Form Sp 4-218 - Sexual Offender Registration (Page 6 of 12) in pdf

Form Sp 4-218 - Sexual Offender Registration Page 6

SECTION N – SUPERVISION

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

184. Is Offender Under Supervision?: Place an “X” in the appropriate box.

185. Supervising Agency: Enter the agency that supervises the sexual offender.

186. Supervision Start Date: Enter the first day of probation/parole (numerically by month, day, and 4-digit year).

187. Supervision End Date: If known, enter the end date of parole/probation (numerically by month, day, and 4-digit

year).

188. Parole Number: Enter the parole number.

ADDITIONAL COMMENTS

This section is used to record any additional comments necessary.

REQUIREMENTS STATEMENTS

This section is used to convey the registration requirements to the offender. The sexual offender must read and check all

registration requirement statements. This form must be signed and dated by both the sexual offender and the registering

official.

If completing this form for a New Registration, submit the form along with facial (frontal), scars, marks, and

tattoo photograph(s), fingerprints, and palm prints to the Pennsylvania State Police at the address found at

the end of this form.

If completing this form for Verification, Address Change, School Change, Employment Change, or Other,

submit the form along with the photograph(s) to the Pennsylvania State Police at the address found at the end

of this form.

Fingerprints, palm prints, and DNA are required for New Registrations at initial registration, or if a sexual offender’s

identity is in question. A facial (frontal) photograph is required for each appearance.

Questions regarding DNA collection or DNA-associated paperwork as well as requests for kits may be directed to:

Forensic DNA Division

80 N. Westmoreland Avenue

Greensburg, PA 15601

724-832-5423

Page 6 of 12

Form Sp 4-218 - Sexual Offender Registration Page 6