(a) An adult individual.
(b) A parent or guardian acting on behalf of a minor when the minor resides with the parent or guardian.
(c) A guardian acting on behalf of an incapacitated individual.
(2) The application must be dated, signed and verified by the applicant and the application assistant who assisted in the preparation of the application.
(3) The application must contain all of the following:
(a) A statement by the applicant that the applicant or the applicant’s child or ward is a victim of domestic violence, a sexual offense, stalking or human trafficking and that the applicant fears for the applicant’s safety or the safety of the applicant’s child or ward.
(b) Evidence that the applicant or the applicant’s child or ward is a victim of domestic violence, a sexual offense, stalking or human trafficking. This evidence may include any of the following:
(A) Law enforcement, court or other federal, state or local government records or files;
(B) Documentation from a public or private entity that provides assistance to victims of domestic violence, a sexual offense, stalking or human trafficking if the applicant or the applicant’s child or ward is an alleged victim of domestic violence, a sexual offense, stalking or human trafficking;
(C) Documentation from a religious, medical or other professional from whom the applicant has sought assistance in dealing with the alleged domestic violence, sexual offense, stalking or human trafficking; or
(D) Other forms of evidence as determined by the Attorney General by rule.
(c) A statement by the applicant that disclosure of the actual address of the applicant would endanger the safety of the applicant or the safety of the applicant’s child or ward.
(d) A statement by the applicant that the applicant:
(A) Resides at a location in this state that is not known by assailants or potential assailants of the applicant or the applicant’s child or ward; and
(B) Will not disclose the location to assailants or potential assailants of the applicant or the applicant’s child or ward while the applicant is a program participant.
(e) Written consent permitting the Attorney General to act as an agent for the applicant for the service of all legal process in this state and the receipt of first-class, certified or registered mail.
(f) The mailing address and telephone number at which the Attorney General can contact the applicant.
(g) The actual address that the applicant requests not be disclosed by the Attorney General that directly relates to the increased risk of the applicant or the applicant’s child or ward as a victim of domestic violence, a sexual offense, stalking or human trafficking.
(h) A sworn statement by the applicant that to the best of the applicant’s knowledge the information contained in the application is true.
(i) A recommendation by an application assistant that the applicant be a participant in the Address Confidentiality Program.
(4) Upon the filing of a properly completed application and upon approval by the Attorney General, the Attorney General shall certify the applicant as a program participant.
(5) Upon certification, the Attorney General shall issue an Address Confidentiality Program authorization card to the program participant. The Address Confidentiality Program authorization card is valid as long as the program participant remains certified under the program.
(6) The term of certification shall be for a period of time determined by the Attorney General by rule, unless prior to the end of the period one of the following occurs:
(a) The program participant withdraws the certification by filing with the Attorney General a request for withdrawal signed by the program participant and acknowledged in writing by a notary public or an application assistant; or
(b) The Attorney General cancels the certification under ORS 192.834.
(7) A program participant may renew the certification by filing an application for renewal with the Attorney General at least 30 days prior to expiration of the current certification. [2005 c.821 §3; 2009 c.468 §3]
Note: See note under 192.820.