Form Sp 4-218 - Sexual Offender Registration (Page 2 of 12) in pdf

SECTION D – IDENTIFIERS

This section is used to record the sexual offender’s identifiers.

23. Have Palm Prints Been Taken?: Place an “X” in the appropriate box. Palm prints are required for all Megan’s

Law sexual offenders at initial registration.

24. Has DNA Been Taken?: Place an “X” in the appropriate box. DNA collection is required for all Megan’s Law

sexual offenders at initial registration.

25. Passport Number: If applicable, enter the passport number.

26. Inmate Number: If applicable, enter the inmate number.

27. Immigration (Alien) ID: If applicable, enter the immigration (alien) identifier (ID).

28. Immigration Status: If applicable, enter the immigration status.

29. FBI Number: If applicable, enter the FBI number.

SECTION E – ALIASES

This section is used to record the sexual offender’s aliases.

30. Current Aliases/Nicknames: Enter ALL aliases/nicknames pertaining to the sexual offender.

SECTION F – SCARS/MARKS/TATTOOS/MISSING BODY PARTS (AMPUTATIONS)

This section is used to record the sexual offender’s scars, marks, tattoos, and missing body parts (amputations).

31. Scars: Enter the location(s) and description(s) of any scars on the sexual offender’s body.

32. Tattoos: Enter the location(s) and description(s) of any tattoos on the sexual offender’s body.

33. Amputations: Enter the location(s) and description(s) of any amputations.

34. Marks: Place an “X” in the appropriate box, and enter the location(s) and description(s) of any marks on the

sexual offender’s body.

SECTION G – ADDRESS INFORMATION

This section is used to record all of the sexual offender’s addresses (where the offender resides or receives mail)

including a correctional facility. If the sexual offender is being released from a correctional facility, do not complete the

facility section.

Correctional Facility

35. Name of Facility: Enter the name of the correctional facility where the sexual offender is incarcerated.

36. Description: Enter the description of the correctional facility (e.g., prison, county, state, federal, work release

center, detention).

37. Telephone Number: Enter the telephone number of the correctional facility.

38. Street Address 1: Enter the street address of the correctional facility.

39. Street Address 2: Enter additional street address information of the correctional facility.

40. City: Enter the city of the correctional facility.

41. State: Enter the state of the correctional facility.

42. Zip Code: Enter the zip code of the correctional facility.

43. County: Enter the county of the correctional facility.

44. Country: Enter the country of the correctional facility.

45. Municipality: Enter the city/township/borough of the correctional facility.

46. Start Date: Enter the first day of incarceration (numerically by month, day, and 4-digit year).

47. End Date: Enter the date of release from incarceration (numerically by month, day, and 4-digit year).

48. Responsible Agency Having Jurisdiction: Enter the responsible agency having jurisdiction at the correctional

facility.

Primary Residence

49. Description: Enter a description of the primary residence of the sexual offender (e.g., house, apartment, cabin,

shelter).

50. Telephone Number: Enter the telephone number of the primary residence, including the area code.

51. Street Address 1: Enter the street address of the primary residence.

52. Street Address 2: Enter additional street address information of the primary residence (include apartment/room

no.).

53. City: Enter the city of the primary residence.

54. State: Enter the state of the primary residence.

55. Zip Code: Enter the zip code of the primary residence.

56. County: Enter the county of the primary residence.

57. Country: Enter the country of the primary residence.

58. Municipality: Enter the city/township/borough of the primary residence.

Page 2 of 12

Form Sp 4-218 - Sexual Offender Registration Page 2

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