of a child, or guardian of an adult individual, who is such a survivor, or I am a household member of such a survivor;(b)
I am not applying to participate in the Safe at Home Program(c)
I give permission to the Secretary of State's Office to verify my participation in the Safe at Home Program to state or local agencies when requested;(d)
I designate the Secretary of State as my agent for service of process and for the purpose of receipt of mail.(e)
I understand that my participation in the Safe at Home Program may be cancelled if1.
I change my legal name and do not notify the Secretary of State's Office in writing prior to the change;2.
Mail forwarded by the Secretary of State's Office is returned as undeliverable by the United States Postal Service;3.
4.
(f)
I understand that it is my responsibility to notify family, friends, businesses, and government agencies of my Safe at Home Program designated address. I recognize that if I share my confidential address, the Safe at Home Program cannot control its distribution;(g)
I realize that my mailing(h)
I understand that I am enrolled in the Safe at Home Program for a four (4) year term. At the end of this term, I realize that I am required(i)
I authorize the Safe at Home Program to notify the State Board of Elections to remove my physical and mailing address from voter registration documents that may(j)
I realize that if I purchase or sell real estate, my information shall(k)
I understand that I am required to(l)
I understand that once I am enrolled in the Safe at Home Program, my actual address shall(m)
I understand that my children under the age of eighteen (18) may be enrolled with me as dependents and that(3)
The Application for Certification to Participate in Safe at Home shall be:(a)
Notarized; and(b)
In English.Section 2.
Certification in the Safe at Home Program.(1)
The Secretary of State shall approve an Application for Certification to Participate in Safe at Home Program and certify the applicant as a program participant if the applicant and the Application for Certification to Participate in Safe at Home Program meet the requirements established in KRS 14.304(2)
The Secretary of State shall notify the applicant or filer whether the Application for Certification to Participate in Safe at Home Program was denied, or the applicant was certified as a program participant.(a)
If an Application for Certification to Participate in Safe at Home Program is denied, the Secretary of State shall inform the applicant or filer of the reason for the denial.(b)
If an applicant is certified as a program participant, the Secretary of State shall:1.
Assign to the program participant a participant number and designated address;2.
Issue to the program participant a Safe at Home Program Participant Card;3.
Provide information about the Safe at Home Program with instructions, frequently asked question and answers, and other information deemed necessary; and4.
Provide a general letter from the Secretary of State that the participant can provide to agencies.(3)
If an applicant is certified as a program participant, participation in the Safe at Home program shall be effective as of the date of the notification of certification.Section 3.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Application for Certification to Participate in Safe at Home Program", July 2023;(b)
"Address Confidentiality Program Participant Card", July 2023;(c)
"Safe at Home Program Participant Change of Information Form", July 2023;(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Secretary of State's Office, 700 Capital Avenue, State Capitol, Suite 152, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m., or may be obtained at sos.ky.gov.HISTORY: (50 Ky.R. 494, 1039; eff. 1-30-2024.)
FILED WITH LRC: October 10, 2023
CONTACT PERSON: Jennifer Scutchfield, Assistant Secretary of State, 700 Capital Avenue, State Capitol, Suite 152, Frankfort, Kentucky 40601, phone (502) 782-7417, fax (502) 564-5687, email jscutchfield@ky.gov.