Form FDACS-01466 "Exemption From Public Records Disclosure" - Florida

What Is Form FDACS-01466?

This is a legal form that was released by the Florida Department of Agriculture and Consumer Services - 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 May 1, 2013;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • 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 Form FDACS-01466 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-01466 "Exemption From Public Records Disclosure" - Florida

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Florida Department of Agriculture and Consumer Services
Office of Agricultural Law Enforcement
EXEMPTION FROM PUBLIC RECORDS DISCLOSURE
NICOLE "NIKKI" FRIED
COMMISSIONER
AGLAW CASE #
This form is a request for exemption of certain information from public records disclosure
involving victims of the following crimes:
a. Sexual Battery
e.
Child Abuse
b. Aggravated Stalking
f.
Harassment
c. Aggravated Battery
g.
Domestic Violence
d. Sexual Offense
h.
Aggravated Child Abuse
I,
Date of Birth
(Print Name)
do hereby request that information which reveals any home or employment telephone
number, home or employment address, or information about my personal assets, not be
released or revealed through any public records disclosure by the Office of Agricultural
Law Enforcement as contained in §119.071, Florida Statutes. Additionally, any request
must include official verification that an applicable crime has occurred and such
information shall cease to be exempt 5 years after the receipt of the written request.
Signature
Date
_____________________________________
Officer Name
Scan document into ACISS. Original form shall be forwarded to the appropriate Bureau
Administrative Assistant for filing.
FDACS-01466 05/13
Florida Department of Agriculture and Consumer Services
Office of Agricultural Law Enforcement
EXEMPTION FROM PUBLIC RECORDS DISCLOSURE
NICOLE "NIKKI" FRIED
COMMISSIONER
AGLAW CASE #
This form is a request for exemption of certain information from public records disclosure
involving victims of the following crimes:
a. Sexual Battery
e.
Child Abuse
b. Aggravated Stalking
f.
Harassment
c. Aggravated Battery
g.
Domestic Violence
d. Sexual Offense
h.
Aggravated Child Abuse
I,
Date of Birth
(Print Name)
do hereby request that information which reveals any home or employment telephone
number, home or employment address, or information about my personal assets, not be
released or revealed through any public records disclosure by the Office of Agricultural
Law Enforcement as contained in §119.071, Florida Statutes. Additionally, any request
must include official verification that an applicable crime has occurred and such
information shall cease to be exempt 5 years after the receipt of the written request.
Signature
Date
_____________________________________
Officer Name
Scan document into ACISS. Original form shall be forwarded to the appropriate Bureau
Administrative Assistant for filing.
FDACS-01466 05/13