Washington Administrative Code
Title 434 - Secretary of State
Chapter 434-840 - Address confidentiality program
Section 434-840-010 - Application process
Universal Citation: WA Admin Code 434-840-010
Current through Register Vol. 24-06, March 15, 2024
(1) The secretary of state shall certify an applicant as a program participant when the secretary of state receives an application that contains:
(a) The full legal name and date of birth of
the applicant(s);
(b) A listing of
all minor children residing at the residential address, each minor child's full
legal name, and each minor child's date of birth, and each minor child's
relationship to the applicant;
(c)
A listing of all adults residing at the residential address requesting
participation, each adult's full legal name, date of birth, and relationship to
the applicant;
(d) The applicant's
actual Washington state residential address;
(e) The telephone number of the
applicant(s);
(f) The address to
which mail should be sent, this may be the same as the residential
address;
(g) A sworn statement,
under penalty of perjury, by the applicant, that the applicant has good reason
to believe either:
(i) That the applicant, or
the minor or incapacitated person on whose behalf the application is made, is a
victim of domestic violence, sexual assault, trafficking, or stalking, and that
the applicant fears for their safety or the safety of their children, or the
safety of any minor children or incapacitated person on whose behalf the
application is made; or
(ii) That
the applicant, as a criminal justice participant as defined in
RCW
9A.46.020, is a target for threats or
harassment prohibited under
RCW
9A.46.020.
(h) The state of Washington personnel number,
if the applicant or any of the persons covered by the application is a
Washington state employee;
(i) The
applicant's signature;
(j) The date
on which the applicant signed the application;
(k) The signature, printed name, and phone
number of the application assistant designated by the secretary of state under
RCW
40.24.080 who assisted in preparation of the
application;
(1) A designation of the
secretary of state to act as legal agent for purposes of service of process and
for the purpose of receipt of mail.
(2) The completed application and any
additional materials shall be submitted to the secretary of state;
and
(3) If the completed
application does not meet the requirements of this part, the secretary of state
will contact the applicant to obtain missing information. The applicant shall
be certified only if the missing information is provided.
Statutory Authority: RCW 40.24.090. 08-23-094, § 434-840-010, filed 11/19/08, effective 12/20/08; 98-19-063, § 434-840-010, filed 9/16/98, effective 10/17/98. Statutory Authority: 1991 c 23. 91-20-074, § 434-840-010, filed 9/26/91, effective 10/27/91.
Disclaimer: These regulations may not be the most recent version. Washington may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.