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JUDICIAL CIRCUIT, IN AND Plaintiff/Petitioner, v. Defendant/Respondent. NOTICE (Clay County Florida Clerk of Court and Comptroller)

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IN THE _________ COURT, ____________
JUDICIAL CIRCUIT, IN AND
FOR______________ COUNTY, FLORIDA
CASE NO.:
Plaintiff/Petitioner,
v.
Defendant/Respondent.
/
NOTICE OF CONFIDENTIAL INFORMATION WITHIN COURT FILING
Pursuant to Florida Rule of Judicial Administration 2.420(d)(2), the filer of a court record at the time of filing
shall indicate whether any confidential information is included within the document being filed; identify the
confidentiality provision that applies to the identified information; and identify the precise location of the confi-
dential information within the document being filed.
Title/Type of Document(s):
Indicate the applicable confidentiality provision(s) below from Rule 2.420(d)(1)(B), by specifying the loca-
tion within the document on the space provided:
Chapter 39 records relating to dependency matters, termination of parental rights, guardians ad litem,
child abuse, neglect, and abandonm
ent. § 39.0132(3), Fla. Stat. (If the document is filed within a
Chapter 39 case, this form is not required.) 3UHFLVH/RFDWLRQ3DJH
Adoption records. § 63.162, Fla. Stat. (If the document is filed within a Chapter 63 adoption case,
this form is not required.) 3UHFLVH/RFDWLRQ3DJH
Social Security, bank account, charge, debit, and credit card numbers in court records. §
119.
0714(1)(i)–(j), (2)(a)–(e), Fla. Stat. (Unless redaction is requested pursuant to § 119.0714(2),
this information is exempt only as of January 1, 2011.) 3UHFLVH/RFDWLRQ3DJH
HIV test results and patient identity within the HIV test results. § 381.004(3)(e), Fla. Stat
3UHFLVH/RFDWLRQ3DJH
Sexually transmitted diseases — test results and identity within the test results when provided by the
Depa
rtment of Health or the department’s authorized representative. § 384.29, Fla. Stat.
3UHFLVH/RFDLWRQ3DJH
Birth and death certificates, including court-issued delayed birth certificates and fetal death certifi-
cates. §§ 382.008(6), 382.025(1)(a), Fla. Stat. 3UHFLVH/RFDWLRQ3DJH
Identifying information in petition by minor for waiver of parental notice when seeking to terminate
preg
nancy. § 390.01116, Fla. Stat. (If the document is filed within a Ch. 390 waiver of parental no-
tice case, this form is not required.) 3UHFLVH/RFDWLRQ3DJH
Identifying information in clinical mental health records under the Baker Act. §394.4615(7), Fla.
Stat.3UHFLVH/RFDWLRQ3DJH
Records of substance abuse service providers which pertain to the identity, diagnosis, and prognosis
FOURTH
of and service provision to individuals who have received services from substance abuse service
providers. § 397.501(7), Fla. Stat. 3UHFLVH/RFDWLRQ3DJH
Identifying information in clinical records of detained criminal defendants found incompetent to
proceed or acquitted by reason of insanity. § 916.107(8), Fla. Stat.3UHFLVH/RFDWLRQ3DJH
Estate inventories and accountings. § 733.604(1), Fla. Stat. 3UHFLVH/RFDWLRQ3DJH
Victim’s address in domestic violence action on petitioner’s request. § 741.30(3)(b), Fla. Stat.
3UHFLVH/RFDWLRQ3DJH
Information identifying victims of sexual offenses, including child sexual abuse. §§ 119.071(2)(h),
119.0714(1)(h), Fla. Stat. 3UHFLVH/RFDWLRQ3DJH
Gestational surrogacy records. § 742.16(9), Fla. Stat. 3UHFLVH/RFDWLRQ3DJH
Guardianship reports and orders appointing court monitors in guardianship cases. §§ 744.1076,
744.3701, Fla. Stat. 3UHFLVH/RFDWLRQ3DJH
Grand jury records. Ch. 905, Fla. Stat. (If the document is filed in a Ch. 905 grand jury proceeding,
this form is not required.) 3UHFLVH/RFDWLRQ3DJH
Information acquired by courts and law enforcement regarding family services for children. §
984.06(3
)–(4), Fla. Stat. (If the document is filed in a Ch. 984 family services for children case, this
form is not required.) 3UHFLVH/RFDWLRQ3DJH
Juvenile delinquency records. §§ 985.04(1), 985.045(2), Fla. Stat. (If the document is filed in a Ch.
985 juvenile delinquency case, this form is not required.) 3UHFLVH/RFDWLRQ3DJH
Information disclosing the identity of persons subject to tuberculosis proceedings and records of the
Department of Health in suspected tuberculosis cases. §§ 392.545, 392.65, Fla. Stat.
3UHFLVH/RFDWLRQ3DJH
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a copy of the foregoing was furnished by U.S. mail / personal service to:
,on , 20 .
Name ……………………..
Address …………………………….
Phone ………………………………
Florida Bar No. …………………….
Note: The clerk of court shall review filings ident
ified as containing confidential information to determine whether the information is fa-
cially subject to confidentiality under the identified provision. The clerk shall notify the filer in writing within 5 days if the clerk deter-
mines that the information is NOT subject to confidentiality, and the records shall not be held as confidential for more than 10 days, unless
a motion is filed pursuant to subdivision (d)(3) of the Rule. Fla. R. Jud. Admin. 2.420(d)(2).
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JUDICIAL CIRCUIT, IN AND PlaintiffPetitioner, v. DefendantRespondent. NOTICE (Clay County Florida Clerk of Court and Comptroller)

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Completed 30 July 2021

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