Here is the text we could read:
ALABAMA LAW ENFORCEMENT AGENCY
Sex Offender Registration Unit
Adult Sex Offender Homeless Acknowledgement & Registration
The Alabama Sex Offender Registration and Community Notification Act1 (“Act”) requires more frequent
registration for adult homeless sex offenders. This document summarizes the additional responsibilities of an
adult sex offender within Alabama that has indicated a Homeless Residency Status and requires the offender to
provide location information for where the offender has resided and plans to reside.
Past Week
Please provide a detailed description of the location or locations where you resided in the past week.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Monday
Tuesday
Wednesday
Thursday
Upcoming Week
Please provide a detailed description of the location or locations where you plan to reside.
1 §§15-20A-1 et seq., Code of Alabama 1975, as amended by Act 2017-414
Page 1
SO-4, 8/1/2017
ALABAMA LAW ENFORCEMENT AGENCY
Sex Offender Registration Unit
Friday
Saturday
Sunday
pecial Duties for Adult Sex Offenders with a Homeless Residency Status
• You must appear in person and report any change in fixed residence to law enforcement where you are
located/reside within three (3) business days upon any change in fixed residence.
• You must comply with all other registration and verification requirements listed in the Act.
• You must register all of the above registration information with the law enforcement agency where you
reside once every 7 days on a day and time specified by the law enforcement agency. If you reside
within the city limits of a municipality, you shall report to the chief of police. If you reside outside of the
city limits of a municipality, you shall report to the sheriff of the county.
If you obtain a fixed residence that complies with the residency restrictions listed in the Act, you must
appear in person within three (3) business days and update your registration information with local law
enforcement in each county of residence.
•
• Any violation of the above provisions shall constitute a Class C felony.
By signing below, I acknowledge that I have read the above information and responsibilities and that I am aware
of all that is required of me under the Alabama Sex Offender Registration and Community Notification Act. If I fail
to comply with any provision of the Act, I understand that I may be charged with a Class C felony in Alabama. I
certify that all the information contained in this form is true and correct.
S
Offender
Printed Name
Social Security Number
Date of Birth
Signature
Date
Page 2
Registering Agency
Agency Name
Officer’s Signature
Printed Name
Date
Adult Sex Offender Homeless Acknowledgement and Registration
This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Alabama state courts.
To learn more about the project, check out our about page.
Downloads: You can download both the original form (last checked 2023-03)
and the machine-processed form with normalized data fields.
About This Form:
- Sourced from eforms.alacourt.gov (2023-03)
- Page(s): 2
- Fields(s): 21
- Average fields per page: 10
- Reading Level: Grade 15
- LIST Grouping(s):
Unknown
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Identified Data Fields:
We have done our best to automaticly identify and name form fields according to our naming conventions.
When possible, we've used names tied to our question library. See e.g., user1_name.
If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.
Here are the fields we could identify.
monday__1 was Monday (0.59 conf)tuesday__1 was Tuesday (0.38 conf)wednesday__1 was Wednesday (0.38 conf)thursday__1 was Thursday (0.38 conf)friday__1 was Friday (0.38 conf)saturday__1 was Saturday (0.35 conf)sunday__1 was Sunday (0.38 conf)monday__2 was Monday_2 (0.33 conf)tuesday__2 was Tuesday_2 (0.33 conf)wednesday__2 was Wednesday_2 (0.33 conf)thursday__2 was Thursday_2 (0.33 conf)friday__2 was Friday_2 (0.33 conf)saturday__2 was Saturday_2 (0.33 conf)sunday__2 was Sunday_2 (0.33 conf)printed_name__1 was Printed Name (0.42 conf)social_security_number was Social Security Number (0.38 conf)date_birth was Date of Birth (0.37 conf)signature_date__1 was Date (1.00 conf)agency_name was Agency Name (0.47 conf)printed_name__2 was Printed Name_2 (0.36 conf)signature_date__2 was Date_2 (1.00 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
monday__1tuesday__1wednesday__1thursday__1friday__1saturday__1sunday__1monday__2tuesday__2wednesday__2thursday__2friday__2saturday__2sunday__2printed_name__1social_security_numberdate_birthsignature_date__1agency_nameprinted_name__2signature_date__2
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