Fillable JOSEPH ABRUZZO REQUEST FOR REDACTION OF EXEMPT PERSONAL (Clerk of the Circuit Court & Comptroller, Palm Beach County)

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JOSEPH ABRUZZO REQUEST FOR REDACTION OF EXEMPT PERSONAL (Clerk of the Circuit Court & Comptroller, Palm Beach County)

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JOSEPH ABRUZZO
CLERK
OF
T
HE
CIRCUIT
COURT
& COMPTROLLER
PAIM
BEACH
COUNTY
REQUEST FOR REDACTION OF EXEMPT PERSONAL INFORMATION
FROM NON-JUDICIAL PUBLIC RECORDS
I request to have exempt personal information removed from records maintained by the Clerk of the Circuit
Court and Comptroller, Palm Beach County.
Current/former government agency employee in the category checked below
Spouse of a current/former government agency employee in the category checked below
Child of a current/former government agency employee in the category checked below
Protected individual requesting redaction in the category checked below
Statutory Basis for Removal:
Victim of violent crime [FS 119.071(2)(j)1]* Juvenile probation/detention officer, house
Victim of an incident of mass violence [FS parent, therapy provider, counselor and their
119.071(2)(o)]* supervisors [FS 119.071(4)(d)2.k.]
Law enforcement officers or civilian staff, Public Defender and APDs [FS 119.071(4)(d)2.l.]
correctional and correctional probation officers [FS
Criminal conflict counsel and civil regional counsel
119.071(4)(d)2.a.] [FS 119.071(4)(d)2.l.]
Dept of Children and Family investigator [FS Dept of Business Regulation investigators and
119.071(4)(d)2.a.] inspectors [FS 119.071(4)(d)2.m.]
Dept of Health investigator of child abuse or Tax collectors (current only) [FS 119.071(4)(d)2.n.]
neglect [FS 119.071(4)(d)2.a.]
Dept of Health personnel involved in eligibility,
Dept of Revenue or local government child support investigation, prosecution, and inspection [FS
collection/enforcement personnel [FS 119.071(4)(d)2.o.]
119.071(4)(d)2.a.]
Impaired practitioner consultants retained by an
Florida Department of Financial Services agency [F.S. 119.071(4)(d)2.p.]
investigative personnel [FS 119.071(4)(d)2.b.]
Emergency medical technician or paramedic [FS
Office of Financial Regulation’s Bureau of Financial 119.071(4)(d)2.q.]
Investigations investigative personnel [F.S.
Agency inspector general office or internal audit
119.071(4)(d)2.c.] department employees with auditing or potential
Firefighter [FS 119.071(4)(d)2.d.]
criminal investigating or disciplinary duties [FS
Justice or judge [FS 119.071(4)(d)2.e.]
119.071(4)(d)2.r.]
State attorney and ASAs [FS 119.071(4)(d)2.f.] Addiction treatment facility director, manager,
Statewide prosecutor and asst. statewide supervisor, nurse, or clinical employee [FS
prosecutors [FS 119.071(4)(d)2.f.] 119.071(4)(d)2.s.]*
General or Special Magistrate [FS 119.071(4)(d)2.g] Child advocacy center director, manager,
Judge of Compensation Claims, Administrative Law supervisor, clinical employee of [FS
Judge [FS 119.071(4)(d)2.g] 119.071(4)(d)2.t.]
Child Support Hearing Officer [FS 119.071(4)(d)2.g] Domestic violence center current or former staff
Local Govt. or Water Mgt. District Human and advocates [F.S. 119.071(4)(d)2.u.]
resources manager/assistant manager [FS
U.S. Attorney and AUSAs [FS 119.071(5)(i)1.]*
119.071(4)(d)2.h.]
U.S. Judge or U.S. Magistrate [FS 119.071(5)(i)1.]*
Local Govt. or Water Mgt. District Labor or Member of US Armed Forces, reserve, or National
employee relations manager/assistant manager [FS Guard, who served after 9/11/01 [FS
119.071(4)(d)2.h.] 119.071(5)(k)1.]*
Code enforcement officer [FS 119.071(4)(d)2.i.] Public guardians and employees with fiduciary
Guardian ad litem [FS 119.071(4)(d)2.j.] responsibilities [FS 744.21031]
*Names of spouse/children for marked individuals are NOTE: Grantor, grantee, or party names cannot be
not exempt removed
Page 1 of 3 | 070121
REQUESTOR CONTACT INFORMATION
Printed Name: _________________________________________________________________________
Telephone Number: ________________Email address: ________________________________________
INFORMATION TO BE REDACTED
Address where I (or qualifying spouse or child) reside (physical, mailing, or street address):
The following additional address information for address where I reside: legal property description
(consider title implications), parcel identification number, plot identification number,
neighborhood name and lot number, GPS coordinates, other description property information that
may reveal home address:
Telephone Number(s)
Social Security Number (do not list SSN) / Date of Birth:
Names of spouse and/or children to be redacted: **
Place(s) of Employment/Location:
Name and Location of School/Daycare Facility of child):
Personal assets (crime victim):
WARNING: There may be consequences to redacting information on a public record, which is a risk
undertaken by the requestor. Only the documents identified by the requestor will be redacted. Once
redaction is requested and completed, future redactions require an additional redaction request.
**However, grantor, grantee, or party names cannot be removed. F.S. 28.2221(2)(b).
PUBLIC RECORD: This form is itself a public record. If a copy of it is requested, all exempt information
contained in this form will be redacted.
DOCUMENTS TO BE REDACTED
The following section is to be completed during or after a visit to the Clerk of the Circuit Court &
Comptroller, Palm Beach County at www.mypalmbeachclerk.com/records/privacy or 205 North Dixie
Hwy, Room 4.2500, West Palm Beach, FL 33401 .
As a result of my review of the Official Records of the Clerk of the Circuit Court & Comptroller, Palm
Beach County, I hereby agree that the Clerk of the Circuit Court & Comptroller, Palm Beach County staff
has my permission to modify a copy of the following documents in accordance with FS 119.071. I
understand that only the modified copy will be made available to the public, unless otherwise ordered
by a court of competent jurisdiction, except as shown below.
Instrument Number Book Page Document Title
Page 2 of 3 | 070121
___________________________________
__________________________________________
Documents Other Than Official Records:
RELEASE TO GOVERNMENTAL AGENCIES: an un-redacted version of these documents will be provided
to the Property Appraiser and Tax Collector to allow them to perform their governmental duties and
responsibilities. To redact information held by the Property Appraiser or the Tax Collector you must
make a written request to those agencies directly under Section 119.071(4)(d)(4). To redact information
held by the Property Appraiser call (561) 355-3230 or by the Tax Collector call (561) 355-2264. If you
wish to release your information to other individuals or entities, please complete a Request to Release
Redacted Information on Recorded Documents form.
RELEASE FOR TITLE SEARCHES: an un-redacted version of these documents may be provided to title
insurers, agents or agencies and attorneys conducting title searches as authorized in section
28.2221(6)(b). Notice of any title search release will be sent to the most recent address on the recorded
documents on the redaction request provided by the requestor.
RELEASE OF PRIOR REDACTIONS:
If you have previously requested protection of a home address that is no longer your residence, you are
required by law to submit a written, notarized request to release the removed information. Please
indicate any prior documents that include removed information that must be restored*:
Instrument Number Book Page Document Title
*Releases for other counties must be submitted directly to that county.
Signature: __________________________________ Date: __________________________________
Job Title of Qualifying Individual Requesting Redaction (for exemptions where current/former agency
employment is required):
__________________________________________________________
Employing Agency of Qualifying Individual Requesting Redaction (for exemptions where current/former
agency employment is required): __________________________________________________________
STATE OF FLORIDA
COUNTY OF _____________
Signed on
Sworn to (or affirmed) and subscribed before me by means of physical presence or online
notarization on (date) _______________________, 20_____ by (affiant name)
.
NOTARY PUBLIC or DEPUTY CLERK
{Print, type, or stamp commissioned name of
notary or clerk}
____ Personally known, OR
____ Produced identification; Type of identification produced/ID#_______________________
Page 3 of 3 | 070121
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JOSEPH ABRUZZO REQUEST FOR REDACTION OF EXEMPT PERSONAL (Clerk of the Circuit Court & Comptroller, Palm Beach County)

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Completed 5 July 2021

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