Epstein Secrets

tPla OW% Woe* oz . ad a .lie letweenfir a Prue Teat rotesaladonieolIteelltorooseuel IlterreaUdetion Ce Pie elearloos For Perceive% P &tarried Spouse's Name Street Address Coy. Scare. ZIP Ca al Ise Corder ow Card for *nun atara bele. , to onstecoe she Send Cards ry Stereo Only 10. Nei Marr

TY IN WHICH THE ENTITY'S OFFItk. ,..411.41_0. CONTACT THE RESPECTIVE 0INTY CLERK FOR FURTHER INFORMATION. EXIST UAI . 7 .. 7. 00/13/1'99 ....= FILER FEES 210.00 PAYMENTS 210.( l ininill il'INUE FILING : 200.00 CASH : .0.( TAX . 0.00 CHECK : 0.( FOURTH FLOOR CERT : 0.00 BILLED: 210.

art I. Name of Income Source Address (City, State) Type of Income Amount Example JP Computers Wash DC Example Salary Example 515.000 MCI (Spouse) Arlington, VA Example Salary Example Over 51.000 1 2 3 4 5 6 7 8 9 10 11 12 13 EFTA_R1_01522034 EFTA02444837 Reporting Wive:wa

mber (Include Area Code) Calendar Year Covered by Annual Report ANNUAL FILER Office I Agency in which Employed (or formerly employed) TERMINATION FILER Dates Covered by Termination Report; Office l Agency in which Formerly Employed Termination Date (mnVdd/W): Who Must File: Any reporting Individu

Fiequest .,rear; 1:2. Business Name V es LI- FOR MARITAL PROPERTY STATES ONLY O Married O Not Married O Legally Separated Name and Address of Spouse ACCOUNT RECORD CHANGES O Close Acct O Add Soc. Sec. No. _ - ____• _- O Cards Returned O Cards Not Returned O Reopen Account O Remove Reissue Blo

BE MAK ED BY THE COUNTY CLERK OF 1E COUNTY IN WHICH THE ENTITY'S OFFfElg. tip ? D. CONTACT THE RESPECTIVE. 0INTY CLERK FOR FURTHER INFORMATION. FILER FEES 210.00 PAYMENTS 210.0 ----- ---- LAUREN KWXNTNER FILING : 200.00 CASH : 0.0 457 MADISON AVENUE TAX 0.00 CHECK : 0.0 FOURTH FLOOR C