Form Sp 4-218 - Sexual Offender Registration Page 4
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12102. Zip Code: Enter the zip code of Employer 1.
103. County: Enter the county of Employer 1.
104. Municipality: Enter the city/township/borough of Employer 1.
105. Country: Enter the country of Employer 1.
106. General Work Area: Enter the portion of the workplace in which the sexual offender moves about while fulfilling
work tasks if the sexual offender’s employment is not at a fixed address.
107. Start Date: Enter the first day of employment at Employer 1 (numerically by month, day, and 4-digit year).
108. End Date: If known, enter the last day of employment at Employer 1 (numerically by month, day, and 4-digit
year).
109. Responsible Agency Having Jurisdiction: Enter the responsible agency having jurisdiction in the area of
Employer 1.
Employer 2
110. Employer: Enter the name of the place of employment of the sexual offender
111. Occupation: Enter the type of work performed (e.g., landscaper, teacher, framer).
112. Supervisor’s Name: Enter the name of the supervisor.
113. Telephone Number: Enter the telephone number of Employer 2, including the area code.
114. Street Address 1: Enter the street address of Employer 2.
115. Street Address 2: Enter additional street address information of Employer 2.
116. City: Enter the city of Employer 2.
117. State: Enter the state of Employer 2.
118. Zip Code: Enter the zip code of Employer 2.
119. County: Enter the county of Employer 2.
120. Municipality: Enter the city/township/borough of Employer 2.
121. Country: Enter the country of Employer 2.
122. General Work Area: Enter the portion of the workplace in which the sexual offender moves about while fulfilling
work tasks if the offender’s employment is not at a fixed address.
123. Start Date: Enter the first day of employment at Employer 2 (numerically by month, day, and 4-digit year).
124. End Date: If known, enter the last day of employment at Employer 2 (numerically by month, day, and 4-digit
year).
125. Responsible Agency Having Jurisdiction: Enter the responsible agency having jurisdiction in the area of
Employer 2.
SECTION J – VEHICLE INFORMATION
This section is used to record sexual offender’s vehicle information for all vehicles owned or operated.
Vehicle 1
126. Vehicle Type: Place an “X” in the appropriate box.
127. Year: Enter the year of Vehicle 1.
128. Make: Enter the make of Vehicle 1 (e.g., Ford, Chevy, GMC).
129. Vehicle Primary Color: Enter the primary color of Vehicle 1.
130. Model: Enter the model of Vehicle 1 (e.g., Escort, Corvette, Accord).
131. Style: Enter the body style of Vehicle 1 (e.g., pickup truck, 2-door or 4-door coupe, SUV, minivan, wagon,
sports car, convertible, hybrid, luxury).
132. Vehicle Secondary Color: If Vehicle 1 has a secondary color, record the color.
133. Vehicle Ownership: Place an “X” in the appropriate box.
134. Vehicle Identification Number (VIN): Enter the vehicle identification number of Vehicle 1.
135. Is This Vehicle Registered?: Place an “X” in the appropriate box.
136. Plate #: Enter the license plate number of Vehicle 1.
137. State: Enter the state where Vehicle 1 is registered.
138. Is License Plate Expiration Date Non-expiring?/Plate Expiration Date: Place an “X” in the appropriate box,
and enter the expiration date if NO is selected.
139. License Plate Type: Enter the type of license plate of Vehicle 1 (e.g., auto, truck, dealer).
140. Additional Details: Enter additional details of Vehicle 1.
141. General Parking Locations: Enter all locations where Vehicle 1 is parked.
Vehicle 2
142. Vehicle Type: Place an “X” in the appropriate box.
143. Year: Enter the year of Vehicle 2.
144. Model: Enter the model of Vehicle 2 (e.g., Escort, Corvette, Accord).
145. Vehicle Primary Color: Enter the primary color of Vehicle 2.
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