(1) To apply for the address confidentiality program, an applicant must:

(a) be a resident of the state of Montana;

(b) be a victim of partner family member assault, sexual assault, or stalking as defined by 40-15-116 , MCA; and

(c) complete the office of victim services address confidentiality application form. The application must, at a minimum, include:

(i) a copy of the victim's driver's license or some other form of identification verifying the victim is a resident of Montana;

(ii) a statement providing information that establishes the victim has been a victim of partner family member assault, sexual assault, or stalking;

(iii) if available, a copy of an applicable record of conviction or order of protection;

(iv) the address the victim requests to be kept confidential;

(v) a telephone number where the victim can be reached; and

(vi) a statement indicating whether the applicant wishes to register to vote or, if registered, to change the applicant's address for voter registration.

(2) Applications must be notarized and may be mailed or faxed to the Office of Victim Services, P.O. Box 201410, 1712 9th Ave., Helena, MT 59620-1410, fax (406) 444-4303.

(3) Incomplete or inaccurate applications will not be accepted by the office of victim services.