U.S. Citizenship and Immigration Services
ORGANIZATIONthe NYS Division of Criminal Justice Services
ORGANIZATION4
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11) Page 2 of 4 EFTA00173133 / Supervisory Special Agent 6. Is employment authorization requested? N Yes 0 No (If yes, please attach completed U.S. Citizenship and Immigration Services Forms 1-765, Application for Employment Authorization, and 1-102, Application for Replacement/Initia! Nonimmigrant Arrival/Departure Document) Note
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 * WARNING: Release of any NCIC information to unauthorized individuals or agencies,including the subject of the data, is prohibited.
SENSITIVE ICE Form 73-031 (4/11) Page 2 of 4 EFTA00173743 6. Is employment authorization requested? Yes n No (II yes, please attach completed U.S. Citizenship and Immigration Services Forms 1-765, Application for Employment Authorization, and 1-102. Application for Replacement/Initial Nonimmigrant Arrival/Departure Document.) Not
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 * WARNING: Release of any NCIC information to unauthorized individuals or agencies,including the subject of the data, is prohibited.
SITIVE ICE Form 73-031 (4/11) Page 2 of 4 EFTA01684005 6. Is employment authorization requested? El Yes ID No (If yes, please attach completed U.S. Citizenship and Immigration Services Forms 1-765, Application for Employment Authorization, and 1-102. Application for Replacement/Initial Nonimmigrant ArriveDeparture Document.) Note;
of Criminal Justice Services Alfred E. Smith Building, 80 South Swan St. Albany, New York 12210. Tell-800-262-DCJS xecutive Deputy Commissioner of the NYS Division of Criminal Justice Services *Federal NCIC * WARNING: Release of any NCIC information to unauthorized individuals or agencies,including the subject of the data, is prohibited.
ENFORCEMENT SENSITIVE EFTA01699762 Application for Replacement/Initial Nonimmigrant Arrival-Departure Document Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form I-102 OMB No. 1615-0079 Expires 10/31/2019 For. i WOO Receipt Action Block UJe. : i I :Otifr• ! New I-94 Number I . Remarks
rvices 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 NCIC * WARNING: Release of any NCIC information to unauthorized individuals or agencies,including the subject of the data, is prohibited.
Entities connected to both U.S. Citizenship and Immigration Services and the NYS Division of Criminal Justice Services
Albany
LOCATION
Michael C.Green
PERSONNew York State Division of Criminal Justice Services
ORGANIZATIONFederal Bureau of Investigation - New York
ORGANIZATION
Jeffrey Epstein
PERSON
Department of Homeland Security
ORGANIZATIONFBI
ORGANIZATION
Homeland Security
ORGANIZATIONLeon Black
PERSON
Julie K. Brown
PERSON
United States
LOCATION
Department of Justice
ORGANIZATION
Michael Bloomberg
PERSONNew York Field Office
LOCATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONU.S. Social Security
ORGANIZATIONFederal, State
ORGANIZATIONPreparer
ORGANIZATIONContact Information, Certification
ORGANIZATIONNational Crime Information Center
ORGANIZATION