Agency Registration Agreement To View Records Online Form - Volusia County Clerk Of Court

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AGENCY REGISTRATION AGREEMENT TO VIEW RECORDS ONLINE
VOLUSIA COUNTY CLERK OF COURT
*Agency/Company Name: __________________________________________
*Required
*Agency Head Name: _____________________________________________
*Required
*Agency Head Title: _______________________________________________
*Required
*Agency Head E-mail Address: ______________________________________
*Required
*Agency Address: ________________________________________________
*Required
*City/State/Zip: ___________________________________________________
*Required
*Agency Head Phone: _____________________________________________
*Required
1. Do you currently have an Internet Access account with the Clerk of Court?
No ___ Yes ___.
If yes, please provide your current login ID: _____________________.
2. This Agreement is for an Agency or Company to view electronic court records as
authorized pursuant to Florida Supreme Court Administrative Order 2015-18
(AOSC15-18) as:
 Authorized state or local government agency/entity
 School Board
 Certified law enforcement officers of federal or state law enforcement
agencies
 State Attorney’s Office
 Florida Attorney General’s Office
 Department of Children and Families, or authorized service providers of the
agency
3. The undersigned appoints the following as Gatekeeper:
*Gatekeeper Name: _______________________________________________
*Required
*Gatekeeper E-mail Address: _______________________________________
*Required
*Gatekeeper Address: _____________________________________________
*Required
*City/State/Zip: ___________________________________________________
*Required
*Gatekeeper Phone: ______________________________________________
*Required
Agency Registration Agreement
Page 1 of 4
CL-0602-1602

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