JOSEPH ABRUZZO
CLERK OF
THE
CIRCUIT COURT & COMPTROLLER
PALM BEACH
COUNIT
__________________________________________
__________________________________________
REQUEST TO THE CLERK OF THE CIRCUIT COURT &
COMPTROLLER, PALM BEACH COUNTY TO RELEASE
REDACTED INFORMATION ON RECORDED DOCUMENTS
(Request by Protected Party)
This request is made by
Printed Name: ______________________________________________
I request that the Clerk of the Circuit Court & Comptroller, Palm Beach County release an
unredacted copy of the following redacted, recorded document:
Date of Request:
Document Title:
Book and Page of Document: Book Page
Instrument Number:
Describe the lawful purpose for the search: _______________________________________________
Identify the individual or property that is the subject of the search: ______________________________
A copy of the redacted document is attached to this request.
Signature
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#___________________________________
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