Tax Year __________________
GENERAL INFORMATION: This form is used for qualified property owners to make an election to restrict public access to their home address information pursuant to Tax Code
Section 25.025.
SECTION 1: Name and Address
______________________________________________________ _____________________________________________________
Name of Person Requesting Confidentiality Name of Property Owner (if different)
______________________________________________________ _____________________________________________________
Primary Phone Number (area code and number) Email Address**
______________________________________________________________________________________________________________
Home Address (number and street), City, State, ZIP Code
SECTION 2: Qualication
Address Confidentiality Program
Armed Forces
Attorney General Employee
Commissioned Security Officer
Community Supervision and Corrections Department
County Jailer
District, Criminal District, County or Municipal Attorney
Family Violence
Federal Judge
Firefighter or Emergency Services Personnel
Juvenile Justice Program or Facility
Juvenile Probation or Supervision Officer
Medical Examiner or Forensic Analyst
Peace Officer
Protective Services Caseworker or Investigator
Sexual Assault, Abuse, Stalking or Trafficking of Persons
State Judge
State Officer or Legislature
Texas Civil Commitment Office
Texas Department of Criminal Justice
Texas Juvenile Justice Department
U.S. Attorney or Assistant U.S. Attorney
U.S. Criminal Investigator
U.S. Federal Protective Service
SECTION 3: Property Types Associated with Home Address
Single-family residential
Multi-family residential
Vacant land
Commercial real and personal
Oil, gas and minerals
Other
SECTION 4: Required Documentation
A victim of family violence, sexual assault, abuse, stalking or trafficking should attach to this request a copy of a protective order, a magistrate’s order for emergency
protection or other independent documentary evidence.
A member of the address confidentiality program should attach to this request proof of certification under Code of Criminal Procedure Article 56.84.
SECTION 5: Certication and Signature
NOTICE REGARDING PENALTIES FOR MAKING OR FILING AN APPLICATION CONTAINING A FALSE STATEMENT: If you make a false statement on this form, you could be
found guilty of a Class A misdemeanor or a state jail felony under Penal Code Section 37.10.
I certify the information in this document and any information attached is true and correct.
____________________________________________________________
Print Name of Property Owner or Authorized Representative
____________________________________________________________ ________________________________________
Signature of Property Owner or Authorized Representative Date
Form developed by: Texas Comptroller of Public Accounts, Property Tax Assistance Division
For additional copies, visit:
comptroller.texas.gov/taxes/property-tax
50-284 • 08-19/13
Harris County Appraisal District
Information & Assistance Division
P. O. Box 922004
Houston, TX. 77292-2004
(713) 957-7800
25.025 (9/2019)
Request for Confidentiality
HCAD Account # ________________________________________
click to sign
signature
click to edit
Request for Condentiality Under Tax Code Section 25.025 Form 50-284
For additional copies, visit: comptroller.texas.gov/taxes/property-tax Page 2
Important Information
GENERAL INFORMATION
This form is used for qualified property owners to make an election to restrict pub-
lic access to their home address information pursuant to Tax Code Section 25.025.
This election remains in effect until rescinded in writing by the qualified individual.
Tax Code Section 25.025 does not prohibit the public disclosure of information in
appraisal records that identifies property by home address if the information does not
identify the qualified individual property owner who has made this election.
State judges (as defined by Election Code Section 13.0021), federal judges and their
spouses are not required to file this request. The Office of Court Administration
automatically notifies the appraisal district at the time of a judge’s qualification for
confidentiality.
FILING INSTRUCTIONS
This form must be filed with the appraisal district office in each county in which the
property is located. Do not file this document with the Texas Comptroller of Public
Accounts. A directory with contact information for appraisal district offices may be
found on the Comptroller’s website.
QUALIFICATIONS
Address Condentiality Program
A participant in the Office of the Attorney General’s address confidentiality program
administered under Code of Criminal Procedure, Chapter 56, Subchapter C.
Refer to section 4 for required documentation to be provided with this request.
Armed Forces
A current or former member of the U.S. armed forces who has served in an area that
the U.S. President designates by executive order as an area in which armed forces of
the United States are or have engaged in combat.
Attorney General Employee
A current or former employee of the Office of the Attorney General who is or was
assigned to a division with duties which involve law enforcement.
Commissioned Security Ocer
Occupations Code Section 1702.002 defines commissioned security officer as a secu-
rity officer to whom a security officer commission has been issued by the Texas Private
Security Board.
Community Supervision and Corrections Department
An officer or employee of a community supervision and corrections department
established under Government Code Chapter 76 who performs a duty described in
Government Code Section 76.004(b).
County Jailer
Occupations Code Section 1701.001 defines a county jailer as a person employed as a
county jail guard under Local Government Code Section 85.005.
District, Criminal District, County or Municipal Attorney
A current or former district attorney, criminal district attorney, county or municipal
attorney whose jurisdiction includes any criminal law or child protective services mat-
ters or the current or former employee of the attorney.
Family Violence
An individual who shows that the individual, the individual’s child or another person
in the individual’s household is a victim of family violence as defined by Family Code
Section 71.004.
Refer to section 4 for required documentation to be provided with this request.
Federal Judge
A current, former or a retired judge of a U.S. court of appeals, a U.S. district court or a
U.S. bankruptcy court; or a current, former or retired magistrate judge of a U.S. district
court; the spouse of the judge or a current or former employee of the judge.
Fireghter or Emergency Medical Services Personnel
A firefighter, volunteer firefighter or emergency medical services personnel as
defined by Health and Safety Code Section 773.003.
Juvenile Justice Program or Facility
A current or former employee of a juvenile justice program or facility as defined by
Family Code Section 261.405.
Juvenile Probation or Supervision Ocer
A current or former juvenile probation or supervision officer certified by the Texas
Juvenile Justice Department, or the predecessors in function of the department under
Title 12, Human Resources Code.
Medical Examiner or Forensic Analyst
A medical examiner or person who performs forensic analysis or testing who is
employed by this state or one or more political subdivisions of this state.
Peace Ocer
A current or former peace officer as defined by Code of Criminal Procedure Article 2.12,
the spouse or surviving spouse of a current or former peace officer or the adult child
of a current peace officer.
Protective Services Caseworker or Investigator
A current or former child protective services or adult protective services caseworker
or investigator for the Department of Family and Protective Services or a current or
former employee of a department contractor performing these functions on behalf
of the department.
Sexual Assault, Abuse, Stalking or Tracking of Persons
An individual who shows that the individual, the individual’s child or another person
in the individual’s household is a victim of sexual assault or abuse, stalking or traffick-
ing of persons.
Refer to section 4 for required documentation to be provided with this request.
State Judge
A current, former or retired judge of an appellate court, a district court, a statutory pro-
bate court, a constitutional county court or a county court at law of this state; a current,
former or retired associate judge appointed under Family Code Chapter 201 or Govern-
ment Code Chapter 54A; a justice of the peace; a master, magistrate, referee, hearing
officer or associate judge appointed under Government Code Chapter 54; or a munici-
pal court judge; the judge’s spouse or a current or former employee of the judge.
Elected State Ocer or Legislative Member
A state officer elected statewide or a member of the legislature.
Texas Civil Commitment Oce
A current or former employee of the Texas Civil Commitment Office or of the prede-
cessor in function of the office or a division of the office.
Texas Department of Criminal Justice
An employee of the Texas Department of Criminal Justice.
Texas Juvenile Justice Department
A current or former employee of the Texas Juvenile Justice Department or of the
predecessors in function of the department.
U.S. Attorney or Assistant U.S. Attorney
A current o
r former U.S. attorney or assistant U.S. attorney and the spouse and child
of the attorney.
U.S Criminal Investigator
A U.S. criminal investigator as described by Code of Criminal Procedure Article 2.122(a).
U.S. Federal Protective Service
A police officer or inspector of the U.S. Federal Protective Service.
REQUIRED DOCUMENTATION
A victim of family violence, sexual assault, abuse, stalking or trafficking should attach
to this request a copy of a protective order, a magistrate’s order for emergency protec-
tion or other independent documentary evidence.
A member of the address confidentiality program should attach to this request proof
of certification under Code of Criminal Procedure Article 56.84.