Public Records Redaction Request

G.S. 132-1.10(g)

(Effective December 1, 2005)

Iredell County, NC

I _________________________________________ (name of requestor) hereby request the Register of Deeds of Iredell County, NC to remove the following information from the Internet Web Site:

(Check what applies and state information)

____ Social Security Number _______________________
____ Employer taxpayer identification ____________________
____ Drivers License ____________________
____ State identification __________________
____ Passport ____________________
____ Checking Account _______________________
____ Savings Account _________________________
____ Credit Card ___________________________
____ Debit Card ___________________________
____ Personal identification (PIN) code ___________________________
____ Passwords__________________________

Requestor must specify exact location in the document where the information is contained: Located in the following document a _______________________ (i.e.: deed or deed of trust) recorded in Book_______Page_______or Document #______________

__________________________________________________(i.e.: page #, paragraph etc)

Signed by Requestor: __________________________________

Printed or typed name of requestor______________________________

Delivered to the Register of Deeds by: Mail ______

Fax ______

Person ______

*Any Person who requests a redaction without proper authority to do so shall be guilty of an infraction, punishable by a fine not to exceed five hundred dollars for each violation.