Form Cr 32 – Fill Out and Use This PDF

ARTICLE62.053,CodeofCriminalProcedure

Release or Discharge from a Penal Institution or Release to Community Supervision,

Parole, Mandatory Supervision or the Law Enforcement RegisteringAuthority

(THISISNOTTHEREGISTRATIONFORM)

FULLNAME

LAST

FIRST

MIDDLE

*IF NOTSTATUTORILYREQUIREDTO REGISTER, CHECK BOX

AND ENTER DISCHARGE DATE:

REGISTERING OFFENSE (TITLE)

STATE*

DISPOSITION DATE

SENTENCE RECEIVED

VICTIM(S) SEX/AGE

*IF NOTSTATUTORILYREQUIREDTO REGISTER, CHECK BOX

AND ENTER DISCHARGE DATE:

DUTYTO REGISTER EXPIRES:

Lifetime

10YearsAfter Discharge

At Discharge (Court/Board Ordered)

VERIFICATION REQUIREMENT:

Annual

(on birthday)

Every 90 Days

Every 30 Days

ASSIGNED RISK LEVEL

If “C” for Civil Commitment please provide date of judgement order:

ADDRESS OR DESCRIPTION OFTHE GEOGRAPHICALLOCATION WHERE PERSON NOTIFIED EXPECTSTO RESIDE: (Full street address, city, state, zip code)

Chapter 62, Code of Criminal Procedure, requires me to register as a sex offender. I understand that:

Initial Verification of Registration Upon Release: Not later than the 7th day after (date of release/placement on community supervision or juvenile probation), I must personally appear at the following local law enforcement authority to verify and complete my registration:

RegistrationVerification

Local Law EnforcementAgency Name:

AgencyAddress/City/State/Zip:

Notification toAuthority for Campus SecurityAgency:

AgencyAddress/City/State/Zip:

IfIhaveajuvenileprobationofficer,communitysupervisionandcorrectionsdepartmentofficer,orparoleofficerandIdonotmovetoanintendedresidence, I must report to my supervising officer not later than the 7th day after the date I was released.

Registration: I am required to register with the local law enforcement authority in any municipality (chief of police) where I reside or intend to reside formorethansevendays. Ifmyresidenceisnotinamunicipality,Imustregisterwiththelocallawenforcementauthorityofthecounty(sheriff)whereIreside or intend to reside for more than seven days. Registration must be completed not later than the 7th day after the date of arrival in the municipality or coun- ty. ThelocallawenforcementauthorityinthemunicipalityorcountyIresideinwillbemyprimaryregistrationauthority. Thedurationofmydutytoregisteris for the period of time indicated above.

Periodic Verification of Registration: I must personally appear at my primary registration authority and verify my registration information annually, every 90 days, or every 30 days, as indicated above.

ChangeofAddress: Notlaterthanthe7thdaybeforeImovetoanewresidenceinthisstateoranotherstate,Imustreportinpersontomyprimary registration authority and to any community supervision and corrections department officer, juvenile probation officer, or parole officer supervising me and inform that authority and officer of my intended move. If my new residence is located in this state, not later than the 7th day after changing address, I must reportinpersonandregisterwiththelocallawenforcementauthorityinthemunicipalityorcountywheremynewresidenceislocated. Ifmynewresidence is located in another state, not later than the 10th day after the date I arrive in the other state, I must register with the law enforcement agency that is iden- tified by the Texas Department of Public Safety as the agency designated by that state to receive registration information. If I do not move to an intended residence, not later than the 7th day after my anticipated move date, I shall report to my primary registration authority and to any supervising officer super- vising me.

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Lack of Address: If I lack a physical address assigned by a governmental entity, I must provide to the local law enforcement authority a detailed description of the geographical location where I reside or intend to reside for more than 7 days. I must report in person to the local law enforcement author- ity not less than once in each 30 day period to confirm my location until a physical address can be provided.

Texas DL/ID Requirement: Not later than the 30th day after the date I am released/placed on community supervision or juvenile probation, I shall present this notice to the appropriate Texas Department of Public Safety, Driver License Office, and obtain a yearly renewable Texas driver license or per- sonalidentificationcertificateforthedurationoftheperiodIamrequiredtoregisterasasexoffender. Thisformwillnotbeacceptedasproofoforiginaliden- tification when obtaining a DLor ID certificate. Failure to obtain a yearly renewable driver license or personal identification certificate will result in the revo- cation of any existing license or certificate issued by theTexas Department of Public Safety.

Status Changes: Not later than the 7th day after the date of the change, I shall report to my primary registration authority any change in the follow-

ing: my name (includes a request for name change and a denial of a request), my physical health (includes hospitalization), job status (includes beginning and leaving employment and changing work locations), and educational status (includes a transfer from one educational facility to another).

Change in On-LIne Identifiers: Notlaterthanthe7thday,Ishallreportanychangestoonlineidentifiersorestablishmentofanynewonlineidentifi- er not already included on my registration form to my primary registration authority in the manner prescribed by the authority.

Institutions of Higher Education: IfIintendtobeemployed,carryonavocation,orbeastudentatapublicorprivateinstitutionofhighereducation inthisstate,Imustnotifytheauthorityforcampussecurityfortheinstitutionandmyprimaryregistrationauthorityofthatfactnotlaterthanthe7thdayafter the date I begin to work or attendschool at the institution. If I stop workingor attendingschool at an institutionof higher education, I must report that fact to theauthorityforcampussecurityandmyprimaryregistrationauthoritynot laterthanthe7thdayafterthedayIstopworkingorattendingschoolattheinsti- tution. If the institution of higher education does not have an authority for campus security, I must provide the required notice to the local law enforcement authority of the municipality or county in which the institution is located. If the institution of higher education is located in another state, I must notify any authority for campus security for that institution not later than the 10th day after the date I begin to work or attend school.

Workers and Students: IfIresideoutsideofthisstateandintendtoworkorattendschoolinthisstate,notlaterthanthe7thdayafterthedateIbegin toworkorattendschool,ImustregisterandverifyregistrationwiththelocallawenforcementauthorityinthemunicipalityorcountyinwhichIworkorattend school. If I reside in this state and work or attend school in another state, I must register with the law enforcement agency that is identified by the Texas Department of Public Safety as the agency designated by that state to receive registration information not later than the 10th day after the date I begin to work or attend school.

Visiting Locations: If on at least 3 occasions during any month I spend more than 48 consecutive hours in a municipality or county other than the municipalityor countyI am registeredin, I mustreportthatfact tothelocallawenforcementauthorityof themunicipalityor countyI am visiting. This notice must be provided before the last day of the month the visits occur.

Postcard Notification Costs: If I am assigned a High risk level or am civilly committed as a sexually violent offender, I shall reimburse the Texas DepartmentofPublicSafetyallcostsincurredbytheDPSinprovidingpostcardnotificationtomycommunityofresidence(Notapplicabletoanadjudication of delinquent conduct).

____Local Law EnforcementAuthority Policies: All registrations, verifications, and notifications must be provided in person within the time periods indi-

cated above. If I appear within a time period indicated above and the local law enforcement authority instructs me that their policy requires me to appear at a later date, I will appear on that later date to register, verify, or to provide a notification, as applicable.

DNASpecimen:ApersonrequiredtoregisterunderthischaptershallcomplywitharequestforaDNAspecimenmadebyalawenforcementagency under Section 411.1473, Government Code.

Criminal Penalties: My failure to comply with any requirement imposed upon me by Chapter 62, Code of Criminal Procedure, is a felony offense. Further, if I am on parole, community supervision, or juvenile probation, my failure to comply with any requirement imposed upon me by Chapter 62, Code of Criminal Procedure, may result in the revocation of my parole, community supervision, or juvenile probation.

PLEASE KEEPACOPY OF THIS FORM FOR YOUR RECORDS. PLEASE PROVIDE REGISTRANT WITHACOPY OF THIS FORM.

FORWARDACOPY TO THE INTENDED PRIMARY REGISTRATIONAUTHORITY.

FAXCOMPLETEDFORMTODPS,SEXOFFENDERCOMPLIANCEUNIT,at512/424-5434

MAILORIGINALTO:TXDPS-CRS,POB4143,AUSTIN,TX78765-4143