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versity/School Name: Campus: Address (Street Address) County Employer (City) Contact: (Stale) (Zip) 3. K Student O E mph:not O Volunteer University/School Name. Start Date: End Date: Campus: Address. (Street Address) County Employer. (City) Contact: . (State) (10) Cyber Communication Accounts K
ed as stated in requirement #2 above, I MUST report in person to the driver's license office of the Department of Highway Safety and Motor Vehicles (DHSMV) and provide proof of initial registration as a sexual offender or predator to secure or renew a valid Florida driver's license or identification ca
mpus Activity 0 I am NOT a student, employes, or volt, ntOr at • tchterstty or Institution of higher reaming. 1. E Sltodanl ❑Employs O Vo'interir University/School Name Address County Stan Dale Cimpun (Street Address) Employer: ity) End Date: Contact Slab.% Professional Licenses O I do NOT have any profess
ntification card displays the designations as identified in #3 above. If iem unable to secure or update a driver license or identification card with DHSMV, I must also report any change of my residence or name within 48 hours after the change to the sheriffs office in the county where I reside or am lo
Campus Activity O I am NOT • student, employs*, or valuators at a university or Institution of higher Miming_ 1. p som.m O Employ.. p Voluntary University/School Name Address County Stan Date End Date. Campus. (Street Address) Employer: (City) Contact: (State) (Zip) Professional Licenses a I do NOT have a
ion of information as required in s2 above. I MUST report binge to the driver license office of the Department of Highway Safety and Motor Vehicles (DHSMV) and provide proof of initial registration as a sexual offender or predator to secure or renew a valid Florida driver license or identification card
Address: (SSA Address) Courtly: Employer: (DIY) Contact (S.ate) (29) O Student O Employee O Vdialtaer Stan Date. __- Campus: End Date 3. University/School Name. Address: (&.teel Mesita) County Employer: (City) Contact. ' (State) (bp) Cyber Communication Accounts O I do NOT use any email addresses or
ed as stated in requirement #2 above, I MUST report In person to the driver's license office of the Department of Highway Safety and Motor Vehicles (DHSMV) and provide proof of initial registration as a sexual offender or predator to secure or renew a valid Florida driver's license or Identification ca
Entities connected to both University/School Name and DHSMV

Jeffrey Epstein
PERSONLeon Black
PERSONState Travel Information
ORGANIZATIONthe Department of Highway Safety and Motor Vehicles
ORGANIZATION
Palm Beach
LOCATIONChristopher Steele
PERSON
Tallahassee
LOCATIONSept & Dec
ORGANIZATIONEnforcement & Investigative Support
ORGANIZATIONDepartment of electronic
ORGANIZATIONColor/Color Scheme
ORGANIZATIONHorne
LOCATION
Financial Trust Company
ORGANIZATIONFDLE Sexual Predator/Offender
PERSONRon DeSantis
PERSONForensic Science Services
ORGANIZATION
Dodge
ORGANIZATIONFlorida Statute 775.21
ORGANIZATION
Vicky Ward
PERSON
Jane Fonda
PERSON