Sex Offender Registry Public Request Form

(Please print legibly)

Submit to SLED, Sex Offender Registry, P. O. Box 21398, Columbia, S.C. 29221-1398 or Fax to 803-896-7022. Information available includes the sex offender’s full name, aliases, identifying physical characteristics, date of birth, home address, offense for which registration was required, and the date, city and state of conviction.

Check beside information requested:

_______ A list of all registered sex offenders in SC*
_______ A list of registered sex offenders in the county of* __________________
_______ A list of registered sex offenders with the following Zip Code* _________
_______ A list of registered sex offenders in the city of* _____________________
_______ Registered sex offender with the address of
                _____________________________________________________________________
                                    (Address must include street number, name and city.)

_______Registered sex offender by the name of ______________________________
                                                                                                                              (Must include full name.)

Hard Copy ____     3.5"Floppy disk (ASCII print file) ____     3.5" Floppy disk (ASCII data file) ____

Are you a victim of or witness to the offense, or a public or private school, child day care center, family day care center, business or organizations that primarily serves children, women or vulnerable adults as defined in Section 43-35-10 (11)? Yes ____   No ____  

The wrong address or incorrect spelling may affect whether a record is found. Records for juvenile subjects require review to determine whether the record may be released.

By signing this form, you certify you are entitled by law to the information requested. The information will be mailed to you at the below address:

Name                      ______________________________

Mailing Address   __________________________________________________________________


Home Phone           _________________

Work Phone           _________________

Signature of Requestor _________________________________

CJ-028
Rev 4/17/02


* A reasonable fee may be charged.