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O NOT mail cash fend entire form, completed and with $900 fee. in the self-mailer envelope, to the Department of State, Division of Corporations, 41 State Street, Albany. IT 12231-0002 9tenniar Statement, Part C — Signing .." ,o-CICC-v"• -r1;• &Niter_ PfURT OR TYPE MAW OF OGREN Se hurt( aawr " STATEIMP
with the pvartment of State every two years rat -01:',40010W-d : . Farm Corporationsare EXEMPT from this 04 012it:' Maas review the information in Parts 1, 2 and 3. Update the *phonies are necessary, proceed to Part 6. A corporation which shown to be past dna on the Department of State's records. Par
O NOT mail cash ;end entire form completed and with $900 fee, in the self -mailer envelope, to the Department of State, Division of Corporations, 41 State Street, Albany. IT 12231-0002 9iennial Statement, Part C — Signing C1/4 tet_ PRINT OR TYPE NAME a SIGNER s e,_re.trAss-i FM" OR surrnrrtnagr :mica DE
s formed or authorized. Farm Corporations are EXEMPT from this requirement and should complete Parts 4 and 5 ONLY.. Please review the information in Parts 1, 2 and 3. Update the information in the space provided, if necessary. If no changes are necessary, proceed to Part 5. A corporation Which fails to
NOT mail cash ;end entire form, completed and with $900 fee. in the self -mailer envelope, to the Department of State, Division of Corporations, 41 State Street, Albany. VI' 12231-0002 918=31 Statement, Part C — Signing PRINT OR TYPE NAME OF SIGNER Set— %re._ jr-Cx-lr PANT' OR All sr, mow h CAT SIGNER
was formed or authorized. Farm Corporations are EXEMPT from this equirement and should complete Pans 4 and 5 ONLY. Please review the information in Parts 1, 2 and 3. Update the nformation in the space provided. if necessary. If no changes are necessary, proceed to Part 5. A corporation which fails to t
Entities connected to both State Street and Parts 1

Jeffrey Epstein
PERSON
American Express
ORGANIZATIONthe State of New York
LOCATIONSouth High Street
LOCATION
Prince Andrew
PERSONSchwartz
PERSONDarren Indyke
PERSON
MasterCard
ORGANIZATION
Columbus
LOCATION
NEW YORK NY
LOCATION
New York State
LOCATIONthe Department of State's
ORGANIZATIONthe City of Albany
LOCATIONTaxpayer Assistance Bureau
ORGANIZATIONthe Principal Executive Office
ORGANIZATIONthe Farm Corporation Exemption
ORGANIZATIONThe Certificate of Dissolution
ORGANIZATIONAlbany
LOCATION
George W. Bush
PERSON
Les Wexner
PERSON