SEXUAL OFFENDER REGISTRATION FORM

SEXUAL OFFENDER REGISTRATION FORM FORUSE MY LAW ENFORCEMENT AGENCiIS PLEASE PRINT - CONIPLE1 ALL SF.CTIONS SISTiONM tares. lakes RBgdlrJWn f i haw on :SJpefostolfteleala SECTION A- TrviSulus I al Let :7,er a ITte lit Stat.02 -R ittl_a gistralt moh minion Name P T iN etas _ _ aS3ai 09.1443343 cOs PCS 41gMEL-- ( Ones leenam c Race: fpgra--_ M Sea. A_ In AVM _l_ThailUrrftE8L___ Er rs Stir_ r . Clove Lien) Sant I I WA Kr> vARK EFiEs Adtet, conuil a "'"' remPorary Address' CON, ii.12115015-9--- Ccroct §gcrof -Jewel Identifiers VS any and al Omit addresses used Insure Messacing aidcs, in vitemelcotrararicalaisardposVqs. and all social neteran deethera ( 1 WA WAIL OP _a- 111-01---- - I unmans ocos , Oivi_EN I X I Erntiesiri _ _ - Conta0 Person_-- — - - -. - Date EnWorel 091ei -Employmentu T _ . i w ki___ i Rh TR -- sossis g 4 siguill_ - (lea C.. EraVoYer - - Corlad Person Dsie Eriactore^' Teleta7m4 iW-2ik2521--AddreSs - - TON - YoWntee Information 1 I WA COMO Person C1Rarwahsn i"PhCce Contact Parc Olrz at*" - - - -- Tefeprtane _ %MN! - Occupational License Information O I X I WA tte:paternal ocense Issuer _ - womoon ix lin Ons Emoted Wafffil - Education Sco$ _ _ wwTgNK-ilehicle. Trailer Vessel. Etc. I Il yiLA DISSIMPbOn RearMakerModeGOW Salm.) HIC S Ft frequent Localen a' Vence - YIN? FORM NOT COMPLETE - TURN PAGE OYER TO CONTINUE SECTION', -Offense Information MN I %Vapor (Ifkopatted by Reason of bandy. 0* OlCanyfcbal MISEenti Maar+ Is•-fof ()We 04 Cenvoban CouraCar No. AG143 06,309008 PROCURING A LINOR F 1.18 FLORIDA FOR PROSTITUTION Aso You Registered as a Sex OflimON in Another State. I I NO(X 1 YES II YES, which state' NEW YORK and at vast LEVEL al SICTIONM - PLEASE READ CAREFULLY BEFORE BONING As a Sena, Offender (Tile 14 V IC § 1121.1131) maw we reo,acto a/ Ow'," M. of, t., p. a, no WIN, tree 13) business days of moing b cr retrnr, to to register n Pe Vrgn islands and leett par regtottaaon allied in each jun1/2 0on n nt,<I, you retail. i t r r, , • • R r e. per- )V.: are e•-:::cycdonivaing sea-am/Ay/men' rocacompensalal ar4,,Ortgilee, Jew 'sew an, ri ta:n 'too y ,, ,,, cfocf. 1 In re trent Mere is a change in you: nu-uo. topic.," f r u .our aa ars ;a Sa'ng information, vehicle information. or interned identifiers. you are :enured b appear .1peraori r I uOepartment ol not later than three 13)wolking days after such change. 3 Is Tee mien! Mal )•Ou roe corset clac LknICO Stales VuOn saris yOu must register your nen adlrett •flo the Department cl Jostor tofort you lea,* ana waa foist also 'cask. in you, rev: state Oct later "La, three (3) business days after arrival there ti wor flea >1St has a tog stfaffon reOurern(re 4 is recent that you are Yarearo)Outsrie of the Wool I Wanclo )“, are So reruns to area' n Fersca at the Depaamoccof Jasloe prior f lever, three '31 r-onaft ;co. Depend, i cr ti c :1pif a, or, oac'a, „ cops at tie Decal- tot O' JuSICe fa rent), ps dOrmatoi .3,3 3) • a•y tar a prod o' ( liSyears 25 years I 1 for life rem f.V.4.r.r.1,:r1 rrr,i 7 Face to CO'llOrr grin tuese ctlgaacas stitsects ',cc to geosecuton Ice tar see to regiOW en update your reversion pursuant Id a. Virgin Islands Code. Title 14. Section 1730. punishable by a fine not less than 51000 nor more than $5.000, or imprisonment for not less than three months nor more than two years. or both: and b. Federal Law, 18 U.S.C. Section 2250. punishaN• by up to 10 year of imprisonment Se Reminded eat under Title I Of the Adam Walsh Act waited the 'Sexual Offender Resostalce and Notolcaton Act ISORNM. at ridadas cerrncted of a sex offense are reputed to readier and keep Per revstairan current in each Nnsochon there he a she resides.* an errs/Flee end is a WWI FAILURE TO DO SO MAY SUBJEC T YOU TO CRIMINAL PROSECUTION YOUR NE XT REGISTRATION DATE: 03 05 2020 Reg strait. I aumosledge Dine atom re:prem.-a as set kern ha se been tautened CI? Wetness: I tent, that I spec !cad' inIcralea trr o'colef of his iher mint'. at set feet atme and be endeared to me an undesualrg of those doles V81 r SI/7 S•rs Cl Pia Panel P•ei Pip.* ;;asseigirseassiostrlinge ss-r . "'us)" - ---see—. VIRGIN ISLANS DEPARTMENT OF JUSTICE OFFICE OF THE ATTORNEY GENERAL VIRGIN ISLANDS SEXUAL OFFENDER REGISTRY Notification of Duty to Report Travel Name of recipient: Jeff red -4, S‘t1 n On this IS4" day of FN.- 2019 . I have been advised, and I understand. Travel to US Jurisdictions 1. That pursuant to chapter 86. Section 1724 lb) I ) in the es em of a change in temporary lodging. I am required to inform the Virgin Islands Ikpart !Wilt of Justice. in person. of any changes to my temporary lodging information and shall notify the Jurisdiction in which I will be temporarily staying, Ira Ials 2 That "temporary lodging" refers to a pla.e o here I abide. lodge, or reside. including. hut not limited to vacation. business, or personal travel destinations outside of the LI. S. Virgin Islands. Initials International Travel That pursuant to Chapter 86. Section 1724 (b) (4) 1 am required to appear in person at the Virgin Islands Department of Justice at least tut cut' one (21) calendar days prior to any intended travel outside of the United States and provide pertinent travel information. z i t_. Initials 2. If a reduction in the 21-day notice requirement is requested, I must submit information in Nippon of the request for approval at the discretion of the Department of :fustier ..- Initials Required Information for Travel I Thal when I appear m person to inform the IMpartment of Justice of my Intent to tray el, 1 must provide the following inhumation, i Destination ii Dates of travel ui Places of arrival and departure is Itinerary details v Address or, in lieu, telephone contact information vi Purpose of travel vii. Any other required information WDOYSORas inlets SDNY GM_00 168299 EFTA_00191904 EFTA01303328