What is the Administrative Request for Disclosure form?
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.
Can public utilities ask participants for their residential street address?
Program participants may be required to provide their residential street address to a public utility service provider for the purpose of obtaining utility services. However, participants can request that their residential address be treated as confidential by presenting the public service utility with a certificate of program participation.
After doing so, the public utility service provider must treat the residential address and all other identifying information as confidential in accordance with the Tennessee Public Records Act, compiled at Title 10, Chapter 7, Part 5.
What is the Petition for Review form?
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.
What is the Withdrawal Form?
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.
What is the Law Enforcement Request for Disclosure form?
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.