Fillable Request For Inspection Of Sealed Record Form printable pdf download

Request For Inspection Of Sealed Record Form

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To:

Defiance County Juvenile Court

Attn: Deputy Clerk

221 Clinton St.

Defiance Oh 43512

Dear Deputy Clerk,

In accordance with ORC 2151.357 (E), I request to inspect records which have been

sealed by the Juvenile Court, for the following person:

Person’s name whose record may have been sealed and additional information if known:

(The Juvenile Court clerk may not be able to help find certain information for cases that have been sealed)

Please Print

Person’s Name:_______________________________________________________

Last

First

M.I.

(Applicant should list name when the juvenile record was obtained, even if different now)

Birth Date:________ Social Security #: ___________-_______-______________

Past or Current Address:________________________________________________

=====================================================================

Applicant’s Name:______________________________________________________

Last

First

M.I.

Title

Applicant’s Address:______________________________________________________

Applicant’s Telephone Number: (_______) ________ - _______________________

Check all that apply

I am a law enforcement officer or prosecutor, or the assistant of a law enforcement officer or prosecutor.

__ The records in question pertain to an act that would be an offense of violence that would be a felony if

committed by an adult, and my inspection is for a valid law enforcement or prosecutorial purpose; as

follows:______________________________________________________________________________

__ The records in question pertain to an alleged violation of division (E)(1) of section 4301.69 of the Ohio

Revised Code (underage alcohol possession), and the inspection is for the purpose of determining whether

the person is eligible for diversion under division (E)(2) of section 4301.69 of the Ohio Revised Code.

__ I am a party in a civil action that is based on a case the records for which are the subject of a sealing

order issued under section 2151.356 of the Ohio Revised Code, and the records are needed for

the civil action. The sealed records shall be used solely in the civil action. I understand that the records are

otherwise confidential and subject to the provisions of this ORC 2151.355, 2151.356, 2151.357 and

2151.358. I also request to copy the records as needed for the civil action.

Sincerely,

________________________________________

_______________

Signature of Applicant

Date

Request for inspection of sealed record by others

Request For Inspection Of Sealed Record Form

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