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ADDRESS CONFIDENTIALITY PROGRAM APPLICATION Section 4015117 Please mail completed application to:ACP PO Box 201410 Helena, MT 596201410For ACP Use only ACP #Filed:Type of application:New Reinstatement

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Gather all necessary information such as personal details, emergency contacts, medical history, and insurance information.

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Who needs safe at home?

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Individuals who live alone

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People with disabilities or chronic illnesses

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Anyone who wants to ensure their safety and wellbeing in case of emergencies

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What is safe at home?

Safe at home is a confidential address program designed to help victims of domestic violence, human trafficking, stalking, and sexual assault keep their actual address confidential.

Who is required to file safe at home?

Individuals who are victims of domestic violence, human trafficking, stalking, or sexual assault are eligible to apply for the Safe at Home program.

How to fill out safe at home?

To apply for Safe at Home, individuals must fill out an application form and provide proof of their victim status.

What is the purpose of safe at home?

The purpose of Safe at Home is to protect the safety and confidentiality of victims of domestic violence, human trafficking, stalking, and sexual assault by providing them with a substitute address for public records.

What information must be reported on safe at home?

Victims enrolled in the Safe at Home program must report any changes to their contact information or address to ensure they receive mail and important communications.

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