2A-7.0022. Application Process

(1) The applicant shall provide the following information to the department:

(a) Full legal name,

(b) Date of birth,

(c) Last four digits of social security number,

(d) Actual home address (street number and name, city, state, zip code),

(e) Mailing address (if different),

(f) Home telephone number,

(g) Work telephone number,

(h) Other telephone number where applicant can be reached,

(i) Name and physical address of employer(s),

(j) School name and physical address if applicable,

(k) A signed and dated sworn statement by the applicant that he or she has good reason to believe that he or she, or the minor or incapacitated person on whose behalf the application is made, is a victim of domestic violence or stalking, and that the applicant fears for his or her safety or his or her children’s safety or the safety of the minor or incapacitated person on whose behalf the application is made.

(2) An application for enrollment may be obtained from an applicant assistant at selected state or local agencies or non-profit organizations that have been designated by the department to assist in the application process.

(3) The application must be received by the department at the following address: Office of the Attorney General, Address Confidentiality Program, P. O. Box 6298, Tallahassee, Florida 32314-6298.

(4) An eligible applicant who has filed a properly completed application with the department shall be certified as a participant. Upon certification, each participant will be issued an authorization card, which will include the following:

(a) Participant’s name,

(b) Authorization code,

(c) Substitute mailing address, and

(d) Expiration date.

(5) Certification shall be effective on the date the application is approved by the department.

(6) Mail received by the department that does not include the name and authorization code of a certified participant may not be able to be forwarded.

(7) If mail forwarded by the department to the participant is returned by the post office, the department will attempt to contact the participant by telephone to verify the address. If contact is not successful within seven days, the participant’s certification will be cancelled and the mail will be returned to the United States Postal Service.

Rulemaking Authority 741.409 FS. Law Implemented 741.403, 741.404, 741.405, 741.406, 741.409, 741.465, 741.4651 FS. History–New 5-4-11, Amended 10-3-11.