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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
sees Probation Type: O State Officer Name. O Federal O County Officer Name City Deicer Name Phone Phone ( ) Phone ( ) County Out of State Travel Information (Complete if permanent or temporary address Is out of state) • Permanently leaving Florida to establish a residence in another stale Temporarily l
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
ede-al Canty Stale City Weight: 180 lbS Hah: Officer Name: Phone ( ) Officer Name: Phone: ( ) OffiCer Name: Phone'. ( ) County Out of State Travel Information (Complete If permanent, temporary, or transient address Is out of state) Permanently leaving Florida b establish a residence In another state/countr
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
eight: 180 lbS Halt State Cry Officer Name: Grey Phone ( Officer Name: Phone: ( ) Officer Name' Canty Pl,nne ( ) Eyes: roue Out of State Travel Information (Complete If permanent, temporary, or transient address Is out of state) O Permanently leaving Florida to establish a residence in another stale/co
Entities connected to both Ronda and State Travel Information

Jeffrey Epstein
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Scarlett Johansson
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