Date Submitted:

Notification of International Travel of Sex Offender 

Subject Information

First Name:

Middle Name:

Sex:

FBI # (internal use only):

Country of Issuance:

Travel Information

Purpose of Travel:

Means of Travel:

Date Departing U.S.:   

Departure Location:

Date Returning to U.S.:

Arrival Location.:   

Destination Country:

Address:

Criminal Record

Date(s) of Conviction:

City and State or Jurisdiction of Conviction: 

Sex Offense(s) of which 
Convicted:

Victim information:  
Age/gender/relationship

Jurisdiction(s) of Current Registry:

Contact information in Destination Country:

Other

Last Name:

Aliases(if any):

Date of Birth:

Citizenship:

Passport#:

Other 
information, (i.e. 
itinerary; visa 
information; 
explain "other" 
responses above)

Name :

Phone #:

Submitter's Information (internal use only)

Agency:

E-mail:

Please send to IOD.NSOTC@usdoj.gov 
With Subject : Sex Offender Travel Notification

V1.0 (Feb 2012)

Instructions and Clarifications for the  
Notification of International Travel of Sex Offender Form 
  
Note:  All blocks with drop-down menus also allow text entry.  If the answer you need is not in the drop-down 
menu, please type in the correct information.  If you choose “Other” please provide that information in the 
“Other Information” box 
  

Aliases  - should include nicknames, aliases, maiden or married names, tribal and ethnic names by which 
they are commonly known (as opposed to sacred), pseudonyms 
Date of Birth  - Actual DOB.  Any “additional” dates of birth should be included in “Other Information” 

FBI # - if available.  This is for U.S. law enforcement purposes only, for example, to better identify the 
offender in NCIC, and will not be sent internationally.  
Citizenship  - country or countries of citizenship 
Passport # - also can be used for Passport cards 

Purpose of Travel  - drop-down menu includes Business, Vacation, Military, Relocation, Deportation, 
and Other.  Like all drop-down menus, you can type additional options. 

Means of Travel  - drop-down menu includes Air, Bus, Car, Ship, Train, and Other.  Like all drop-down 
menus, you can type additional options. 

Departure Location  - If from a specific airport, port, or bus or train station, please specify, with city and 
state, otherwise city and state. 
Date Returning to U.S.  - when known 

Arrival Location  - Upon returning to U.S., if to a specific airport, port, or bus or train station, please 
specify, with city and state, otherwise city and state. 

Address  - If available, within destination country.  Please be as specific as possible.  If you need more 
space, use the “Other Information” box. 

Date(s) of Conviction: Only include convictions for which the offender needs to register 

City and State or Jurisdiction of Conviction:  Includes state, local, tribal, territorial, foreign, federal, 
military, and any other courts of conviction. 

Sex Offense(s) of which Convicted:  Include crime name rather than just the code number (e.g., Sexual 
Abuse rather than 18 U.S.C. §2242) 
Victim Information: when available, please include age  
Jurisdiction(s) of Current Registry: If multiple (residence, employment, school) please include all  

Contact information in Destination Country  - phone numbers, email address, geographic address 

Other information  - any specifics about itinerary (airline & flight number, ship name, date/times of 
arrival and departure, multiple stops or layovers); visa information; explanations for any “other” 
responses in drop-down menus; anything that needed more space than the above boxes allowed 

Submitter's information  - for internal use only if the U.S. Marshals or INTERPOL (US) needs more 
information, and will not be sent internationally 

V1.0 (Feb 2012)

• 

• 

• 

• 

• 

  
• 

• 

• 

• 

• 

• 

  
• 

• 

• 

• 

• 

  
• 

  
• 

  
•