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REQUEST TO THE CLERK OF THE CIRCUIT COURT & COMPTROLLER, PALM BEACH COUNTY
TO ADD INFORMATION FROM A FINAL JUDGMENT FOR AN INJUNCTION FOR THE
PROTECTION OF A MINOR TO A PUBLICLY AVAILABLE INTERNET WEBSITE
Any affected person has a right to request that a county recorder or clerk of the court add information
to a publicly available Internet website if that information involves the identity of a respondent against
whom a final judgment for an injunction for the protection of a minor under s. 741.30, s. 68 784.046, or
s. 784.0485 is entered, unless the respondent is a minor. The request must be in writing and contain the
case number. To make a request contact the clerk’s office by mail or in person at Clerk of the Circuit
Court & Comptroller, 205 North Dixie Highway, Room 4.25, West Palm Beach, Florida 33401 or by email
at CCRPRIVACY@mypalmbeachclerk.com
.
This request is made by:
Printed Name: ______________________________________________
I request that the Clerk of the Circuit Court & Comptroller, Palm Beach County add information
related to the case listed below, including the identity of a respondent (who is not a minor), to a
publicly available Internet website.
Date of Request:
Case Number (Required): _______________________________________________
Book and Page of Document: Book Page
Instrument Number:
I attest that I am authorized to complete this form regarding the above mentioned case.
Signature
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