CIRCUIT COURT
DISTRICT COURT OF MARYLAND FOR
City/County
Located at
Plaintiff
Court Address
Case No.
vs.
Defendant
REQUEST TO SHIELD INFORMATION IN A CASE RECORD (Rule 16-1009(b)(2))
In my judgment, the following information which consists of (i) a case record, (ii) part of a case record; or (iii) information contained in the case record, is confidential and not subject to inspection under the Court Access Rules. The information that should not be disclosed is (and you must be specific):
The reason(s) the information should not be disclosed is (and you must be specific):
Please answer the following questions that will assist the court in its decision: Have you ever made a request to shield? Yes No Yes No
If "yes," was such previous request to shield before a clerk/custodian, Commissioner or a Judge?
If applicable, indicate the name of the clerk/custodian, Commissioner or Judge and the approximate date the request was made:
List what, if any, relationship you have to the record (e.g., filer of the record, subject of the record, witness cited in the record, etc.):
CC-DC 52 (2/2008)
Page 1 of 2
Case No.
VERIFICATION
I solemnly affirm under the penalties of perjury that the contents of this Request are true and correct to the best of my knowledge, information and belief.
Date Signature
ORDER/APPROVAL
ORDERED/APPROVAL, this day of , 20 , by
that the above Request to Shield is hereby GRANTED DENIED.
Date
Signature
CC-DC 52(2/2008)
Page 2 of 2
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