4
Shared Docs
4
Same-Page
4 / 4
Mentions
Supplement 8, 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 OMBNo.1615-0099 Expires 1//31/2023 START HERE - Type or print in ink. This form should be completed by Federal, state. local,
be completed by Federal, state. local, or tribal law enforcement agencies for victims under the Victims of Trafficking and Violence Protection Act (VTVPA). Public Law 106-386, as amended. PART 1. Victim Information I. Full Legal Name Family Name (Last Name) Given Maine (Pint Name) Middle Name (if
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. 1M 5-0099 Expires 12/31/2023 START HERE - Type or print in ink. This form should be completed by Federal, state, local
be completed by Federal, state, local, or tribal law enforcement agencies for victims under the Victims of Trafficking and Violence Protection Act (VTVPA). Public Law 106-386, as amended. PART 1. Victim Information 1. Full Legal Name (First Name) Middle Name (if any) 2. Provide any other names y
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
be completed by Federal, state, local, or tribal law enforcement agencies for victims under the Victims of Trafficking and Violence Protection Act (VTVPA). Public Law 106-386. as amended. PART 1. Victim Information 1. Full Legal Name Family Name (Last Name) Given Name (First Name) Middle Name (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
be completed by Federal, state, local, or tribal law enforcement agencies for victims under the Victims of Trafficking and Violence Protection Act (VTVPA), Public Law 106-386, as amended. PART 1. Victim Information I. Full Legal Namc Family Name (Last Name) Given Name (First Name) Middle Name (if
Entities connected to both U.S. Citizenship and Immigration Services and VTVPA

Jeffrey Epstein
PERSONFBI
ORGANIZATION
United States
LOCATION
Ghislaine Maxwell
PERSONU.S. Social Security
ORGANIZATIONDivision/Office of Certifying
ORGANIZATIONReloc Sent
LOCATIONNew York Field Office
LOCATION
Birth
PERSONDelaration of Law Enforcement
ORGANIZATIONDaytime Telephone Number
ORGANIZATIONEl Completed
LOCATION
Slovakia
LOCATIONItem A.
PERSONUSC 2423(a
ORGANIZATIONDSC 1591(a
ORGANIZATIONDSC 2423(a
ORGANIZATIONSignature of Law Enforcement
ORGANIZATIONSignature of Supervisor
ORGANIZATIONEl State
LOCATION