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This form should be submitted only by program participants who no longer wish to participate in the Safe at Home Program. Remember that your withdrawal request must be properly signed and notarized in order to be processed.
Use this form to request that the Secretary of State verify your eligibility, and the eligibility of your children, for enrollment in public benefits programs or public schools. Participants should fill in their information and take this form to the public benefits agency or public school to be completed by a case manager or registrar. The form should then be submitted directly to the Safe at Home Program for verification and certification. Participants must ensure that their residential address is up to date and that the Safe at Home Program has fully verified their residential address prior to submitting the form.
se this form to let the Safe at Home Program know about any changes in your contact information, your household composition, and more. If you have any questions about this form, please contact the Safe at Home program directly for assistance. Remember that any changes to your contact information or your application information should be reported to the Safe at Home Program within 30 days from the date the change occurred.
This form is intended for use only by authorized administrative agency officials at either the state or local level. If you have questions regarding this form, please contact the Safe at Home Program directly.
Use this form to let the Safe at Home Program know that you have legally changed your name. Be sure to attach documentation of the change to your submitted form. Remember that a legal change of your name must be reported to the Safe at Home Program within 10 days of the change.
This form is intended for use only by authorized law enforcement officials to request disclosure of information pertaining to a program participant. If you have questions regarding this form, please contact the Safe at Home Program directly.
Use this form to request a contested case hearing. Participants may request a contested case hearing if they have been notified that their program participation is to be terminated, with limited exceptions, or when they have been notified that their confidential information has been requested by an administrative agency and the Secretary of State has determined that some or all of their information should be disclosed. If you think that you may want to request a contested case hearing, please contact the Safe at Home Program directly to discuss your concerns.
Use this form to request that the Safe at Home Program facilitate the transfer of records from one public school to another. Safe at Home is also happy to facilitate the transfer of records to or from a private school to another school, public or private.
This form should be used only by victims services professionals and other advocates who wish to be trained and certified as an Application Assistant. Please contact the Safe at Home Program directly for more information regarding upcoming training sessions or to schedule a training in your area.
- Corporations*
- Limited Liability Companies (LLC’s)*
- Limited Partnerships (LP’s)*
- Limited Liability Partnerships (LLP’s)*
- General Partnerships+
*All of the above business entities file formation documents.
+Filings by general partnerships are not for the purpose of forming or maintaining a general partnership in Tennessee. Document filing is for the purpose of providing public notice of basic information about a general partnership, such as the agency authority of its partners, and such filings are optional and voluntary.
A specimen is an actual example of the use of the mark in commerce. It is the means by which the public would view your mark and be aware of the specific goods or services offered.
For trademarks, examples of acceptable specimens are tags or labels that are attached to the goods, containers for the goods, displays associated with the goods, or photographs of the goods showing use of the mark of the goods themselves. Invoices, announcements, order forms, bills of lading, leaflets, brochures, catalogs, publicity release, letterhead and business cards may be acceptable specimens for trademarks if they sufficiently demonstrate that the mark is being used with the goods. If it is impractical to send the actual specimens because of its size, photographs or other acceptable reproductions that show the mark on the goods, or packaging for the goods, must be furnished.
For services marks, examples of acceptable specimens are signs, brochures about the services, advertisements for the services, business cards or stationary showing the mark in connection with the services, or photographs that show the mark either as it is used in the rendering or advertising of the services. The specimen must either show the mark and include some clear reference to the type of services rendered under the mark in some form of advertising, or show the mark as it is used in the rendering of the service (for example, on a store front or the side of a delivery truck).
The specimen should not be larger than 8 ½ inches by 11 inches and should be flat. Small specimens, such as tags or labels, must be taped or pasted to a sheet of paper and labeled “SPECIMEN”.
The reasons for rejection include, but are not necessarily limited to:
- An incomplete form is submitted. All blanks must be filled in for both registration and renewal applications.
- An acceptable specimen is not provided. A specimen is required for both registration and renewal applications.
- No signature.
- Incomplete dates. Dates must include month, day and year.
- The application is completed in pencil. All registration and renewal applications must be typewritten or completed in ink.
- Failure to include the $20.00 per classification filing fee.
- Failure to include the type of goods and/or services to be provided.
- Failure to include the mode or manner of use.
- Failure to include a classification in the application.
- A new owner is listed in a renewal application.