TEXAS DEPARTMENT OF PUBLIC SAFETY SEX OFFENDER UPDATE FORM soa 04200 150 risk ever: Lord Ful Name of Reisvant, COLeinnant hyanor Dearfez dato ot sith: LO-LE-LL sy (st) @iioote) F%00d3 oF. soc DF Rave: lef — sow a ae cout Case tho. L399203- FLOSLCA County where otlense occured: _AALLAS. —__bisposton Date: 2-3 Discharge Date:_Z.- 9-8 S_ Enter 3 ne aplieiaia ical = Approved Dovid 0 days a 90 days a ‘Amended Probation Amount In custody : pe ees (Combined oigna probation & extended tno) sea nny Changes Indicated Iver: eseeeeCHECeessesveseeFeEreCeS ee eseeETE 'No Longer Required to Register: Expired—Duly to register has expired, Exempt—Copy of court documentation must be attached. Risk Level: GH M © (Circle One) Diver icons. : A sate: TX type Gwe tater niivess: 3DLS BR MAIR Fetephone t:ihlshy 35 - IeLers (Physical address, city, state and zip code) ‘Urban O Rural ence 7 eae =e Vehicle J6RAKR do. é: f - iz Mai ‘Year Wake “Model ‘Siyle wake Type ‘Color ‘Occupational License #:____-_ Occupational Licensing Authority: SN cvxupaion: RETIAGO Name of Enployer Cotytown: Campus Code: © Student 0 Worker — Name & Address of registrant's nearest relative. iI 7 {In acoordanco to Chapter 62,Artcle 62.06, Code of Criminal Procedure, you are required to verily your registration as a sex ‘offender with focal law enforcement. Falture fo verly your registration with law enforcement vl result in cfhinal penattes being fled against you and may result in the revocation of any community supervision. THUMB PRINT VERIFICATION AGENCY ORUNAMETXOS‘7.A0L00 TELEPHONE #: z ‘Texas Dopartmoit of Pubic Safety—Crime Records Service—Sex Offender Registration Program PO Box 4143, Austin, Toxas 78765-4143 ‘GR (Rev. 10103)