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Confidentiality Request Form

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 *

Confidentiality Request
Agree

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.

Note: Other governmental agencies may wish to contact you in regard to actions that

pertain to, or affect, your property or property rights. The Orange County Comptroller requires your permission before forwarding your mailing address to these governmental agencies:

Signature

Signature: 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”.



Today's Date
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.