Orange County Comptroller - Social Security Removal

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Notice

Request to Remove Financial Account
and/or Social Security Numbers
from Public Inspection

The Orange County Comptroller is making images of documents viewable on her publicly available Internet web site. Therefore, in accordance with Section 119.071(5)(a)(7), Florida Statutes, any person has the right to request the Comptroller to redact/remove his or her social security, credit card, charge card, debit card, and/or bank account number(s) from the image or copy of any Official Record that has been placed on the publicly available Internet website.

To locate documents which might contain these numbers, please follow these directions: Go to the Official Records Search page (http://www.occompt.com/disclaimer.html). Click on the ACCEPT button at the bottom of the Disclaimer page, click on Public Search, then do your search by Party Name. The Search Results screen provides the document information needed to complete the Financial Account and Social Security Redaction Form below. You will need to view the specific document by clicking on VIEW.

If you find a document on which your own social security, credit card, charge card, debit card, and/or bank account number appears and you would like to request that the numbers be redacted, please fill out the Request to Remove Financial Account and/or Social Security Redaction Form below. This form can be printed out and faxed, hand delivered, or mail to us. Or you can fill the form out online and click the submit button. This form is not secure. If you do not wish to use it, you may use one of the other options.

Please allow us two business days from the date of receipt
of your request to comply with your request.

Orange County Comptroller’s
Official Records Department
109 E. Church St. Suite 300
Orlando, FL 32801
Phone 407- 836-5115
Fax 407-836-5120
www.occompt.com

Request to Remove Financial Account and/or Social Security
Numbers from Public Inspection

I am requesting that my Social Security, credit card, charge card, debit card, and/or bank account number(s) be removed from public inspection in accordance with §119.071(5)(a)(7).

* Required Field

My Full Name is:

Relationship to Requester:

Other names that I may have used:

E-mail:

*
(You will be notified via email after redaction is complete.)

Daytime Phone Number:

Home Address (including city, state, and zipcode):

This request for removal of information from public inspection is itself to be kept confidential. It may only be used by the Orange County Comptroller’s staff in order to process my request.

I agree to indemnify and hold blameless the Orange County Comptroller and the Comptroller’s staff for actions or reactions that may be the direct or indirect result of my request. Further, I agree to personally identify those documents of record pertaining to me.

E-Signature: Please type your full name in the box below:

*
Date:*

The following section is to be completed during or after a visit to the Orange County Comptroller’s document search feature at www.occompt.com or the office at 109 E. Church St. Suite 300, Orlando, FL, 32801.

As a result of my review of the Official Records of Orange County, I hereby agree that the Orange County Comptroller’s Official Records staff has my permission to modify a copy of the following documents in accordance with §119.071(5)(a)(7). I understand that only the modified copy will be made available to the public.