DRAFT04

☐ COURT OF APPEALS ☐ COURT OF SPECIAL APPEALS
☐ CIRCUIT COURT ☐ DISTRICT COURT OF MARYLAND FOR
Located at
STATE OF MARYLAND
OR
Plaintiff/Petitioner

Court Address

vs.

City/County

Case No.
Defendant/Respondent

NOTICE REGARDING RESTRICTED INFORMATION PURSUANT TO RULE 20-201.1

D

R

AF
T

Title of submission submitted as confidential:
☐ 1. RESTRICTED DOCUMENT: THE ENTIRE DOCUMENT IS NOT SUBJECT TO INSPECTION
☐ Child Abuse/Neglect: record created by an agency concerning child abuse or neglect required by statute to be kept
confidential. Rule 16-907(e); Family Law Article, § 5-707; Human Services, § 1-202
☐ Emergency Evaluation: a case record relating to a petition for an emergency evaluation declared confidential under § 10-630
of the Health General Article. Rule 16-907(j)(6)
☐ Expunged Criminal Case Record: Rules 4-508 and 16-907(g)(1)
☐ Financial Statement: in a ☐ child support action. Rule 9-206 ☐ Family Law action. Rules 9-202 & 203
☐ Hearing Closed to the Public: recording/transcript of hearing closed to the public. Rule 16-907(h)
☐ Marital Property: Joint Statement of Marital and Non-Marital Property. Rule 9-207
☐ Marriage License Application: until the effective date of the license. Rule 16-907(b)(2)
☐ Medical Report: or other correspondence from a doctor or health care professional. Rule 16-907(j)
☐ Peace Order Denied/Dismissed/Consented - Shielded: case records shielded under Courts Article § 3-1510(b)(2). Rule 16-907(d)
☐ Pregnancy - Marriage Licensed Application: certification of pregnancy of a person under 18 from doctor or nurse
practitioner in an application for a marriage license. Rule 16-907(b)(1)
☐ Presentence Investigation Report: (confidential until entered into evidence)
☐ Protective Order Case: petition is sealed until the earlier of service or denial of the petition. Rule 16-907(c)
☐ Protective Order Denied/Dismissed/Consented - Shielded: case records shielded under FL Article § 4-512(b)(2). Rule 16-907(d)
☐ Refusal to Testify: case record of refusal of an individual to testify in a criminal action against spouse. Rule 16-907(g)(4)
☐ Sealed or Shielded: (entire document) by court order. Rule 16-912(c) & (d)
☐ Sealing or Shielding Motion: while pending, but not to exceed five (5) business days. Rule 16-912(b)
☐ Tax Returns: state and federal tax returns. Rule 16-907(k)
☐ Other:
Rule or Statute:
☐ 2. DOCUMENT FROM A CONFIDENTIAL CASE TYPE FILED INTO A NON-CONFIDENTIAL CASE TYPE
Example, when filing into a juvenile case do not mark the submission confidential solely because a juvenile case is confidential;
however, when filing a case record from a juvenile case, ERPO case, etc. into a non-confidential case
type, it should be marked confidential.
☐ Adoption: record from an action for adoption of a child. Rule 16-907(a)(1)(A)
☐ Revoke Consent: record from an action to revoke consent to adoption or guardianship for which there is no pending adoption
or guardianship proceeding in that county. Rule 16-907(a)(1)(C)
☐ Guardianship: ☐ all case records in a case involving guardianship of a child. Rule 16-907(a)(2); ☐ except for docket entries
and orders entered under Rule 10-108, papers and submissions filed in guardianship actions or proceedings under Title 10
of the Maryland Rules. Rule 16-907(f).
☐ Juvenile Court: records from an action in juvenile court. Rule 16-907(a)(2)
☐ ERPO: record relating to a petition for an extreme risk protective order. Public Safety, §5-602(c)(1)
☐ 3. CONFIDENTIAL INFORMATION - Rule 16-908 Note: when a submission contains both confidential and
non-confidential information, you must file a redacted and non-redacted copy of the submission. Rule 20-201(h)(2).
☐ The ☐ name ☐ address ☐ telephone # ☐ email address ☐ place of employment of: ☐ an individual who reports the
abuse of a vulnerable adult. Rule 16-908(a) ☐ a victim or victim’s representative in a ☐ criminal action ☐ juvenile
delinquency action ☐ protective order action who has requested that the information be shielded. Rule 16-908(c)
☐ a payee contained in a payee consent filed per Rule 15-1302(c)(1)(G) (structured settlement). Rule 16-908(f)
☐ any part of the Social Security or Federal Tax I.D. number of an individual. Rule 16-908(f)
☐ the home address, telephone number, and private e-mail address of an employee of the State or a political subdivision. Rule
16-908(b)
Date

CPF ID No.

Fax

Printed Name

Telephone Number

Address

E-mail

MDJ-XXX (XX/2020)

Signature

City, State, Zip