Epstein Secrets

l Name: Daniel MullkoffClick here to enter full name m iVCCtItA Email Address: Phone Number: Social Security Number: Address 1 Address 2: City:New York State: New York Zip: Citizenship: Country of Birth: If you have spoken with a FBI Victim Specialist, please provide their name: Click here to enter VS

ny incidental charges incurred such as snacks, mini bar, Pay-Per-View, phone charges, etc. K Yes, my support person will require separate lodging (El No, my support person will not require separate lodging If bringing a support person, will your support person require airport transportation? 0 Yes,

1111111111 1 III 11 III EFTA00604698 Page 6 of 8 IT-204 (2007) TCC INTERNATIONAL LLC Section 8 - New York modifications (see instnictions) 107 New York State additions Number A - Total amount B - New York State allocated amount 107a. E A - 107b. E A - 107c. E A - 107d. E A - 107e. E A - 107f. E A

statement been restated for the income statement period on line 2? El Yes. (If 'Yes,' attach an explanation and the amount of each item restated.) El No. b Has the paitnersfria's income statement been restated for any of the five income statement periods preceding the period on line 2? Yes. (If 'Ye

ed an order of protection in this case? Has the DA asked the court to order restitution? Did the court order the suspect to pay restitution? K Yes El No K Yes 0 No 0 Not Yet K Yes K No 0 Yes 0 No (If Yes, attach a copy.) 0 Yes 0 No 0 Not Yet 0 Yes (Amount $ )0 No 0 Not Yet ca°6-4-47 NOTE -

the services listed on this form. Remember: You must bill your insurance company or benefits plan before the OVS can pay. Mall your documents to: New York State Office of Victim Services AE Smith Building 80 S. Swan Street Albany, NY 12210.8002 Rev. September 2015 Page 4 of 4 EFTA00038441 --- PAGE BRE