Request For Inspection Of Sealed Record Form

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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:_______________________________________________________
(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:______________________________________________________
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
__ 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.
Signature of Applicant
Request for inspection of sealed record by others


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Parent category: Legal