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Marsy’s Law FL Constitution, Article 1, §16(b) Victim’s Right to Confidentiality Form

  1. Florida Constitution, Article 1, Section 16(b)(5):

    Every victim is entitled to the following right, beginning at the time of his or her victimization: “The right to prevent disclosure of information or records that could be used to locate or harass the victim or the victim’s family, or which could disclose confidential or privileged information of the victim.”

  2. , as the victim and as my right, do hereby

  3. (Please select one)*

  4. to have the Aventura Police Department disclose information or records that could be used to locate or harass me or my family, or which could disclose confidential or privileged information related to me.

  5. I HAVE READ AND UNDERSTOOD THE ABOVE PARAGRAPH. I HAVE BEEN INFORMED OF MY RIGHT UNDER THE CONSTITUTIONAL PROVISION REFERENCED ABOVE.

  6. (If the victim is under age 18, a parent or guardian’s signature should be obtained.)

  7. On Behalf of the Victim

  8. (if applicable)

  9. Leave This Blank:

  10. This field is not part of the form submission.