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se screens on the person named above, including negative responses, have been identified and forwarded to U.S. Immigration and Customs Enforcement, Homeland Security Investigations, Parole and Law Enforcement Programs Unit. 5. No promises have been made to the Victim that he or she will remain in the United States beyond the a
io laws. nature 3.b. Date of Signature (mm/dd/yyyy) ► 1.11Lt /iota) Applicant's Contact Information 4. Applicant's Daytime Telephone Number 5. Applicant's Mobile Telephone Number 6. Applicant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the fo
se screens on the person named above, including negative responses, have been identified and forwarded to U.S. Immigration and Customs Enforcement, Homeland Security Investigations, Parole and Law Enforcement Programs Unit. 5. No promises have been made to the Victim that he or she will remain in the United States beyond the a
e, and correct. Applicant's Contact Information Applicant's Signature 3. Applicant's Daytime Telephone Number 7.a. A licant's Si nature S 4. Applicant's Mobile Telephone Number (if any) 7.b. Date of Signature (mm/dd/yyyy) oi./I412620 5. A licant's Email Address (if any) NOTE TO ALL APPLICANTS: If you do out this appli
se screens on the person named above, including negative responses, have been identified and forwarded to U.S. Immigration and Customs Enforcement, Homeland Security Investigations, Parole and Law Enforcement Programs Unit. 5. No promises have been made to the Victim that he or she will remain in the United States beyond the a
3.a. Applicant's Signature S 3.b. Date of Signature (mm/dd/yyyy) ► Applicant's Contact Information 4. Applicant's Daytime Telephone Number 5. Applicant's Mobile Telephone Number 6. Applicant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the fo
Entities connected to both Homeland Security Investigations and Applicant's Mobile Telephone Number

Jeffrey Epstein
PERSON
Homeland Security
ORGANIZATION
Department of Homeland Security
ORGANIZATIONAlbany
LOCATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONFederal, State
ORGANIZATIONPreparer
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONNational Crime Information Center
ORGANIZATIONU.S. Citizenship and Immigration Services
ORGANIZATIONthe Social Security Administration
ORGANIZATIONNew York Field Office
LOCATION
Michael C.Green
PERSONthe NYS Division of Criminal Justice Services
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONMonitoring Group
ORGANIZATIONMonitoring Case
ORGANIZATIONContact Information, Certification
ORGANIZATIONBirth (mo.
LOCATION