Texas > Local County > Galveston
Request For Social Security Number Redaction - Texas
| Request For Social Security Number Redaction Form. This is a Texas form and can be used in Galveston Local County . |
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GALVESTON COUNTY DISTRICT CLERK REQUEST FOR SOCIAL SECURITY NUMBER REDACTION Pursuant to Section 552.147 of the Government Code, I,___________________________, do hereby request the District Clerk of Galveston County, Texas to redact and/or remove from public access, (within a reasonable period of time after the date this form is completed and presented to the same), all but the last four (4) digits of the social security number of ___________________ in their official public records, including electronically stored information maintained by or under the control of the Clerk in the document and/or documents I have specifically listed below. I further understand that this request may be refused if another law requires a social security number to be maintained in a government document. I request that all but the last four (4) digits of the social security number of ________________ be redacted from the following specific document and/or documents*: 1. Cause Number: _____________________________________________________________; Style of Case, (names of parties): ___________________________________________________________________________; ___________________________________________________________________________; Document(s) and page number within said document: A. Document Name; _____________________________________________ Page Number within Document;________; B. Document Name; _____________________________________________ Page Number within Document;________; C. Document Name; _____________________________________________ Page Number within Document;________. 2. Cause Number: _____________________________________________________________; Style of Case, (names of parties): ________________________________________________ ___________________________________________________________________________; Document(s) and page number within said document: A. Document Name;_____________________________________________ Page Number within Document;________; B. Document Name;_____________________________________________ Page Number within Document;________; C. Document Name;_____________________________________________ Page Number within Document;________. (*PLEASE CONTINUE ON THE BACK OR ON AN ATTACHED PAGE AS NEEDED) "I the undersigned do hereby attest that I am the owner, or custodial parent of the owner, of the Social Security number that appears in the document(s) listed herein. I submit this request along with proof of my identification for the purpose of preventing full disclosure of the Social Security number(s) the subject of this redaction request, and I understand that the last four (4) digits must remain in the public documents as required by law." Printed Full Name Signature Daytime Phone Number Date Address City/State/ZIP FOR OFFICE USE ONLY Date request received:_________________ Date Redaction Completed:____________ Identification Copied: YES NO Website Notified to Update: YES NO Redaction Process Completed by:____________________________________________________, Deputy Comments:____________________________________________________________________________ (Form revised May 2012) American LegalNet, Inc. www.FormsWorkFlow.com
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