Sec. 12.06.01.05. Registration Statement

A. A registrant shall complete, sign, and date a registration statement form with a supervising authority.

B. A registration statement includes the following information supplied by the registrant:

(1) Registrant's full name;

(2) Address as follows:

(a) Registrant's address, including county; or

(b) If on work release or temporary leave, the address of the State or local correctional facility granting work release or temporary leave;

(3) Registrant's fingerprints obtained at the time of registration by, or at the direction of, the supervising authority;

(4) For nonresident registrants:

(a) The name of the registrant's employer or school; and

(b) The address, including county, of the registrant's work site or site of school attendance;

(5) Registrant's signature; and

(6) Date signed.

C. A registration statement includes the following information supplied by the supervising authority:

(1) Registrant's photograph obtained at the time of registration;

(2) Registrant's Social Security number, as required under Criminal Procedure Article, §11-706(a)(7), Annotated Code of Maryland;

(3) Any aliases used by a registrant, including dates of birth and Social Security numbers;

(4) For each crime for which the registrant is required to register:

(a) Name of the crime, including statutory citation if applicable and available;

(b) Date of conviction;

(c) Name of Maryland court and county, or other court and location, where the registrant was convicted;

(d) Date the crime was committed; and

(e) Victim's age at the time the crime was committed;

(5) Registrant category, or multiple categories if applicable;

(6) Date of release;

(7) Term of registration;

(8) For a sexually violent predator:

(a) Identifying factors, including scars, marks, tattoos, and other significant physical characteristics;

(b) The prior sexually violent offense or offenses that are the basis for the proceeding under Criminal Procedure Article, §11-703, Annotated Code of Maryland; and

(c) Dates and places of treatment received for a mental abnormality or personality disorder;

(9) Information required in order to reimburse supervising authorities for the cost of processing registration statements under Criminal Procedure Article, §11-713(3), Annotated Code of Maryland; and

(10) Any attachments necessary to facilitate the accurate and timely registration of the registrant.