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Notice Of Confidential Information - Florida
| Notice Of Confidential Information Form. This is a Florida form and can be used in General Palm Beach Local County . |
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IN THE ___________ COURT, 15TH JUDICIAL CIRCUIT, IN AND FOR PALM BEACH COUNTY, FLORIDA _________________________ Plaintiff/Petitioner, v. _________________________ Defendant/Respondent. ______________________________________ / NOTICE OF CONFIDENTIAL INFORMATION WITHIN COURT FILING Pursuant to Florida Rule of Judicial Administration 2.420(d)(2), the filer of a court record at the time of filing shall indicate whether any confidential information is included within the document being filed; identify the confidentiality provision that applies to the identified information; and identify the precise location of the confidential information within the document being filed. Title/Type of Document(s): _____________________________________________________________ Indicate the applicable confidentiality provision(s) below from Rule 2.420(d)(1)(B), by specifying the location within the document on the space provided: Chapter 39 records relating to dependency matters, termination of parental rights, guardians ad litem, child abuse, neglect, and abandonment. § 39.0132(3), Fla. Stat. (If the document is filed within a Chapter 39 case, this form is not required.) Location: ______________________________________________________________________________ Adoption records. § 63.162, Fla. Stat. (If the document is filed within a Chapter 63 adoption case, this form is not required.) Location: ______________________________________________________________________________ Social Security, bank account, charge, debit, and credit card numbers in court records. § 119.0714(1)(i)-(j), (2)(a)-(e), Fla. Stat. (Unless redaction is requested pursuant to § 119.0714(2), this information is exempt only as of January 1, 2011.) Location: ______________________________________________________________________________ HIV test results and patient identity within the HIV test results. § 381.004(3)(e), Fla. Stat. Location: ______________________________________________________________________________ Sexually transmitted diseases test results and identity within the test results when provided by the Department of Health or the department's authorized representative. § 384.29, Fla. Stat. Location: ______________________________________________________________________________ Birth and death certificates, including court-issued delayed birth certificates and fetal death certificates. §§ 382.008(6), 382.025(1)(a), Fla. Stat. Location: ______________________________________________________________________________ Identifying information in petition by minor for waiver of parental notice when seeking to terminate pregnancy. § 390.01116, Fla. Stat. (If the document is filed within a Ch. 390 waiver of parental notice case, this form is not required.) Location: ______________________________________________________________________________ Identifying information in clinical mental health records under the Baker Act. § 394.4615(7), Fla. Stat. Location: ______________________________________________________________________________ CASE NO.: ______________________ rev. 10/11/12 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Records of substance abuse service providers which pertain to the identity, diagnosis, and prognosis of and service provision to individuals who have received services from substance abuse service providers. § 397.501(7), Fla. Stat. Location: ______________________________________________________________________________ Identifying information in clinical records of detained criminal defendants found incompetent to proceed or acquitted by reason of insanity. § 916.107(8), Fla. Stat. Location: ______________________________________________________________________________ Estate inventories and accountings. § 733.604(1), Fla. Stat. Location: ______________________________________________________________________________ Victim's address in domestic violence action on petitioner's request. § 741.30(3)(b), Fla. Stat. Location: ______________________________________________________________________________ Information identifying victims of sexual offenses, including child sexual abuse. §§ 119.071(2)(h), 119.0714(1)(h), Fla. Stat. Location: ______________________________________________________________________________ Gestational surrogacy records. § 742.16(9), Fla. Stat. Location: ______________________________________________________________________________ Guardianship records and orders appointing court monitors in guardianship cases. §§ 744.1076, 744.3701, Fla. Stat. Location: ______________________________________________________________________________ Grand jury records. Ch. 905, Fla. Stat. (If the document is filed in a Ch. 905 grand jury proceeding, this form is not required.) Location: ______________________________________________________________________________ Information acquired by courts and law enforcement regarding family services for children. § 984.06(3)-(4), Fla. Stat. (If the document is filed in a Ch. 984 family services for children case, this form is not required.) Location: ______________________________________________________________________________ Juvenile delinquency records. §§ 985.04(1), 985.045(2), Fla. Stat. (If the document is filed in a Ch. 985 juvenile delinquency case, this form is not required.) Location: ______________________________________________________________________________ Information disclosing the identity of persons subject to tuberculosis proceedings and records of the Department of Health in suspected tuberculosis cases. §§ 392.545, 392.65, Fla. Stat. Location: ______________________________________________________________________________ Presentence investigation reports and attached psychological or psychiatric evaluations. Fla. R. Crim. P. 3.712; §§ 921.231(1)(i), 948.015(9), Fla. Stat. Location: ______________________________________________________________________________ CERTIFICATE OF SERVICE I HEREBY CERTIFY that a copy of the foregoing was furnished by U.S. mail / personal service to: __________________________________________, on ____________________, 20___. ________________________________ Attorney Name ...................................... Address ................................................. Phone.................................................... Florida Bar No. ..................................... Note: The clerk of court shall review filings identified as containing confidential information to determine whether the information
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