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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.
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.
- Complaints must be filed on a Title III HAVA complaint form. Complaint forms may be found at your local county election office, the State Coordinator of Elections office or online.
- All complaints must be in writing, notarized, signed, and sworn to by the complainant. The complaint may be filed with either the Coordinator of Elections or the local county election office.
- Once a formal complaint is filed, the Coordinator of Elections or designee will decide the resolution of the complaint.
- A complainant may request a hearing on the record.
- The Coordinator of Elections or designee will gather information which may include written responses from the parties. Once all the information is gathered, the Coordinator of Elections or designee will determine whether or not there is a violation of Title III.
- If it is determined that a violation of Title III has occurred, the State shall provide an appropriate remedy in accordance with Title III.
- If it is determined that no violation of Title III has occurred, the State shall publish the dismissed complaints of the procedures.
- A final determination must be made within 90 days of the complaint being filed. Only the complainant may agree to extend this period of time.
- If a final determination is not made within 90 days and no extension is granted, the complaint shall be resolved within 60 days through alternative dispute resolution. All previous proceedings, including the record and any correspondence, shall be forwarded to an administrative law judge for alternative dispute resolution.
Title IV of the Help America Vote Act requires each state to establish a state-based administrative complaint procedure. This procedure allows individuals to file a complaint if any person believes that a violation under Title III of the Help America Vote Act has occurred, is occurring or is about to occur.
A violation of Title III would include issues dealing with the following HAVA sections:
- voting system standards
- provisional voting
- voter information requirements
- statewide voter registration database and
- accessibility for persons with disabilities
If your complaint does not fall within one of the above categories, you may still file a complaint with your local county election office, the State Coordinator of Elections office or online using a general complaint form.
Program Participants are not subject to selection for state or municipal jury duty. T.C.A. § 40-38-607.
Program participants should not appear on state or municipal jury selection lists. If a program participant is selected for jury service, the summoning court should excuse the program participant.
If a program participant receives a jury summons for either state or municipal jury duty, the Participant must notify the summoning court of the participant's exempt status and provide a copy of the Participant's Certificate of Program Participation, if requested.
Participants may not fail to respond to a jury summons.
A complaint form may be filed with the State Coordinator of Elections office or with the local county election office.
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.
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.
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.
- Whenever a program participant is required by law to swear to or affirm the participant’s address, the participant may use the participant’s substitute address. T.C.A. §§ 40-38-602, 606.
- Wherever a program participant is required by law to establish residency, the participant may use the participant’s substitute address. T.C.A. §§ 40-38-602, 606.
- The substitute address may be used for motor vehicle records and may be printed on a drivers license. T.C.A. § 40-38-602.
- The substitute address may also be used as your official mailing address for all public utilities and public utility service providers. T.C.A. §§ 40-38-602, 606.
- Participants may also request that private entities use the substitute address, although they are not required to do so.
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.
Private businesses are not required by statute to accept a Safe at Home Participant's substitute address. However, private companies or agencies are encouraged to make every effort to keep a participant’s information safe by accepting the substitute address whenever possible. If agency or business employees have questions about using the substitute address, they may 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.
- When listing, appraising, or assessing property taxes;
- When collecting property taxes;
- On any document related to real property recorded with a county clerk or recorder.
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.
Program Participants must vote by absentee ballot. T.C.A. § 40-38-607.
Program participant absentee ballots must be treated as confidential and must be processed confidentially by the Administrator of Elections. Program participants shall appear in the statewide official voter registration list only by the Participant Identification Number.
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.
As authorized by law, properly designated law enforcement agency officials and administrative agency officials may request disclosure of information relating to a program participant. T.C.A. § 40-38-609. What information may be available to law enforcement or administrative agency officials?
- Properly designated law enforcement agency officials and administrative agency officials may request confirmation of program participation pertaining to a supposed program participant.
- Properly designated law enforcement agency officials and administrative agency officials may request disclosure of information pertaining to a program participant, including the confidential address, subject to the discretion of the Secretary of State. Program Participants may be entitled to prior notice and appeal rights.
- Disclosure of a participant’s confidential address, or any other information contained within a program participant’s file, shall be limited to ensure that the disclosure and dissemination of the confidential address will be no greater than necessary for the specific purpose for which it was requested.