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ring instrunent. ITEM 21 - The Schedule and Voucher Number will be entered by the office which stoat ly schedules the approved amount for payment by the Treasury Department. ITEM 22 - Enter, if appropriate, my data not provided for elsewhere on the receiving report, such as, reasons for any claim amounts disalbwed. EFTA
ECLARATION OF SERVICE' I declare under penalty of perjury under the laws of the United Stales of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who m
rdering insetuant ITEM 21 • The Schedule and Voucher Number will be entered by the office which comity schedules the approved amount for pan* em the Treasur. Denaturant ITEM 22 - Es, of appropriate. any data not provickd for elsewhere on the receiving report, such as, reasons fir any claim amounts dna lb
DECLARATION OF SERVICE' I declare under penalty of penury under the laws or the United States Or America that the foregoing Information contatned in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1As to who may
ordering instrunent ITEM 21- The Schedule and Voucher Number will be entered by the office which stually schedules the approved amount for moment by the Treasury Department. ITEM 22 Enter, if appropriate, my data not provided for elsewhere on the receiving report,such as, reasons for any claim amounts disallowed. EFTA0
CLARATION OF SER VICE' I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who m
Entities connected to both U.S. Treasury and the Return of Service

Jeffrey Epstein
PERSON
United States
LOCATION
George W. Bush
PERSON
Ghislaine Maxwell
PERSON
Donald Trump
PERSONFBI
ORGANIZATION
Department of Justice
ORGANIZATION
Prince Andrew
PERSONLeon Black
PERSON
Condoleezza Rice
PERSON
Vicky Ward
PERSON
Marc Rich
PERSON
New York
LOCATION
Samantha Power
PERSON
Joi Ito
PERSON
Julie K. Brown
PERSON
Prince Charles
PERSON
India
LOCATION
Paul Ryan
PERSON
Colorado
LOCATION