BENTON COUNTY SHERIFF’S OFFICE
Your Agency Name Here
On-going registration requirements:
________________________________________ RISK LEVEL _________
Offender’s Name
Level 1 offender’s addresses must be verified in person by law enforcement at the registered address at least one time per year. If an offender is not at home when a verification attempt is made, the officer will leave a business card. The offender must call the number on the card to complete their annual verification. Verifications may be conducted more often and possibly during off hours and/or evenings and weekends. Offenders Initials ___________
Level 2 offender’s addresses must be verified in person by law enforcement at the registered address at least once every 6 months. If an offender is not at home when a verification attempt is made, the officer will leave a business card. The offender must call the number on the card to complete the 6 month check in. Verifications may be conducted more often and possibly during off hours and/or evenings and weekends.
Offenders Initials ____________
Level 3 offender’s addresses must be verified in person by law enforcement at the registered address at least once every 90 days. If an offender is not at home when a verification attempt is made, the officer will leave a business card. The offender must call the number on the card to complete the 90 day check in. Verifications may be conducted more often and possibly during off hours and/or evenings and weekends.
Offenders Initials ____________
All Transient / Homeless Offenders must report in person on a weekly basis and provide a list of the addresses and/or locations where they have stayed the previous week ( 7 days ) including vehicle make, model, year and plate number. If offender parks their car in front of a residence but does not stay inside the residence, they must still provide that address with a notation that they stayed inside their vehicle. Reporting shall be on Wednesday of each week and shall occur during normal business hours. Offenders are required to report in person and shall not have others drop off their reporting form and address list. Providing false information and/or having any other person report in for you will result in Failure to Register charges being filed with the________ County Prosecutor’s office.
Offenders Initials ____________
Transient check in day is Wednesday of each week
IF you are incarcerated you must register with the County where you intend to reside within 3 business days of release from that facility.
Offenders Initials ____________
** ALL ADDRESS CHANGES MUST BE REPORTED IN PERSON AT THE SHERIFF’S OFFICE WITHIN 3 BUSINESS DAYS OF A MOVE. OFFENDER’S MOVING WITHIN THE SAME COUNTY THEY’RE REGISTERED IN - MAY SEND A CHANGE OF ADDRESS BY CERTIFIED MAIL 3 BUSINESS DAYS BEFORE THE MOVE OCCURS. ANY CHANGES OF ADDRESS INVOLVING MORE THAN ONE COUNTY AND/OR STATE MUST BE COMPLETED IN PERSON WITHIN 3 BUSINESS DAYS OF THE MOVE. BOTH COUNTIES AND/OR STATES MUST BE NOTIFIED.
_____________________ Offenders Initials ____________
Date
_______________________________________________ _______________________________________________
Offender Signature Signature of _________County Official
In addition to annual verifications at the place of residence all offenders must keep their employment, phone numbers & vehicle information updated by calling the _______ County Sheriff’s Office with any changes made.
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