Information on obtaining or renewing your security ID

1. President: Eduardo X.
Pereira Vice President:
Margot Moss Treasurer:
Teresa Enriquez Secretary:
Brian Kirlew
MIAMI CHAPTER
CO-FOUNDED 1963, BY DANIEL S. PEARSON AND HARRY W. PREBISH
Dear FACDL-Member,
For those attorneys who wish to obtain a Security By-Pass Identification Card, please find below the
Security ID Application Form and a FACDL Membership Renewal Form. Each new applicant must
complete the new Application Form and where applicable, the Public Records Exemption Certification
Form found below. Applications must include a check made out to FACDL-Miami for $20. This fee
includes the payment of $10 to AOC for processing fee of the ID card as well as $10 for costs incurred by
FACDL for the processing of the applications.
Once you have completed the application please mail it along with payment to:
FACDL -Miami Secretary, Brian Kirlew
1320 NW 14 Street
Miami, FL 33125
All new applications and related fees, will be submitted to the Administrative Office of the Courts
by FADCL Miami on the 15th of each month. The approved applicants will be notified by FACDL and
advised that their new ID is ready for pick up at the Courthouse Center. When responding to pick up your
new ID card you will be required to bring the "Acknowledgement Form” found below, affirming that you
will follow all program rules.
Please remember that this program is still relatively new and may continue to experience growing pains.
Also, keep in mind that FACDL-Miami does not have an Executive Director or staff and all members of the
Executive Board who are working on this program are also trying to practice law. Needless to say, your
patience is much appreciated.
While this ID is a privilege, it is not limited to our membership; please feel free to forward this letter and
the accompanying forms to anyone who may be interested in securing an ID. There are twenty Judicial
Circuits in the State of Florida and there is one that allows attorneys to By-Pass security. Please be
responsible, and ensure that the efforts of our past president Betty Llorente and our new Chief Judge
Soto are not wasted. Finally, if you have not renewed your FACDL Miami membership and appreciate the
efforts made on your behalf in this and other initiatives, please consider renewing at this time with the
attached form.
Best regards,
Eduardo ‘Eddie’ Pereira
FACDL-Miami, President

2. CRIMINAL DEFENSE ATTORNEY
APPLICATION FORM
INSTRUCTIONS: PLEASE ANSWER ALL QUESTIONS AND PRINT CLEARLY.
New application
Renewal
_ [please check one]
NAME:
_
(Last)
(First)
DRIVER’S LICENSE #:
RACE: WHITE
(Middle)
DATE OF BIRTH:
BLACK
_ HISPANIC
GENDER: MALE
FEMALE
_/
_/
(Month) (Day) (Year)
_ OTHER (SPECIFY)
_
OFFICE ADDRESS:
(Street)
(City)
(State)
(Zip)
E-MAIL ADDRESS:
TELEPHONE:
_
_
(Work)
(Cell)
FLORIDA BAR LICENSE INFORMATION:
FLORIDA BAR NUMBER:
DATE ADMITTED:
MEMBER IN GOOD STANDING:
_Yes
_No
Please indicate whether you QUALIFY / DO NOT QUALIFY (please CIRCLE one) for an exemption from a Chapter
119 Public Records request. If you do qualify, please submit a PUBLIC RECORDS EXEMPTION CERFTIFICATE along
with this Application.
I HEREBY CERTIFY THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE TO THE BEST OF MY
KNOWLEDGE. I UNDERSTAND AND AGREE THAT AS AN APPLICANT A CRIMINAL BACKGROUND INVESTIGATION
WILL BE PERFORMED TO DETERMINE MY ELIGIBILITY FOR ISSUANCE OF A SECURITY ACCESS COURT
IDENTIFICATION BADGE.
I UNDERSTAND AND AGREE THAT FALSIFICATION OF ANY STATEMENT ON THIS
APPLICATION AND/OR FINDING OF PREVIOUS CRIMINAL CONVICTION OR PENDING CRIMINAL ACTION MAY
PROHIBIT THE ISSUANCE OF A SECURITY ACCESS COURT IDENTIFICATION BADGE.
_
SIGNATURE OF APPLICANT
DATE
Administrative Office of the Courts Security-Bypass ID Processing Fee:
$0 - for renewal of Security-Bypass ID (for 2013 only)
$10 – for new Security-Bypass ID applicants

3. Public Records Exemption Certification Form
The following public records exemptions apply to personal information contained in State
Court System records. These exemptions do not protect personal information contained in records held
by other state or local governmental entities.
All social security numbers held by the State Courts System are confidential under Section
119.071(5)(a)(5), Florida Statutes.
I,
, certify that:
1.
I qualify to have my home addresses, telephone numbers and date of birth; home
addresses, telephone numbers, dates of birth and places of employment of my spouse and
children; and names and locations of schools and day care facilities attended by my children
exempted from public records disclosure in accordance with Section 119.071(4)(d), Florida
Statutes, based upon the following provisions:
(a) former justice or judge of the State Courts System.
(b) former general or special magistrate or child support enforcement
hearing officer for a state court and I have provided a written statement that I have
made reasonable efforts to protect this information from being accessible through
other means available to the public.
(c) spouse or child of the above.
2.
I qualify to have my home addresses, telephone numbers, date of birth, and
photograph; home addresses, telephone numbers, photographs, dates of birth and places of
employment of my spouse and children; and names and locations of schools and day care
facilities attended by my children exempted from public records disclosure in accordance
with Section 119.071(4)(d), Florida Statutes, based upon the following provisions:
(a) active or former sworn or civilian law enforcement personnel, including
correctional officer or correction probation officer.
(b) spouse or child of the above.
3.
I qualify to have my home addresses, telephone numbers, date of birth and
photographs; home addresses, telephone numbers, photographs, dates of birth and places of
employment of my spouse and children, and names and locations of schools and day care
facilities attended by my children exempted from public records disclosure in accordance
with Section 119.071(4)(d), Florida Statutes, based upon the following provisions:
(a) active or former Department of Children and Families personnel whose
duties include the investigation of abuse, neglect, exploitation, fraud, theft, or other
criminal activities.
(b) active or former Department of Health personnel whose duties are to
support the investigation of child abuse or neglect.
(c) active or former Department of Revenue or local government personnel
whose responsibilities include revenue collection and enforcement, or child support
enforcement.
(d) firefighter certified in compliance with Section 633.35.
(e) current or former human resource, labor relations, or employee
relations director, assistant director, manager, or assistant manager of any local
government agency or water management district whose duties include hiring and

4. firing employees, labor contract negotiations, administration, or other
personnel-related duties.
(f) current or former state attorney, assistant state attorney, statewide
prosecutor, or assistant statewide prosecutor.
(g) current or former public defender, assistant public defender, criminal
conflict and civil regional counsel, and assistant criminal conflict and civil regional
counsel.
(h) current or former code enforcement officer.
(i) current or former juvenile probation officer, juvenile probation
supervisor, detention superintendent, assistant detention superintendent, juvenile
justice detention officer I and II, juvenile justice detention officer supervisor, juvenile
justice residential officer, juvenile justice residential officer supervisors I and II,
juvenile justice counselor, juvenile justice counselor supervisor, human services
counselor administrator, senior human services counselor administrator,
rehabilitation therapist, and social services counselor of the Department of Juvenile
Justice.
(j) spouse or child of the above.
4.
I qualify to have my home addresses, telephone numbers and photographs; names,
home addresses, telephone numbers, and places of employment of my spouse and children;
and names and locations of schools and day care facilities attended by my children exempted
from public records disclosure in accordance with Section 119.071(4)(d) and (5)(i), Florida
Statutes, based upon the following provisions:
(a) current or former United States attorney or assistant United States
attorney and I have requested that the above personal information be exempt from
public disclosure, and I have provided a written statement that I have made
reasonable efforts to protect this information from being accessible through other
means available to the public.
(b) current or former United States Court of Appeals judge, United States
District Court judge or United States magistrate and I have requested that the above
personal information be exempt from public disclosure, and I have provided a written
statement that I have made reasonable efforts to protect this information from being
accessible through other means available to the public.
(c) current or former investigators or inspectors with the Department of
Business and Professional Regulation and I have provided a written statement that I
have made reasonable efforts to protect this information from being accessible
through other means available to the public.
5.
I qualify to have my home addresses, telephone numbers, places of employment,
date of birth and photographs; names, home addresses, telephone numbers, dates of birth,
and places of employment of my spouse and children; and names and locations of schools
and day care facilities attended by my children exempted from public records disclosure in
accordance with Section 119.071(4)(d), Florida Statutes, based upon the following provisions:
(a) current or former guardian ad litem and I have provided a written
statement that I have made reasonable efforts to protect this information from being
accessible through other means available to the public.
(b) spouse or child of the above.

5. 6.
I qualify to have my home addresses and telephone numbers; names, home
addresses, telephone numbers and places of employment of my spouse and children; and
names and locations of schools and day care facilities attended by my children exempted
from public records disclosure in accordance with Section 119.071(4)(d), Florida Statutes,
based upon the following provisions:
(a) county tax collector and I have provided a written statement that I have
made reasonable efforts to protect this information from being accessible through
other means available to the public.
(b) spouse or child of the above
_
Print Name
_
Signature
_
Date

6. ACKNOWLEDGMENT ADMINISTRATIVE
OFFICE OF THE COURTS
CRIMINAL DEFENSE ATTORNEY SECURITY SCREENING
I, the undersigned, do hereby acknowledge that I understand that in receiving a court issued security
identification card I am allowed to by-pass security screening measures utilized at the RICHARD E.
GERSTEIN (REG) COURT FACILITY ONLY BETWEEN the HOURS of 8:00 A.M. to 12:00 NOON, MONDAY
through FRIDAY. I acknowledge that such court security by-pass authorization is a privilege, not a right,
and may be terminated, either in part, or in whole, at any time. The issuance of a court security by-pass
identification badge is contingent upon my adhering to and abiding by all policies that provide me the
privilege of being able to by-pass court security screening measures at the REG, to wit: maintaining my
status as a member in good standing of the Florida Bar; the prohibition against bringing a weapon of any
type into this facility, subjects me to arrest; and informing the Administrative Office of the Court of any
criminal action which results in my arrest. Further, if at any time, I do not comply with the above policies,
my security identification card will be subject to revocation; and shall be surrendered without delay. I
further understand that if I bring a weapon into the REG, my action will result in the termination of this
program for all criminal defense attorneys participating in the program.
I understand that I must comply with any random security check conducted by court security staff.
I further understand that I must maintain, with the Administrative Office of the Courts, a current address
and phone number and failure to do so could result in the revocation of my security identification card.
The Chief Judge retains the right to withhold a court issued security identification card for any reason not
specifically covered by any of the previously stated reasons for exclusion.
Printed Name:
Florida Bar#:
Date:
Signature:
NOTE: There will be a $20 fee to replace a lost security identification card. Only checks or money
orders will be accepted; made payable to the Board of County Commissioners.