Okla. Stat. tit. 17, § 17-180.12

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

Oklahoma Statutes - Title 17. Corporation Commission Page 155

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.