Revision 7/2020
A safe label name is a fictitious name used on the Safe at Home (SAH) outgoing mail
envelope as an additional safety measure. The use of a safe label name is optional. If
you would like to use a safe label name, complete this form and return it to SAH. Your
chosen safe label name cannot be the name of any actual, known person. This includes
the name of relatives, friends and celebrities. You will need to place your safe label name
in your mailbox so that your mail carrier will deliver mail in that name.
A safe label name is not a legal name change. Mail received in the SAH office MUST
be addressed using the participants legal name. The safe label name will only be used
for outgoing mail from SAH.
Participants Full Legal Name
Chosen Safe Label Name
SAH APT Number
By signing below, I affirm and acknowledge that I have read, understand, and agree with
the above statements.
Signature
Date
Return Form to:
Safe At Home
899 East 12
th
St.
PO Box 959
Des Moines, IA 50319
Request for
Safe Label Name