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Victim Witness Division

CHANGE OF INFORMATION FORM
(for corrections or additions only)

 

 

State of Ohio vs.
(enter defendant's name)
Case Number:
- CR-
Victim's Name:
I am the victim in the above-captioned matter. I can be reached through the information listed below.
The victim is a child, elderly, deceased, incapacitated, or incompetent. The person listed below will be the victim’s representative.
   
Victim/Representative Name:
   
Mailing Address
Street:
City:
State:
Zip:
 
Home Phone Number:
Cell Phone Number:
E-Mail Address:
Work Phone Number:
Normal Work Hours:
Name of Alternate Contact:
Phone Number of Alternate Contact:
Relationship of Alternate Contact:
   
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