AGOVA - Victim Notification Form

Victim Assistance Hotline: 1-800-626-7676

Crime Victim Information » Before you fill out the form below...

Please ensure The Alabama Attorney General's Office of Victim Assistance has your current address. You may not be notified of the sex offender's release if you do not fill out this form.

Section 15-20-34 of the Code of Alabama, as amended by Act 2001-1127, requires the Alabama Attorney General's Office of Victim Assistance to notify victims of their criminal sex offender's release from prison. Specifically, this section provides:

The Alabama Attorney General's Office of Victim Assistance shall notify the victims who file a written request to be notified of a criminal sex offender's pending release. This request may be made on a form provided by the Attorney General's Office of Victim Assistance. The Attorney General's Office of Victim Assistance shall send a notice to the address provided on the form notifying the victim that the criminal sex offender will be released and the location at which the criminal sex offender will reside. It shall be the responsibility of the victim to inform the Attorney General's Office of Victim Assistance if the victim's address or any other pertinent information on the notice request changes. If the notice sent by the Attorney General's Office of Victim Assistance is returned as undeliverable, no further action shall be required of the Attorney General's Office of Victim Assistance. See 2001 Ala. Acts No. 01-1127.

The Alabama Attorney General's Office of Victim Assistance can be reached by calling 1-800-626-7676 or 334-242-7300, or by fax at 334-242-4780. You can, a) print the form, fill it in, and mail it to us; b) fill in the PDF form online, print it out, and mail it in to us; or c) use the electronic online notification form below the links.

If you prefer the XHTML version of this form, then go to HERE.

• Adobe Acrobat Manual Fill-in Form (17KB; must be printed and mailed to AG's office)
• Adobe Acrobat Online Fill-in Form (38KB; must be printed and mailed to AG's office)

Victim Notification Online Form

Please fill out the form completely. All fields with an * are required.

Section 1. Victim Information [required]
Victim Information *First Name» Middle»  *Last Name» *Is victim a minor or deceased? N/A Minor Deceased
Section 2. Victim Contact Information
If victim is deceased or a minor, the Victim Family Contact section is REQUIRED:
Victim Contact Information +First Name» Middle» +Last Name» +Relationship to Victim»
Section 3. Contact Information - Victim or Victim Contact
Contact Information Street Address» City» State» --SELECT-- Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Mexico Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip» County» Mailing Address [if different] City» State» --SELECT-- Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Mexico Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip» County» Telephone Numbers: [Numbers only; example: 3345551212, using no dashes, Area Code first] Home» Work» Cell» Fax» *Email» *Email again, to confirm» [A valid email address is required for you to receive your email confirmation.]
Section 4. Crime Information
Crime Information *County of Crime» --SELECT-- Autauga Baldwin Barbour Bibb Blount Bullock Butler Calhoun Chambers Cherokee Chilton Choctaw Clarke Clay Cleburne Coffee Colbert Conecuh Coosa Covington Crenshaw Cullman Dale Dallas DeKalb Elmore Escambia Etowah Fayette Franklin Geneva Greene Hale Henry Houston Jackson Jefferson Lamar Lauderdale Lawrence Lee Limestone Lowndes Macon Madison Marengo Marion Marshall Mobile Monroe Montgomery Morgan Perry Pickens Pike Randolph Russell St. Clair Shelby Sumter Talladega Tallapoosa Tuscaloosa Walker Washington Wilcox Winston Circuit Court Case #» *Defendant's Name» AIS Number» Crime Committed» Sentence»