Sex Offender Information Request

You may request from your city/town police department whether: a specific individual identified by
name, date of birth or sufficient personal identifying characteristics is a sex offender; or whether any sex
offenders live or work within the same city or town of a specific address. You may specify the address
of a home, school, daycare facility, playground, etc.; or whether any sex offenders live or work on a
specific street.

In response to your request, you will receive a report which indicates the name of the offender, the home
address, the work address, the offense(s) and date(s) for which the offender was convicted/adjudicated,
the offender’s age-sex-race-height-weight-eye and hair color, and a photograph if available.

Please be advised that the law only permits the public to receive information on sex offenders required
to register and finally classified by the Sex Offender Registry Board as a level 2 (moderate risk) or level
3 (high risk) offender. Therefore, information is not available to the public if the sex offender is a level
1 (low risk) offender or if he/she has not yet been finally classified a level 2 or level 3 by the Board.

All inquiries shall be recorded and kept confidential; provided that the records may be disseminated to
assist or defend any criminal prosecution.

Name of Requester(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Date of Birth

Date of Request

If you are inquiring whether a specific individual is a sex offender, please fill out the following section.

Subject's Name

First Last

Personal Identifying Characteristics

Sex

Race

Date of Birth or Approximate Age

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Height

Weight

Eye Color

Hair Color

Other information

If you are inquiring whether any sex offenders live or work on a specific street, please fill out the following section.

Address

Street Address City State / Province / Region

If you are inquiring whether any sex offenders live or work within the same city or town of a specific adress, please complete the following section.

Address

Street Address City State / Province / Region

If you are inquiring whether a specific individual is a sex offender, please fill out the following section.

If you are inquiring whether any sex offenders live or work on a specific street, please fill out the following section.

If you are inquiring whether any sex offenders live or work within the same city or town of a specific adress, please complete the following section.

FOR EMERGENCIES 9-1-1