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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
tate's responsibility to protect U.S. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other
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 &
tate's responsibility to protect U.S. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other
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
tate's responsibility to protect U.S. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other
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 &
tate's responsibility to protect U.S. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other
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 (
tate's responsibility to protect U.S. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other
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
tate's responsibility to protect U.S. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other
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
tate's responsibility to protect U.S. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other
Entities connected to both Birth and System of Records

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