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INY00 Federal Bureau of Investigation - New York New York State Division of Criminal Justice Services Alfred E. Smith Building, 80 South Swan St. Albany, New York 12210. Tel:l-800-262-DCJS Michael C.Green, Executive Deputy Commissioner of the NYS Division of Criminal Justice Services *Federal NCIC *
or print in black ink Part 1. Information About You U.S. Physical Address To Be Completed by an Attorney or Accredited Representative, if any. K Select this box if Form O-28 is attached to represent the applicant. Attorney State License Number I. Alien Registration Number (A-Number) 6.a. In Ca
INY00 Federal Bureau of Investigation - New York New York State Division of Criminal Justice Services Alfred E. Smith Building, 80 South Swan St. Albany, New York 12210. Te1:1-800-262-DCJS Michael C.Green, Executive Deputy Commissioner of the NYS Division of Criminal Justice Services *Federal NCIC *
amp Action Block Valid From K Authorization/Extension Valid Through Alien Registration Number A- , Remarks To be completed by an attorney or K Select this box if Form G-28 Attorney or Accredited Representative Board of Immigration Appeals (BIA)- accredited representative (if any). is attached.
INY00 Federal Bureau of Investigation - New York New York State Division of Criminal Justice Services Alfred E. Smith Building, 80 South Swan St. Albany, New York 12210. 'Fel: I -800-262-DCJS Michael C.Green, Executive Deputy Commissioner of the NYS Division of Criminal Justice Services *Federal NCI
U.S. physical address in Item Numbers 6.a. - 6.1. 1 1 La. In Care Of Name To Be Completed by an Attorney or Aerredited Representative, if any. K Select this box if Form G-28 is attached to represent the applicant. Attorney State License Number Lb. Street Nut and Name 6.c. Apt. 0 Ste. 0 FIr.
Entities connected to both Albany and K Select

Jeffrey Epstein
PERSONNew York State Division of Criminal Justice Services
ORGANIZATIONthe NYS Division of Criminal Justice Services
ORGANIZATION
Michael C.Green
PERSONFederal Bureau of Investigation - New York
ORGANIZATION
Homeland Security
ORGANIZATION
Department of Homeland Security
ORGANIZATIONNew York Field Office
LOCATIONHomeland Security Investigations
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONU.S. Citizenship and Immigration Services
ORGANIZATIONFederal, State
ORGANIZATIONPreparer
ORGANIZATIONNational Crime Information Center
ORGANIZATIONthe Social Security Administration
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONMonitoring Group
ORGANIZATIONMonitoring Case
ORGANIZATIONContact Information, Certification
ORGANIZATION