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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
1.94 when I entered as a nonimmigrant member of the military, and I am filing this application for an initial Form 1-94. 4. Class of Admission at Last Entry into the United States E2 5. Place of Last Entry into the United States (City and State) NEW "PAsspoet ciplizpv-“ow. LDS ANhel-6,5 Form 1-102
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;
it appears on Form 1-94, I-94W, or I-95. 3.a. Family Name (Last Name) 3.b. Given Name (First Name) 3.c. Middle Name 4. Class of Admission at Last Entry into the United States E2 5. Place of Last En into the United States City and State) Form 1-102 10/19/17 N Page 2 of 4 EFTA01684010 Part 4.
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
I-94 when I entered as a nonimmigrant member of the military, and I am filing this application for an initial Form I-94. 4. Class of Admission at Last Entry into the United States E 5. Place of Last Entry into the United States (City and State) OartJ: :Pro- cessing Information . La. Are you filing th
Entities connected to both U.S. Citizenship and Immigration Services and Last Entry

Jeffrey Epstein
PERSON
Department of Homeland Security
ORGANIZATIONFBI
ORGANIZATION
Homeland Security
ORGANIZATION
United States
LOCATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONAlbany
LOCATIONNew York Field Office
LOCATIONFederal, State
ORGANIZATIONPreparer
ORGANIZATIONU.S. Social Security
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONthe Social Security Administration
ORGANIZATION
Michael C.Green
PERSONthe NYS Division of Criminal Justice Services
ORGANIZATION
Birth
PERSONNew York State Division of Criminal Justice Services
ORGANIZATIONNational Crime Information Center
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONMonitoring Group
ORGANIZATION