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Victims Rights
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Victims’ Rights Request Form Online
Victims’ Rights Request Form Online
Victims' Rights Request Form
Form Completed by
Law Enforcement
Victim
Prosecutor
Reporting Agency
Agency Telephone Number
Reporting Officer / Badge No.
Report Number
Case Number (if known)
Court
Clermont Municipal Court
Clermont Common Pleas Court
Clermont County Juvenile Court
Arraignment / Bond Hearing - Date / Time - 24hr
Victim of a violent offense, sexually orientated offense, or violation of protection order *
Yes
No
Victim Information
First Name
Last Name
Address
Address Line 1
Address Line 2
City
State
Zip Code
Victim Email
Victim Telephone
Preferred Method of Contact
Telephone
Text Message
Email
U.S. Mail
Please provide my name and contact information, and that of my representative, if applicable, to the custodial agency, if any.
Yes
No
I would like to request the following rights:
I WANT my name, address, and identifying information removed from:
Law Enforcement records
Prosecutor records
Court records
I WANT notice of the arrest, escape, or release of the offender through VINE (Victim Information Notification Everyday)
Yes
No
I WANT to confer with the prosecutor in the case in addition to the times listed above
Yes
No
I WANT reasonable and timely notice of all public proceedings
Yes
No
I would like to request an interpreter
Yes
No
I WANT to appoint a victim's representative
Yes
No
First Name
Last Name
Address
Address Line 1
Address Line 2
City
State
Zip Code
Submit Form
