W. Va. Code R. § 153-37-4

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 153-37-4 - Program Participant Application and Certification Process

4.1. An applicant shall complete, date, sign and provide all the information required under W.Va. Code § 48-28A-103, and as requested on the application.

4.2. The application shall include an attestation by the applicant that disclosure of the applicant's address threatens the safety of the applicant or the applicant's children or the minor or incapacitated person on whose behalf the application is made.

4.3. An applicant shall specify a residential or mailing address in West Virginia for which confidentiality is requested and a telephone number where the applicant may be contacted by the Office of the Secretary of State.

4.4. The application form shall include, but not be limited to, the applicant's name and date of birth, a listing of all minor children residing with the applicant, including each minor child's date of birth, and each minor child's relationship to the applicant, a statement that the applicant shall not disclose her or his residential or mailing address to the alleged batterer, stalker, or person threatening her or his safety or that of her or his minor children, the application preparation date, the printed name and signature and recommendation of the application assistant.

4.5. Acceptance into the program shall be effective on the day an applicant is certified by the program manager.

4.6. An individual who is certified as a program participant shall be issued a program participant's authorization card which includes her or his name, authorization code, designated address and certification expiration date.

4.7. The term of a program participant's certification shall be four years unless the certification is withdrawn or canceled pursuant to W.Va. Code § 48-28A-104.

4.8. If there is a change in the program participant's residential or mailing address from the one listed on the application, the program participant shall notify the program manager in writing of such change within 10 days of the change in residence.

W. Va. Code R. § 153-37-4