St Lucie County Clerk Of Court – Fill Out and Use This PDF

Select all that apply: government agency employee, spouse of a government agency employee, child of a government agency employee, or protected individual requesting redaction, in the category checked.

Under Statutory Basis for Removal, check the box that applies.

*Attach official verification of crime (i.e. police report or injunction). Five-year renewable exemption. **Names of spouse/children for marked individuals are not exempt. ***Partial Home Address (not including city and zip code)

Marked ** are Victim of an incident of mass violence, Addiction treatment facility director, manager, supervisor, nurse, or clinical employee, U.S. attorney, asst. attorney, Court of Appeal judge, district judge, or magistrate, and Military personnel authorized to access secret information or servicemember of a special operations force. Congressional Member or Public Officer is marked ***.

Grantor, grantee, or party names cannot be removed from Official Records unless they contain the street address.

Under REQUESTOR CONTACT INFORMATION, enter the Printed Name, Telephone Number and Email Address.

Under INFORMATION TO BE REDACTED, check the address where I (or qualifying spouse or child) reside (physical, mailing, or street address) and enter it.

For the additional address information for the address where I reside, check legal property description (consider title implications), parcel identification number, plot identification number, neighborhood name and lot number, GPS coordinates, or other description property information that may reveal home address, and enter it.

Check Telephone Number(s) and enter them.

Social Security Number (do not list SSN) / Date of Birth: check it and enter the Date of Birth; do not list the Social Security Number.

To have the name of a spouse or child redacted, check Name of Spouse and/or Children to be redacted and enter the names.

Check and enter Place(s) of Employment/Location, Name and Location of School/Daycare Facility of Child, or Personal Assets (crime victim) for each one that applies.

There may be consequences to redacting information on a public record, which is a risk undertaken by the requestor. Only the documents identified by the requestor will be redacted.

Once redaction is requested and completed, future redactions require an additional redaction request. However, grantor, grantee, or party names cannot be removed, unless the street address is included in the name, such as in a trust or LLC. (s. 28.2221(2)(b), F.S.)

This form is itself a public record. If a copy of it is requested, all exempt information contained in this form will be redacted.

The requestor agrees to indemnify and hold harmless the Clerk of the Circuit Court & Comptroller of St. Lucie County and the staff for any consequences arising from this request for confidentiality.

Under DOCUMENTS TO BE REDACTED, complete the section during or after a visit to the Clerk of the Circuit Court & Comptroller's Office, St Lucie County at http://www.stlucieclerk.gov [official records search] or 201 S Indian River Drive Ft Pierce, FL 34950.

For each document, enter the Instrument Number, Book, Page and Document Title.

List Documents Other Than Official Records on their own lines.

Only the modified copy will be made available to the public, unless otherwise ordered by a court of competent jurisdiction.

Sign on the Signature line and enter the Date signed.

The Notary Public marks physical presence or online notarization, fills in this day of and by, and marks Personally Known to me or who has produced identification. The Notary Public signs Signature of Notary Public State of Florida and prints, types or stamps a name in Print, Type, or Stamp Name of Notary Public.