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VRF-1536 (Vorpal Request Form: Vorpal Offender Registration)
Purpose: Manual Request for core insertion from outside source.
Complete the form to the best of you knowledge. Fields in pink are required.
When completed, Submit the form and ROVO will review it. If, for any reason the ROVO needs more information, you will be contacted with further instructions.

VRF-1536
Human Verifier -
 Email Address -
Vorpal Offender Data (enter the Vikoons information below)
Last Name
First Name
M
AKA
Sex
Male / Female
DOB-(Date of birth)
 DOD -(Date of death)
 (If DOD)Cause of Death
City/State (Where this offender resides)
Zip
Offense Date -
Offense -
Note -
If offender is employed, please complete the section below
Employer -
Occupation -