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WILLIAMS COUNTY VICTIM'S RIGHTS

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Steps

1. Basic Submission Information This section is complete This section is incomplete
2. Victim's Rights Election This section is complete This section is incomplete
3. Victim Contact Information This section is complete This section is incomplete
4. Representative Contact Information This section is complete This section is incomplete

Basic Submission Information

Per Ohio Revised Code 149.43 this document is not a public record.
Type of Form*
1. Initial
2. Updated
Form Completed By:*
1. Victim
2. Law Enforcement
3. Prosecutor
Submitted
Submitted
Submitted
Police Report#
Municipal Case#
Common Pleas Case#
Reporting Agency & Phone Number*
Officer Name
Badge#
Arraignment or Initial Appearance
Arraignment or Initial Appearance
Arraignment or Initial Appearance
Location
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Victim's Rights Election

Per Ohio Revised Code 149.43 this document is not a public record.
WILLIAMS COUNTY VICTIM'S RIGHTS ELECTION
RIGHTS THAT MUST BE REQUESTED
Please select all that apply.
1. I want my name, address, and identifying information to be redacted (removed) from law enforcement records
2. I want my name, address, and identifying information to be redacted (removed) from prosecutor records
3. I want my name, address, and identifying information to be redacted (removed) from court records
4. I want notice of the arrest, escape, or release of the offender.
5. I want reasonable and timely notice of all public proceedings.
6. I want to confer with the prosecutor in the case.
7. I want to be notified of subpoenas, motions, or other requests to access any of my personal information.
8. I want to appoint a Victim's Representative.
9. I want interpretation services during contacts with criminal justice system officials.
Interpretation Services Requested
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Victim Contact Information

Per Ohio Revised Code 149.43 this document is not a public record.
VICTIM CONTACT INFORMATION
If you select to appoint a representative, please provide their contact information also.
First Name
Middle
Last Name
Contact Preference
Please mark at least one
1. Phone
1. Email
1. Mail
1. Text
Phone Number
Alternate Phone
Email Address
Fax Number
Address 1
Address 2
City
State
Zip Code
Custodial Agency Notification
1. Please provide my name and contact information, and that of my representative, if applicable, to the custodial agency, if any.
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Representative Contact Information

Per Ohio Revised Code 149.43 this document is not a public record.
Optional Notification for Representative
1. As the victim, I do not wish to receive notices about this case. Please provide notices to my representative.
REPRESENTATIVE CONTACT INFORMATION
First Name
Middle
Last Name
Contact Preference
Please mark at least one
1. Phone
1. Email
1. Mail
1. Text
Phone Number
Alternate Phone
Email Address
Fax Number
Address 1
Address 2
City
State
Zip Code

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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