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ampa v014dy pen* 3114 feCOM1104044 rya npvnarne who have pronoun" rorprnrd ti WOW) °Into P.)155 1. Name Last EPSTEIN First JEFFREY 2. Date of Birth (nunaktlYYYY) 01 20 1953 5. Social Security Number Middle EDWARD no Clo OOP DOTS Code Cott Exp. 3. Sex 4. Place of Birth (City & Slate if
01 20 1953 5. Social Security Number Middle EDWARD no Clo OOP DOTS Code Cott Exp. 3. Sex 4. Place of Birth (City & Slate if in the U.S., or City & Country as it is presently known ) M F X NEW YORK, NY S. Email Address (o 0. my_omededomein com) 7. Primary Contact Phone Number 090 44 3348 JEE
linppltants who have prevously 1. Name Last K D L O ri DP DOTS Code. End. # Exp. EPSTEIN First Middle .4Zie741 JEFFREY EDWARD 2. Date of Birth (mm/ddlyyyy) 01 20 5. Social Security 3. Sex IA F x 6. Email Address 4. Mace of Birth (City & State N in the U.S.. of City & Country as it i
WARD 2. Date of Birth (mm/ddlyyyy) 01 20 5. Social Security 3. Sex IA F x 6. Email Address 4. Mace of Birth (City & State N in the U.S.. of City & Country as it is presently known.) 1953 NEW YORK, NY Ki-4*.e14 i'MriTI2S1 Number top.. my emaiWomain.com) 7. Primary Contact Phone Number JEEVACATION
Cd Fee. EF Postage Other 1111111 11111 Date DS-82 08-2013 Page 1 of 2 EFTA00296116 Name of Applicant (Last. First & Middle) Date of Birth (mmfddiyyyy) EPSTEIN, JEFFREY EDWARD 01/20/1953 12. Height 13. Hair Color 14. Eye Color 5ft. GRAY BLUE 15. Occupation 16. Employer or Schoo
ocial Security Number 3. Sex IA F X Middle K D [_] O r! DP DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City & State if in the U.S.. or City & Country as it is presently known.) NEW YORK, NY 6. Email Address to.g.. my [email protected]) 7. Primary Contact Phone Number [email protected] S. Ma
lidlyperiod and is reeemmended Ic ppleares who have prevously required the addrion el visa pages. 1. Name Last EPSTEIN First JEFFREY 2. Date of Birth (mm/ddlyyyy) 01 20 1953 5. Social Security Number 3. Sex F x Middle K D L O DP DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City &
53 5. Social Security Number 3. Sex F x Middle K D L O DP DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City & State N in the U.S.. or City & Country as it is presently known.) NEW YORK, NY 6. Email Address (e.g.. my [email protected]) 7. Primary Contact Phone Number 8. Mailing Address: Line 1:
page rat:ph:arts who have prevausly required 1. Name Last LID I :O ri DP DOTS Code. End. X Exp. First Middle zee+ Z•IC - taczct— 2. Date of Birth (mm/ddryyyy) 5. Social Security Number 3. Sex 4. Place of Birth (City & State if in the U.S.. or City & Country as it is presently known.) 14 X
rst Middle zee+ Z•IC - taczct— 2. Date of Birth (mm/ddryyyy) 5. Social Security Number 3. Sex 4. Place of Birth (City & State if in the U.S.. or City & Country as it is presently known.) 14 X 6. Email Address (e.g. 7. Primary Contact Phone Number 8. Mailing A ress: ins nee; . . Box, or URB. 9 E. 71S
dlyperiod. and is recommended ic peltards oho have previously required the addeban of visa pages. 1. Name Last EPSTEIN First JEFFREY 2. Date of Birth (mmiddryyyy) 01 20 1953 5. Social Security Number 3. Sex kt F X Middle ED [Jo D DP DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City
5. Social Security Number 3. Sex kt F X Middle ED [Jo D DP DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City & State if in the U.S.. or City & Country as it is presently known.) NEW YORK, NY 6. Email Address (e.g.. my [email protected]) 7. Primary Contact Phone Number El MI ■ 8. Mailin Address:
idlyperiod. and is recommended [flppltares who have previously required the midden el visa pages. 1. Name Last EPSTEIN First JEFFREY 2. Date of Birth (mmiddlyyyy) 01 20 1953 3. Sex IA F X Middle ED Lc) 1- 1, DP DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City & Stare if in the U.S
dlyyyy) 01 20 1953 3. Sex IA F X Middle ED Lc) 1- 1, DP DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City & Stare if in the U.S.. or City & Country as it is presently known.) NEW YORK, NY 5. Social Security Number 6. Email Address (o.g.. my [email protected]) ■ 8. Mailing Address: Line I: Str
Entities connected to both Birth and City & Country

Jeffrey Epstein
PERSONLeon Black
PERSONJane Doe
PERSONDarren Indyke
PERSONU.S. PASSPORT RENEWAL APPLICATION
ORGANIZATION
Philadelphia
LOCATIONSTATE DEPARTMENT FACILITY
ORGANIZATIONPassport Records
ORGANIZATIONNational Passport Processing Center
ORGANIZATIONOverseas Citizen Services Records
ORGANIZATIONthe Federal Claims Collection Standards
ORGANIZATION
United States
LOCATIONINTERNATIONAL AIR TRAVEL
ORGANIZATIONU.S. Embassy
ORGANIZATION
BERMUDA
ORGANIZATIONA U.S. PASSPORT ISSUED
ORGANIZATIONTHE TRADITIONAL PASSPORT BOOK
ORGANIZATIONTHE U.S. PASSPORT CARD
ORGANIZATIONPassport Services
ORGANIZATION
the Internal Revenue Service
ORGANIZATION