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are *r€00mrsredeC •rs. ape meta dro lova preenudy Tortured the eaddion of ma peps 1. Name Last EPSTEIN First Middle JEFFREY EDWARD 2. Date of Birth (rrunickVyyyy) 3. Sox F 01 20 1953 X NEW YORK, NY 5. Social Security Number I D . I DP DOTS Code End. A Exp. 4. Place of Birth (City & S
N 40 MIN Attention Read WARNING on page I of instructions Please select the document(s) for which you are applyiN: (20 U.S. Passport Book El U.S. Passport Card LJ Both ThaUS perspen card is a vaid for ranmanonal Pr ISM. Pa more remnant See race 1 of emir:tem I23 28 Page Book (Standard) CI 52 Page Book (
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
t The U.S. passport CI 28 Page Attention: Read WARNING on page I of instructions select the document(s) for which you are applylmr Book El U.S. Passport Card LJ Both card is gal valid lor irdernalkinal a travel. Fe, more information see page t ol instructions Book (Standard) fl 52 Page Book (Non•Stand
lidlyperiod. and is recommended [ncialcarts who have prevausly required the addden el visa pages. 1. Name Last EPSTEIN First JEFFREY 2. Date of Birth (mmiddryyyy) 01 20 1953 5. Social Security Number 3. Sox IA F X Middle ED Ho DIM DOTS Code. End. # Exp. EDWARD 4. Place of Birth (City &
N:40 MIN Attention: Read WARNING on page I of instructions Please select the document(s) for which you are applybig: NI U.S. Passport Book 0 U.S. Passport Card LJ Both The U.S. passport card is gat valid kw international air travel. Fee more interniaten see page 1 el instructiens CI 28 Page Book (Standard
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
28 Page Book (Standard) Note: The 52 option is for those who Read WARNING on page I of instructions document(s) for which you are applyln 0 U.S. Passport Card LJ Both for iniernalanal air travel. For mere information see page 1 of instruetiees. la 52 Page Book (Non•Standarcl) frequently travel abroad du
ity period. and is recommended lOnspicarts who have previously required the midden el visa pages. 1. Name Last EPSTEIN First JEFFREY 2. Date of Birth (mm/ddlyyyy) 01 20 1953 5. Social Security Number 3. Sex PA F x Middle DO Ljo r: DP DOTS Code. End. g Exp. EDWARD 4. Place of Birth (
:40 MIN Attention: Read WARNING on page I of instructions Please select the document(s) for which you are applybig: [XI U.S. Passport Book 0 U.S. Passport Card LJ Both The U.S. passport card is raj valid kr international of travel. For mace infermatsan see page I el a-ritualises. 0 28 Page Book (Standard)
Entities connected to both Birth and Passport Card

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