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Request to Restrict Public Dissemination of Personal Information on the Internet

  1. Annual Renewal and Disclaimer

    You will be notified annually to confirm that you still qualify and/or still own the subject property.


    Interested parties (banks, title companies, etc.) will still have access to unredacted documents in person.

  2. Enter N/A if no property is owned

  3. Type of Protected Person

    Please indicate the type of Protected Person you are applying as below. You must answer affirmatively in at least one of the numbered categories. Please note: you must reapply annually to continue to be blocked.

    Link to Title 18 of the Colorado Revised Statutes.

    Link to Title 24 of the Colorado Revised Statutes.

  4. 1. A participant in the Address Confidentiality Program, as defined by C.R.S. 18-9-313 and 24-30-2101, with a valid Address Confidentiality Program authorization card.
  5. 2. A Protected Person pursuant to C.R.S. 18-9-313, specifically;
  6. 3. An Election Official pursuant to C.R.S 18-9-313.5
  7. 4. An immediate family member of a Protected Person. Pursuant to C.R.S. 18-9-313, immediate family means a Protected Person's spouse, child or parent or any other blood relative who lives in the same residence as the Protected Person.
  8. 5. An immediate family member of an Election Official. Pursuant to C.R.S. 18-9-313.5, immediate family means an Election Official's spouse, child, or parent or any other person who lives in the same residence as the Election Official.
  9. Leave This Blank:

  10. This field is not part of the form submission.