| (a) An application must be submitted through the form
published on the OAG website, and must be signed, dated, and affirm
the following:
(1) the applicant fears for the safety of the applicant,
the applicant's child, or another person in the applicant's household
because of threat of immediate or future harm by a person alleged
to have committed family violence, a sexual offense, stalking, or
trafficking of persons;
(2) the applicant lives at, or will relocate to, a
residential address that is, to the best of their knowledge, unknown
to the person who committed the alleged family violence, sexual offense,
stalking, or trafficking of persons;
(3) if there is an existing court order or a pending
court case for child support or child custody or visitation that involves
the applicant, the name of the legal counsel of record and each parent
involved in the court order or pending case; and
(4) the applicant designates the OAG as agent to receive
service of process and mail on behalf of the applicant.
(b) In addition to the application, the OAG may require
an applicant to submit independent documentary evidence that family
violence, a sexual offense, stalking, or trafficking of persons occurred.
Independent documentary evidence may include, but is not limited to:
(1) an active or recently issued protective order;
(2) an incident report or other record maintained by
a law enforcement agency or official;
(3) a statement from a physician or other health care
provider regarding the applicant's medical condition as a result of
the family violence, sexual offense, stalking, or trafficking of persons;
(4) a statement from a mental health professional,
a member of the clergy, an attorney or other legal advocate, a trained
staff member of a family violence center, or another professional
who has assisted the applicant in addressing the effects of the family
violence, sexual offense, stalking, or trafficking of persons; or
(5) any other information the OAG deems appropriate.
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