6
Shared Docs
6
Same-Page
6 / 6
Mentions
te and include his telephone and fax number A A EFTA00155344 Supplement B, U Nonimmigrant Status Certification Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form 1-918 OMB No. 1615-01 Expires 04/30/202 Remarks For 115C IS Use Only ► START HERE - Type or print in black or blue ink. Part 1.
l names, use the space provided in Part 7. Additional Information. 3.a. Family Na (Last Na 3.b. Given Na (First Nam 3.c. Middle Na 4. Date of Birth (nun/dd/yyyy) 5. Gender O Male Ela Female Part 2. Agency Information 1. Name of Certifying Agency Federal Bureau of Investigations Name of
Supplement B, Delaration of Law Enforcement Officer for Victim of Trafficking in Persons Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form I-914 OMB No. 1615-0099 Expires 12/31/2023 START HERE - Type or print in ink. This form should be completed by Federal, state, local
section, use the space provided in Part 9. Additional Information. Family Name (Last Name) Given Name (First Name) Middle Name (if any) Date of Birth (ddirrun/yyyy) 4. Gender or Sex El Male El Female El Other Alien Registration Number (A-Number) (if any) P. A- U.S. Social Security Number (SSN)
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
y/town/village, state/province, and country where you were born. 19.a. Citv/TownNilla e of Birth 19.b. State/Province of Birth 19.c. Country of Birth =IS 20. Datc of Birth (mm/dd/yyyy) I Information About Your Last Arrival in the United States 21.a. Form 1-94 Arrival-Departure Record Number (if
in Charge EFTA01653121 Supplement B, Delaration of Law Enforcement Officer for Victim of Trafficking in Persons Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form 1-914 OMB No. 1615-0099 Expires 12/3112023 START HERE - Type or print in ink. This form should be completed by Federal, state, local
e the space provided in Part 9. Additional Information. Family Name (Last Name) Given Namc (First Name) Middle Name (if any) 3. 5. 6. Date of Birth (dd/mm/yyyy) 4. Gender or Sex K Male ❑X Female K Other Alien Registration Number (A-Number) (if any) ► A- U.S. Social Security Number (SSN) (if
Application for Naturalization Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form N-400 OMB No. 1615-0052 Expires 03/31/2019 For USCIS Use Only Date Stamp Receipt Action Block Remarks ► START HERE - Type or
N Page I of 20 EFTA00525459 Part 2. Information About You (Person applying for naturalization) (continued) A- 3. Other Names You Have Used Since Birth (include nicknames, aliases, and maiden name, if applicable) Family Name (Last Name) Given Name (First Name) Middle Name (if applicable) 4. Name
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
tate/province, and country where you were born. 19.a. CityfrownNillage of Birth 19.b. State/Province of Birth 19.c. Country of Birth 20. Date of Birth (mm/dcVyyyy) Information About Your Last Arrival in the United States 21.a. 21.b. 21.e. 21.d. Form I-94 Arrival Ito Passport Number Departu
Entities connected to both U.S. Citizenship and Immigration Services and Birth

Jeffrey Epstein
PERSONLeon Black
PERSONFBI
ORGANIZATION
United States
LOCATION
Department of Homeland Security
ORGANIZATION
Department of Justice
ORGANIZATION
Ghislaine Maxwell
PERSON
George W. Bush
PERSON
Prince Andrew
PERSON
Julie K. Brown
PERSON
Philadelphia
LOCATION
Donald Trump
PERSON
Homeland Security
ORGANIZATION
Joe Biden
PERSON
John F. Kennedy
PERSON
Maine
LOCATION
Alfredo Rodriguez
PERSON
Prince Charles
PERSONU.S. Social Security
ORGANIZATION
Virginia Giuffre
PERSON