violence. A. A customer or applicant who has been determined to be a victim of domestic violence, stalking, or harassment, as defined in Section 109 of Title 43 of the Oklahoma Statutes or Section 644 of Title 21 of the Oklahoma Statutes, by any of the following: 1. An existing protective order; 2. Law enforcement personnel; 3. A designated representative of a certified domestic violence shelter or certified domestic violence program pursuant to Section 18p-6 of Title 74 of the Oklahoma Statutes; or 4. A designated representative of a domestic violence shelter or domestic violence program operated by a federally recognized Indian tribe, shall be exempt from the public utility's initial credit and deposit requirements as established by the public utility. This determination shall be evidenced by submission of the certification letter, provided in subsection B of this section, to the public utility. The certification letter expires after ninety (90) days. B. Certification Letter for Victim of Domestic Violence for Waiver of Initial Utility Deposit: IF A VALID PROTECTIVE ORDER IS ATTACHED TO THIS FORM, A CERTIFYING AGENCY OR OFFICER DOES NOT NEED TO COMPLETE THE FOLLOWING SECTIONS. This letter serves to certify that ___________________________(Name of Applicant for Service) is a victim of domestic violence, stalking, or harassment, as defined in Section 109 of Title 43 of the Oklahoma Statutes or Section 644 of Title 21 of the Oklahoma Statutes, and therefore has demonstrated satisfactory credit for the purposes of establishing service. The requirement of initial deposit shall be waived for the above named customer. (Only one Certifying Agency is required.) By my signature, I certify that the following Certifying Agency has determined that, based on the information gathered at the time of intake/assessment/provision of services, the above-named Applicant reported experiences of domestic violence and was assessed to be a victim of domestic violence. Agency Name: ____________________________________________ Contact Number: _________________________________________ Signature: ______________________________________________ Printed Name: ___________________________________________ Title: __________________________________________________ Date: ___________________________________________________ By my signature I certify that I have personally responded to or have confirmed via internal records that an officer of the _____________________________ Police Department has responded to an incident occurring within the municipal boundaries of the _____________________________ (municipality) where the above-named Applicant was reported to be a victim of domestic violence. Department Representative Signature: ____________________________________________ Department Representative Printed Name: ____________________________________________ Badge Number (if applicable): ____________________________________________ Date: ______________________________________ This form expires ninety (90) days from the date of the signature of the certifying individual. C. The utility shall deem the certification letter and the contents thereof as confidential and exempt from disclosure.
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