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HEA 1371 - Request To Restrict Access To Home Address

  1. Pursuant to IC 36‐1‐8.5, HEA 1371, the following covered persons must submit a written request to the Hamilton County Auditor to restrict access through a public property data base web site to his/her home address as it appears in the county’s tax management system:

  2. a) Supreme court, court of appeals, tax court, circuit court, superior court, municipal court, county court, federal court or small claims court; or,
    b) Magistrate, commissioner, or juvenile referee of a court.

  3. a) A police officer (including a correctional police officer), sheriff, constable, marshal, prosecuting attorney, special prosecuting attorney, special deputy prosecuting attorney, the securities commissioner, or the inspector general; or,
    b) A deputy of any of the persons specific in subdivision (a); or,
    c) An investigator for a prosecuting attorney or for the inspector general; or,
    d) A conservation officer; or,
    e) An enforcement officer of the alcohol and tobacco commission; or,
    f) An enforcement officer of the securities division of the office of the secretary of state.

  4. Someone who is certified as a program participant in the address confidentiality program established by the attorney general under IC 5‐26.5‐2.

  5. An individual who holds or formerly held office at any time during the preceding four (4) years in the executive or legislative branch

  6. If a property transaction transferring the property to another party occurs, the restriction on said property will be removed. If the covered person purchases another property, a new form shall be submitted to the County Auditor.

  7. I,

  8. request that the Hamilton County Auditor restrict access to the address of my actual personal residence through any record made available to the general public within a public property data base web site that includes my residential information.

  9. Requester is currently employed as a (Check only the ONE that applies)*











  10. l (We) hereby certify that the above statement is true, correct and complete.

  11. Leave This Blank:

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