the Social Security Administration
ORGANIZATIONStudent and Exchange Visitor Information System
ORGANIZATION4
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. Marital Status 18.a. Country Single O Married O Divorced O Widowcd LovAiz. I 12. Have you previously filed Form 1-765? OYes ENo 13.a. Has the Social Security Administration (SSA) ever officially issued a Social Security card to you? @Yes O No NOTE: If you answered "No" to Item Number 13.a., skip to Item Number 14. I
. Your Current Immigration Status or Category (for example, B-2 visitor, F-I student, parolee, deferred action, or no status or category) E2 26. Student and Exchange Visitor Information System (SEVIS) Number (if any) ► N- Information About Your Eligibility Category 27. Eligibility Category. Refer to the Who May File Form 1-765 section
l Status gs) Single 0 Married 0 Divorced K Widowed 18.a. Country 12. Have you previously filed Form I-765? 18.b. Country Oyes JNo 13.a. Has the Social Security Administration (SSA) ever officially issued a Social Security card to you? @Yes 0 No NOTE: If you answered "No" to Item Number 13.a., skip to Item Number 14. I
25. Your Current Immigration Status or Category (for example, B-2 visitor, F- I student, parolee, deferred action, or no status or cate o ) 26. Student and Exchange Visitor Information System (SEWS) Number (if any) ► N- 28.c. Employer's E-Verify Company Identification Number or a Valid E-Verify Client Company Identification Number 29.
your father's birth name. 16.a. Family Name (Last Name) 16.b. Given Name (First Name) Mother's Name Provide your mothers birth name. 13.a. Has the Social Security Administration (SSA) ever officially issued a Social Security card to you? 0 NOTE: If you answered "No" to Item Number 13.a., skip to Item Number 14. If you ans
. Your Current Immigration Status or Category (for example, B-2 visitor, F-I student, parolee, deferred action, or no status or category) E 26. Student and Exchange Visitor Information System (SEVIS) Number (if any) ► N- Information About Your Eligibility Category 27. Eligibility Category. Refer to the Who May File Form I-765 section o
your father's birth name. 16.a. Family Name (Last Name) 16.b. Given Name (First Name) Mother's Name Provide your mothers birth name. 13.a. Has the Social Security Administration (SSA) ever officially issued a Social Security card to you? 0 NOTE: If you answered "No" to Item Number 13.a., skip to Item Number 14. If you ans
. Your Current Immigration Status or Category (for example, B-2 visitor, F-I student, parolee, deferred action, or no status or category) E 26. Student and Exchange Visitor Information System (SEVIS) Number (if any) ► N- Information About Your Eligibility Category 27. Eligibility Category. Refer to the Who May File Form I-765 section o
Entities connected to both the Social Security Administration and Student and Exchange Visitor Information System

Jeffrey Epstein
PERSON
United States
LOCATION
Homeland Security
ORGANIZATION
Department of Homeland Security
ORGANIZATIONthe NYS Division of Criminal Justice Services
ORGANIZATIONAlbany
LOCATIONNew York Field Office
LOCATION
Michael C.Green
PERSONU.S. Immigration and Customs Enforcement
ORGANIZATIONFederal, State
ORGANIZATIONPreparer
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONNational Crime Information Center
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONMonitoring Group
ORGANIZATIONMonitoring Case
ORGANIZATIONContact Information, Certification
ORGANIZATIONICE-011 Immigration and Enforcement Operational Records
ORGANIZATIONthe Intelligence Community
ORGANIZATION