Transcription of OFFENDER ACKNOWLEDGEMENT NOTICE: Duty to …
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OFFENDER ACKNOWLEDGEMENT NOTICE: Duty to …
1 - 15 _____ OFFENDER INITIAL and DATE OFFENDER ACKNOWLEDGEMENT notice : duty to Register Instructions - Agencies with responsibilities under North Carolina General Statutes, Article 27A, Sex OFFENDER and Public Protection Registration Programs may choose to use this document to assist the agency with their requirements in this area. - This form may be used in conjunction with CIIS - 59, North Carolina Sex OFFENDER Registration Card. - Read carefully. Print legibly. TO BE COMPLETED BY AGENCY Date: Notifying Agency: NC SRN #: OFFENDER Name: FBI #: Telephone# INCLUDE AREA CODE LAST, FIRST MIDDLE Home NC SID #: WORK NC DOC #: MOBILE Address Verified by Agency: Verified for Mail Delivery: Photos: Fingerprinted: Y N Conducted Home Visit Y N Use Y N All Photo Profiles to SBI Y N Physical Address: Vehicle(s): 1.
1 - 15 _____ OFFENDER INITIAL and DATE OFFENDER ACKNOWLEDGEMENT NOTICE: Duty to Register Instructions - Agencies with responsibilities under North Carolina General Statutes, Article 27A, Sex Offender and Public
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