Missouri Regulations § 15 CSR 30-70.030 Program Participant Application and Certification Process

(1) An applicant to the program shall complete and sign the standard application form provided by the secretary and provide all the information required under section 589.663 RSMo and these rules. The standard application form shall include, but not be limited to, the date the application was prepared; the applicant's signature; and the signature and registration number of the application assistant who assisted the applicant in applying to become a program participant, as provided in section 589.663 RSMo; a designation of the secretary as agent for purposes of service of process and for receipt of first-class mail, legal documents, and certified mail; a signed statement that the applicant has good reason to believe that the applicant is a victim as defined by the statute or resides in the same household as a victim and fears future harm; a mailing address where the applicant may be contacted by the secretary and the telephone number or numbers where the applicant may be called by the secretary; and one (1) or more address(es) that the applicant requests not be disclosed for the reason that disclosure will jeopardize the applicant's safety or increase the risk of violence to the applicant or members of the applicant's household. The applicant shall be provided the option to sign a form authorizing the secretary, or the secretary's designee, to open and review legal documents addressed to the program participant at the designated address, including, but not limited to, summonses, writs, demands, notices, or service of process that are delivered by personal service, certified mail, or United States Postal Service before forwarding such documents to the participant, to enable the secretary to notify the participant if an immediate response is required from the participant. The applicant may attach any relevant supporting documentation such as police reports or court documents to the application. The program participant application form, 2018, incorporated herein by reference, is published by the Missouri Secretary of State, PO Box 1767, Jefferson City, MO 65102-1767. This form does not include any amendments or additions. The form is available at the secretary of state's office or may be obtained by email to safeathome@sos.mo.gov or by mailing a written request to Safe at Home, PO Box 1409, Jefferson City, MO 65102-1409.

(2) The application assistant who assists the applicant shall provide the applicant with the opportunity to register to vote or to change the name or address on the applicant's voter registration record on forms provided by the secretary. The completed voter registration application shall not contain the applicant's address. The completed voter registration application shall be transmitted to the secretary with the applicant's completed program application.

(3) The application assistant who assists the applicant shall forward by first-class mail or by facsimile transmission (FAX) the completed application to the program manager of the secretary within twenty-four (24) hours of completion. If the application is forwarded by FA X the application assistant shall also mail the original application to the secretary. The application assistant shall not keep a copy of the completed application. The secretary shall provide return envelopes and a FA X number to application assistants to expedite return of the program applications.

(4) A properly completed application shall be effective on the day that it is certified by the program manager. The program manager shall, within five (5) business days of receipt of a completed application, either certify the applicant for participation in the program or notify the applicant of the reason(s) why the applicant was not certified.

(5) An individual who is certified as a program participant shall be issued an authorization card/letter which includes the participant's name, authorization code, designated address, voter code, signature, and certification expiration date immediately upon certification by the program manager.

(6) The term of a program participant's certification shall be four (4) years following the certification date of the application unless the certification is withdrawn by the participant or canceled by the secretary before that date pursuant to section 589.666 , RSMo or these rules. The program manager shall send a program participant notification of an expiring certification and a renewal form not later than four (4) weeks prior to the expiration of the program participant's certification.

(7) If there is a change in the program participant's name, mailing address, or other address from the one (1) listed on the application, the program participant shall notify the program manager of such change within ten (10) days of the change on a form prescribed by the secretary.