Page 1 of 2 Request for JUSTICE User ID - External Agency Name of New User: Job Title: Agency/Entity Name: Agency/Entity Address: Requestor Name (If different from user): Requestor Job Title: Requestor Phone: Requestor Email Address: This user ID is needed by: (effective date) and is Temporary / Ongoing If temporary, date to expire ID: All JUSTICE user accounts for external entities are granted access to public information in County and District courts, in the following case types: Civil, Criminal, Juvenile, Probate, Small Claims and Traffic. Confidential Information in JUSTICE Agencies can apply for access to specifically protected personal and financial information in juvenile and civil records under Supreme Court Rules 247 6-1464(A), 6-1521(A), or 6-1701(A). If the requested user ID shall require access to confidential information/filings in JUSTICE, the agency222s approved form must accompany this request. Access requested and attachment included: Yes No Sealed Record Information in JUSTICE Nebraska statutes 43-2,108.05 and 29-3523 governing sealing of juvenile and adult criminal court records grants authority to specified individuals or entities to access a sealed record. If the requested user ID shall require access to sealed juvenile and adult records, this request must include the specific statutory authority and is subject to approval by the Court Administrators office. Access requested Yes No American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Description of authority to view adult/juvenile records sealed under statute: Each agency or official granted access and assigned a JUSTICE user ID(s) shall agree: a.To safeguard the JUSTICE user ID(s) and password(s).b.To never permit another person to access JUSTICE with the user ID(s) and password(s).c.To never use another official or agency222s user ID(s) and password(s) to access JUSTICE.d.To log off JUSTICE when access to JUSTICE is complete and never leave workstations unattendedwhile logged on to JUSTICE.e.To notify the JUSTICE Help Desk when use of the user ID(s) is no longer required by the official oragency.f.To use the information obtained from JUSTICE solely for the purpose(s) authorized by statute,other express authority, or this agreement. I understand and agree to the terms of use for a JUSTICE user ID. Any violation of this agreement, or the statute or other authority upon which this agreement is based, shall terminate the official or agency222s access to JUSTICE immediately. All JUSTICE User IDs are deleted after 90 days of inactivity. Signature of new JUSTICE user: Dated: American LegalNet, Inc. www.FormsWorkFlow.com