Florida > Local County > Miami-Dade > Civil
Request For Confidentiality - Florida
| Request For Confidentiality Form. This is a Florida form and can be used in Civil Miami-Dade Local County . |
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REQUEST FOR CONFIDENTIALITY Miami-Dade Clerk of Courts This request is being made for confidentiality according to Florida Statutes 119. Print your name and reason you are claiming confidentiality based on the above Florida Statute. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I attest that as a __________________________________________ I am covered under Florida Statute______________ and hereby request that my (Home Address or Social Security Number) _______________________________ be redacted from Book ___________ Page____________ ______________________________________________________________________________ _______________________________________________________________________ of the Official Records of Miami-Dade County. The information provided on this request for confidentiality is itself to be kept confidential. The information may only be used by the Miami-Dade County Recorder's staff in order to process my request for confidentiality. I agree to indemnify and hold harmless the Miami-Dade Clerk of Courts for any and all claims proximately resulting from this request. Furthermore, I affirm that the only document(s) being redacted is/are identified by Book and Page above. ________________________________________________________ Signature and Date ________________________________________________________ Print Full Name ________________________________________________________ Address ________________________________________________________ City, State, Zip ________________________________________________________ Telephone State of Florida County of_________________________ Sworn to (or affirmed) and subscribed before me this ______day of _____________________, by__________________________________________________________________________. Personally known ________or produced identification________________________________. Type of identification produced __________________________________________________. Signature of Notary_________________________ Incomplete document will not be processed. Accepted by _________________________ _________________________ Print Name American LegalNet, Inc. www.USCourtForms.com Date __________________________
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