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Registrant Information Name. JEFFREY E EPSTEIN (Fria Middle Last Suffix) 'MSclouse Ca your Social Security Number (SSN) is mandatory pursuant to Ronda law. sections 77521.943.0435. 944.607. 985.481. F.S.. and federal law. 12 USC 16901. et sec use of your SSN le for the purposes of dantication POLE
St Thomas (City) Contact Person: Start pate: 07/26/2012 VI 00802 IStals) (ZIP) Mailing Address • Sams as Permanent O game as Tempersty Meese note: The registrant has 'sported additional Phone Numbers phones not discrleyrd hem E I do NOT have or use any home or mobile phone rumbono 9E 7
5-12 2.2921 PM EFTA00098651 Registration No: 605414 Person Number: 73274 Mailing Address • Same u Permanent 0 Um* es Temporary Phone Numbers Meese noir The registrant has reported uldillomil phones not displayed Mn` CI I do NOT hem or use any home or mobile phone numbers 9 E 71s1 St Phone Nu
ate 0 Moving from another state to permanently establish a residence in Florida Visiting from another state and establishing a to wrndry address in Ronda El Oiler (please desaibe): Otto of Oopiou10. Da* of Snivel: we be permanently leaving donde to maintain his immanent residence in die us swgin wa
fficer Name: Phone. ( ) Cc my Out of State Travel information (Complete if permanent or temporary address Is out of state) 0 Permanently leaving Ronda to establish a residence in another state 0 Temporarily leaving Florida to visit another state 0 Moving from another state to permanently establish
Cator/Cola Scheme) O Used asafetida°, (Weide Type) El NOT used as • residence Baena Tag P) (Stale) Vessels K I do NOT own a wawa or houseboat Meese note: The registrant has reported ad maul weals not displayed hen. 1. 2010 Other While (Thor) (Vessel Type) The vessel is: (CelodColor Scheme)
0 Moving from another state to permanently establish a residence in Florida 0 Visiting from another state and establishing a temporary address I Ronda 0 Other (please describe): Date of Depertire: Date of Arrival: 0m0512019 Current Permanent Address Future Permanent Address 358 El DrIllo Way
riColOr Scheme) (Venda Type) O NOT used as a residence O Used as a resident* peened by registrant Vessels O I do NOT own • vessel or houseboat Meese note: The registrant ha reported additional vessels not displayed hero. 1. 2011 Otter (Tear) (Vessel Type) yes (RegetratiOn Sy This vessel Whi
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