Denton County Clerk
Redaction of SSN Request Form
NOTE: Redaction of SSN as authorized by the Government Code Sec. 552.147 will remove
the first 5 digits of the requestor’s Social Security Number, leaving the last 4 digits of the
Social Security Number visible in the document on file. You must complete this form for
each document that you request a SSN to be redacted.
PRINT LEGIBLY
I request removal of my Social Security Number from the Official Public Record in the Denton
County Clerk’s Office in document number:
.
Full Name of Requestor:
First Middle Last
Names of individuals whose SSN are to be redacted: (Note: Only a parent may request the
redaction of a child’s SSN on a document, unless the child is of legal age at present.)
Signature of Requestor Date Signed
TO BE COMPLETED BY CLERK:
*Type of Identification Presented:
Clerk’s Initials:
Date Redaction Completed: Clerk’s initials:
*If this form is mailed to the County Clerk’s office, you must include a photocopy of requestor’s
Driver’s license. The photocopy will be destroyed after verification.
Denton County Clerk
Juli Luke
P.O. Box 2187
Denton, Texas
76202-2187
www.dentoncounty.com/ccl
click to sign
signature
click to edit
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