Form Sp 4-218 - Sexual Offender Registration (Page 5 of 12) in pdf

146. Make: Enter the make of Vehicle 2 (e.g., Ford, Chevy, GMC).

147. Style: Enter the body style of Vehicle 2 (e.g., pickup truck, 2-door or 4-door coupe, SUV, minivan, wagon,

sports car, convertible, hybrid, luxury).

148. Vehicle Secondary Color: If Vehicle 2 has a secondary color, enter the color.

149. Vehicle Ownership: Place an “X” in the appropriate box.

150. Vehicle Identification Number (VIN): Enter the vehicle identification number of Vehicle 2.

151. Is This Vehicle Registered?: Place an “X” in the appropriate box.

152. Plate #: Enter the license plate number of Vehicle 2.

153. State: Enter the state where Vehicle 2 is registered.

154. 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.

155. License Plate Type: Enter the type of license plate of Vehicle 2 (e.g., auto, truck, dealer).

156. Additional Details: Enter additional details for Vehicle 2.

157. General Parking Locations: Enter all locations where Vehicle 2 is parked.

SECTION K – INTERNET IDENTIFIERS

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

158. Email Address: Enter ALL email addresses affiliated with the sexual offender.

159. Site Identifiers/Site Affiliation(s):

Enter all identifiers affiliated with the sexual offender (e.g., Facebook,

Twitter, Tagged, MySpace).

SECTION L – LICENSE IDENTIFIERS

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

Driver’s License

160. Driver’s License Number: Enter the sexual offender’s driver’s license number.

161. Issuing State: Enter the state in which the driver’s license was issued.

162. Expiration Date: Enter the expiration date (numerically by month, day, and 4-digit year).

163. Is License Current?: Place an “X” in the appropriate box.

Professional License (If applicable, complete this section.)

164. License Number: Enter the sexual offender’s professional license number (e.g., plumber, barber, pilot).

165. License Type: Enter the type of professional license.

166. Issuing Agency: Enter the issuing agency for the professional license.

167. Issuing State: Enter the state that issued the professional license.

168. Expiration Date: Enter the expiration date of the professional license (numerically by month, day, and 4-digit

year).

169. Is license Current?: Place an “X” in the appropriate box.

SECTION M – OFFENSE

This section is used to record the sexual offender’s offense(s).

170. Country of Conviction: Enter the country in which the sexual offender was convicted.

171. State of Conviction: Enter the state of conviction.

172. County of Conviction: Enter the county of conviction.

173. OTN: Enter the Offense Tracking Number (OTN).

174. Offense: Enter the offense.

175. Offense Date: Enter the date of the offense (numerically by month, day, and 4-digit year).

176. Arrest Date: Enter the actual date of arrest (numerically by month, day, and 4-digit year).

177. Conviction Date: Enter the date of conviction/found guilty (numerically by month, day, and 4-digit year).

178. Was the Offender Adjudicated Delinquent as a Juvenile?: Place an “X” in the appropriate box.

179. Was the Juvenile Offender Civilly Committed as a Sexually Violent Delinquent Child (SVDC)?: Place an

“X” in the appropriate box.

180. Additional Information: Enter additional information of the offense.

181. Were Any of Offender’s Victims Minors?: Place an “X” in the appropriate box.

182. Victim 1/Age: Enter the age of Victim 1 at the time of the offense. Place an “X” in the appropriate box, and

enter the relationship of Victim 1 to the sexual offender.

183. Victim 2/Age: Enter the age of Victim 2 at the time of the offense. Place an “X” in the appropriate box, and

enter the relationship of Victim 2 to the sexual offender.

Page 5 of 12

Form Sp 4-218 - Sexual Offender Registration Page 5

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