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.

If you are unsure as to what type of business (i.e. Corporation, Limited Liability Company, Partnership, etc.), you may need to contact an attorney or tax professional, as this office is unable to assist in that determination. For information on types of business entities and tax, treatments consult the IRS, Tennessee Office of the U.S. Small Business Administration or the Business Enterprise Resource Office (BERO) at the Tennessee Department of Economic and Community Development.

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.

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.

You may obtain Form #SS-4507, Application for Certification of Municipal Clerks & Recorders and Continuing Education Credit, from our website or upon request from our office. 

For certification, the application must be accompanied by a copy of the certificate(s) from the institution(s) at which the qualifications were completed.  The certificate(s) (other than a degree) should indicate the number of hours completed.  If credit is claimed for job-related seminars, then documents must also be submitted outlining seminar content. 

For continuing education credit, the application must be accompanied by a copy of the certificate(s) of attendance and a statement as to the number of credit hours completed.  If credit is claimed for job-related seminars, then documents must also be submitted outlining seminar content. Please note that the Division of Business Services does not pre-certify seminars for content applicability or for applicable credit hours. Applications are accepted by mail, fax or in person. Upon receipt and approval of an application, the Division of Business Services will issue to the applicant a certificate confirming the certification or continuing education credit. 

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 municipality with a population of 1,500 or more according to the 1990 Federal Census or any subsequent Federal Census, which employs an officer or employee responsible for exercising any of the duties of Municipal Clerk & Recorder, must have at least one certified person.   For other municipalities, certification is optional. 

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.

1. The correct fee is not paid. The annual report fee for a corporation is $20, and an additional $20 is required if any change is made concerning the registered agent/registered office. The annual report fee for LLCs is $300 minimum up to a maximum of $3000. The fee increases by an additional $50 per member for every member over 6 members up to a maximum of $3,000.
2. An officer is not listed. If the business is a Tennessee for-profit corporation, the corporation must list at least one officer. If the business is a Tennessee nonprofit corporation, a president and secretary or required.
3. The board of directors are not listed, the box indicating that the board is the same as the officers listed is not marked, or the box indicating that the corporation does not have directors is not marked.
4. The annual report is not signed and/or dated.
5. The annual report is not typed or filled out in ink.

To retain certification, a certified person is required to attend a minimum of  18  hours of continuing education courses every  3  years.   This requirement may be met by attending a minimum of 18 credit hours from any of the following or combination thereof, provided that the hours were not used to complete the required hours of education for certification: 

• The Academy for Advanced Education (U.T.);
• The International Institute of Municipal Clerks annual conference or state, provincial or regional clerks meetings;
• Seminars conducted by the Tennessee Municipal League;
• Leadership and Technical Programs (U.T. Municipal Training); or 
• Job-related seminars.

• Any person who is licensed to practice law in Tennessee and who satisfies continuing legal education requirements  
• Any person who has been appointed or is acting in the capacity of  a city manager or administrator and who possesses a M.A. degree in public administration  
• Any person who is a certified public accountant holding a certificate as provided in Section 62-1-106 or Section 6-1-107
• Any person who has served as both a city judge and city recorder for at least 25 years

To be certified, a person must obtain certification from the International Institute of Municipal Clerks or must complete a minimum of 100 credit hours from any of the following or combination thereof:

• The Municipal Clerks Institute (U.T.); 
• The U.T. Center for Government Training
• Seminars conducted by the Tennessee Municipal League;  
• Leadership and Technical Programs (U.T. Municipal Training); 
• Job-related seminars; or 
• An A.A. or A.S. degree (maximum credit of 25 hours) or a B.A. or B.S. degree (maximum credit of 50 hours), provided that credit will be given for only one degree.