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Confidentiality Request Form

Printable Version of This Form

Law Enforcement/Public Safety Request to Remove Information from Public Inspection

I am filing this request to remove information from public inspection in the Orange County Official Records in accordance with §119.071 and/or §741.465, F.S. I hereby swear or affirm that the following information is true and correct.

I attest that I am an individual covered under §119.071 or § 741.465, F.S. as: Required *

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Signature

I agree to indemnify and hold blameless the Orange County Comptroller and the Comptroller’s staff for actions or reactions that may be the direct or indirect result of my request. Further, I agree to personally identify those documents of record pertaining to me.

Please sign your full name in the box below. If you are submitting this form electronically, typing your name in the space below will be considered an “electronic signature”.

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Today's Date

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Documents

The following section is to be completed during or after a visit to the Orange County Comptroller’s document search feature at www.occompt.com or the office at 109 East Church St., Suite # 300, Orlando, FL 32801.

As a result of my review of the Official Records of Orange County, I hereby agree that the Orange County Comptroller’s Official Records staff has my permission to modify a copy of the following documents in accordance with §119.071 and/or §741.465, F.S. I understand that only the modified copy will be made available to the public.

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