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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.
- A nonresident fiduciary is a person who does not reside in Tennessee, or a bank or trust company not authorized to do business in Tennessee, that is appointed by will, deed, trust agreement, court order or otherwise to serve as trustee of a corporate or personal trust, personal representative of an estate, guardian, conservator for an incompetent person, guardian for a minor or in any other fiduciary capacity.
- Only certain types of individuals, banks or trust companies may serve as nonresident fiduciaries. Please consult Tennessee Code Annotated, Section 35-50-107 for a complete listing of qualified persons or entities.
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.
A nonresident person, bank or trust company cannot serve in a fiduciary capacity in Tennessee unless and until it has appointed in writing the Tennessee Secretary of State as its agent for service of process. This appointment authorizes the Secretary of State to receive and to forward to the nonresident fiduciary by registered or certified mail all process in any action or proceeding relating to any trust, estate or matter within this State in which the person, bank or trust company is serving as fiduciary.
The appointment document submitted to the Secretary of State must contain the following items:
- The name of the specific trust, estate, or person for which the fiduciary has been appointed;
- The name and out-of-state street address (including zip code) of the fiduciary;
- A statement clearly designating the Tennessee Secretary of State as agent for service of process;
- An original signature of the nonresident person or the representative of the bank or trust company (or a certified copy of the signed appointment document); and
- The date the document is signed.
- The appointment document need not be in affidavit form or notarized.
- The appointment document must be accompanied by a filing fee of $10.00. Please make checks or money orders payable to the Tennessee Secretary of State.
Agent Appointment by Nonresident Fiduciary form is also available.
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 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.
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.
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.