3
Shared Docs
3
Same-Page
3 / 3
Mentions
ence. Routine Use(s): The information collected on this form may be shared with a criminal, civil, or regulatory law enforcement authority (whether Federal, State, local, territorial, tribal, international or foreign) where the information is necessary for collaboration, coordination and de-confliction of inve
er. 3.a. Street Number and Name Preparer's Full Name 3.b. O Apt. K Ste. O Flr. l.a. Preparer's Family Name (Last Name) 3.c. City or Town I.b. Prepares Given Name (First Name) 3.d. State 3.e. ZIP Code 3.1. Province 2. arees Business or Organization Name (if any) 3.g. Postal Code 3.h. Country
ence. Routine Use(s): The information collected on this form may be shared with a criminal, civil, or regulatory law enforcement authority (whether Federal, State, local, territorial, tribal, international or foreign) where the information is necessary for collaboration, coordination and de-confliction of inve
er. 3.a. Street Number and Name Preparer's Full Name 3.b. O Apt. K Ste. O Flr. l.a. Preparer's Family Name (Last Name) 3.c. City or Town I.b. Prepares Given Name (First Name) 3.d. State 3.e. ZIP Code 3.1. Province 2. arees Business or Organization Name (if any) 3.g. Postal Code 3.h. Country
ence. Routine Use(s): The information collected on this form may be shared.with a criminal, civil, or regulatory law enforcement authority (whether Federal, State, local, territorial, tribal, international or foreign) where the information is necessary for collaboration, coordination and de-confliction of inve
her than the Applicant Preparer's Full Name Provide the following information concerning the preparer: 1.a. Preparers Family Name (Last Name) Lb. Prepares Given Name (First Name) 2. Prepares Business or Organization Name Preparer's Mailing Address 3.a. Street Number and Name 3.b. Apt. K Ste. K Fl
Entities connected to both Federal, State and Prepares

Jeffrey Epstein
PERSON
United States
LOCATIONFBI
ORGANIZATION
Department of Homeland Security
ORGANIZATIONNew York Field Office
LOCATION
Homeland Security
ORGANIZATIONAlbany
LOCATIONNew York State Division of Criminal Justice Services
ORGANIZATIONthe Social Security Administration
ORGANIZATION
Michael C.Green
PERSONthe NYS Division of Criminal Justice Services
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONPreparer
ORGANIZATIONNational Crime Information Center
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONMonitoring Group
ORGANIZATIONMonitoring Case
ORGANIZATIONContact Information, Certification
ORGANIZATIONFederal Bureau of Investigation - New York
ORGANIZATION