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er information section. Mail the form to the address on the reverse side of this form along with the filing fee. The fee is payable by check. VISA, MasterCard or American Express. Checks must be payable to the "Department of State. Credit Card/Debit Card Authorization forms can be found on our • .dos.ny.
ions. Please note Farm Corporations must file a paper form. PAPER FILING: • Farm corporations are exempt but must notify the Department by checking the Farm Corporation Exemption Box below, completing the signer information sect ' his form to the Department of State at the address on the reverse side of this form. Forms ma
er information section. Mail the form to the address on the reverse side of this form along with the filing fee. The fee is payable by check, VISA. MasterCard or American Express. Checks must be payable to the "Department of State". Credit Card/Debit Card Authorization forms can be found on our website at
ons. Please note Farm Corporations must file a paper form. PAPER FILING: • Farm corporations are exempt but must notify the Department by checking the Farm Corporation Exemption Box below. completing the signer information section and mailing this form to the Department of State at the address on the reverse side of this fo
er information section. Mail the form to the address on the reverse side of this form along with the filing fee. The fee is payable by check. VISA, MasterCard or American Express. Checks must be payable to the "Department of State". Credit Card/Debit Card Authorization forms can be found on our website at
ions. Please note Farm Corporations must file a paper form. PAPER FILING: • Farm corporations are exempt but must notify the Department by checking the Farm Corporation Exemption Box below, completing the signer information section and mailing this form to the Department of State at the address on the reverse side of this fo
er information section. Mail the form to the address on the reverse side of this form along with the filing fee. The fee is payable by check, VISA, MasterCard or American Express. Checks must be payable to the 'Department of State'. Credit Card/Debit Card Authorization forms can be found on our website at
ions. Please note Farm Corporations must file a paper form. PAPER FILING: • Farm corporations are exempt but must notify the Department by checking the Farm Corporation Exemption Box below. completing the signer information section and mailing this form to the Department of State at the address on the reverse side of this fo
Entities connected to both MasterCard and the Farm Corporation Exemption

Jeffrey Epstein
PERSON
American Express
ORGANIZATION
George W. Bush
PERSONDarren Indyke
PERSON
Ghislaine Maxwell
PERSON
NEW YORK NY
LOCATION
Prince Andrew
PERSON
New York City
LOCATION
Les Wexner
PERSON
Columbus
LOCATION
New York State
LOCATIONthe Southern District
LOCATION
New York
LOCATIONthe State of New York
LOCATIONSchwartz
PERSONthe City of Albany
LOCATIONThe Certificate of Dissolution
ORGANIZATIONFBI
ORGANIZATIONthe Department of State's
ORGANIZATIONParts 1
LOCATION