DJJ Form LS5E203 "Request for Reference Service" - Florida

What Is DJJ Form LS5E203?

This is a legal form that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2003;
  • The latest edition provided by the Florida Department of Juvenile Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DJJ Form LS5E203 by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download DJJ Form LS5E203 "Request for Reference Service" - Florida

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STATE OF FLORIDA
FLORIDA STATE RECORDS CENTER
DEPARTMENT OF
JUVENILE JUSTICE
REQUEST FOR REFERENCE SERVICE
Records Management
Form LS5E203R1-7/2003
SEND ORIGINAL AND TWO COPIES TO:
FOR RECORDS CENTER USE ONLY
Department of Juvenile Justice
THE RECORD ITEMS LISTED
DATE REQUEST
Records Management
BELOW WERE READY FOR
RECEIVED
PICKUP/DELIVERY ON
2737 Centerview Drive, Suite 1427
Tallahassee, FL 32399-3100
Or by Fax: (850) 413-0057
DATE
ATTENTION: Records Management
SRC STAFF INITIALS
1. TYPE OF SERVICE REQUESTED (Check One Only)
a. Check Out (Retrieval)
b. Copy of Records
c. Information from Records
d. Permanent Withdrawal
2. BOXES AND/OR FILES REQUESTED
c. BAR CODE NUMBER
a. LINE
b. DESCRIPTION OF BOX OR FILE REQUESTED
(“C” number or Acc. + SRC Number for boxes,
NUMBER
or “F” number for files)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
3. REMARKS
4. NAME OF AUTHORIZED REQUESTER
5. TEL. NO.
9. RECEIPT FOR RECORDS LOANED OR WITHDRAWN
I have received the record items listed above.
6. LOCATION
7. DATE
8. AGENCY (Name and Address)
Agency Representative Signature
Date
Save As
Reset/Clear Form
STATE OF FLORIDA
FLORIDA STATE RECORDS CENTER
DEPARTMENT OF
JUVENILE JUSTICE
REQUEST FOR REFERENCE SERVICE
Records Management
Form LS5E203R1-7/2003
SEND ORIGINAL AND TWO COPIES TO:
FOR RECORDS CENTER USE ONLY
Department of Juvenile Justice
THE RECORD ITEMS LISTED
DATE REQUEST
Records Management
BELOW WERE READY FOR
RECEIVED
PICKUP/DELIVERY ON
2737 Centerview Drive, Suite 1427
Tallahassee, FL 32399-3100
Or by Fax: (850) 413-0057
DATE
ATTENTION: Records Management
SRC STAFF INITIALS
1. TYPE OF SERVICE REQUESTED (Check One Only)
a. Check Out (Retrieval)
b. Copy of Records
c. Information from Records
d. Permanent Withdrawal
2. BOXES AND/OR FILES REQUESTED
c. BAR CODE NUMBER
a. LINE
b. DESCRIPTION OF BOX OR FILE REQUESTED
(“C” number or Acc. + SRC Number for boxes,
NUMBER
or “F” number for files)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
3. REMARKS
4. NAME OF AUTHORIZED REQUESTER
5. TEL. NO.
9. RECEIPT FOR RECORDS LOANED OR WITHDRAWN
I have received the record items listed above.
6. LOCATION
7. DATE
8. AGENCY (Name and Address)
Agency Representative Signature
Date
Save As
Reset/Clear Form