"Request Form for Social Security Number Removal" - Clay County, Florida

Request Form for Social Security Number Removal is a legal document that was released by the Clerk of Court and Comptroller's Office - Clay County, Florida - a government authority operating within Florida. The form may be used strictly within Clay County.

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Request Form for Social Security Number Removal
Date:
Name of Holder of Social Security Number:
Phone Number: (optional)
Relationship to Requester:
Attorney, specify
[ ] Legal Guardian, specify
[ ] Self
For Redaction/Removal of Social Security Number from an Official Record Image on a Publicly
Available Internet website, please provide:
Instrument Number
Book and Page Number
Document Type
For Redaction/Removal of Social Security Numbers from Court Records, please specify:
Case Number
Document Name
Page Number
Signature:
For Office Use Only:
Date Request Received
Date Request Completed
Clerk Processing Request
Request Form for Social Security Number Removal
Date:
Name of Holder of Social Security Number:
Phone Number: (optional)
Relationship to Requester:
Attorney, specify
[ ] Legal Guardian, specify
[ ] Self
For Redaction/Removal of Social Security Number from an Official Record Image on a Publicly
Available Internet website, please provide:
Instrument Number
Book and Page Number
Document Type
For Redaction/Removal of Social Security Numbers from Court Records, please specify:
Case Number
Document Name
Page Number
Signature:
For Office Use Only:
Date Request Received
Date Request Completed
Clerk Processing Request