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resentative of the above-named attorney and certify that I am able to meet this responsibility. I am also aware of the Bureau of Prisons' Policy on Inmate Legal Activities and certify that I am able to and will adhere to the requirements of this policy. I pledge to abide by Bureau of Prisons regulations and institution
Uzi) • if outside the 10. The above listed information is true and correct. Applicant's Signature %ty4le 10a. Date /afrb PRIVACY ACT NOTICE Authority for Collecting Information: E.O. 10450: 5 CSC :303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 USC 3301 purposes end Uses: Information provided on this form will
resentative of the above-named attorney and certify that I am able to meet this responsibility. I am also aware of the Bureau of Prisons' Policy on Inmate Legal Activities and certify that I am able to and will adhere to the requirements of this policy. I pledge to abide by Bureau of Prisons regulations and institution
outside the 10. The above listed information is true and correct. Applicant's Signature %ty4le (979,yi,;\ 10a. Date /afril PRIVACY ACT NOTICE Authority for Collecting Information: E.O. 10450; 5 CSC :303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 SSC 3301 purposes end Uses: Information provided on this form will
resentative of the above-named attorney and certify that I am able to meet this responsibility. I am also aware of the Bureau of Prisons' Policy on Inmate Legal Activities and certify that I am able to and will adhere to the requirements of this policy. I pledge to abide by Bureau of Prisons regulations and institution
d country if outside the U.S.A) WM • 10. The above listed information is true and correct. Applicant's Signature lOa. Date PRIVACY ACT NOTICE Authority for Collecting Information: E.O. 10450; 5 CSC :303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 USC 3301 purposes end Uses: Information provided on this form will
Entities connected to both Inmate Legal Activities and Authority for Collecting Information

Jeffrey Epstein
PERSONFederal, Municipal County
ORGANIZATIONFederal Bureau of Prisons
ORGANIZATION
United States
LOCATIONUSC 2585
ORGANIZATIONthe Legal Department
ORGANIZATION
Metropolitan Correctional Center
ORGANIZATIONPark Row
LOCATIONNational Crime Information Center
ORGANIZATIONSarah M. Sacks
PERSON
Sarah Kellen
PERSONMorse
PERSONthe State of New York
LOCATIONO'Brien
PERSONNEW YORK STATE DEPARTMENT OF STATE
ORGANIZATIONSociety National Office
ORGANIZATIONMotel Nittalijey
ORGANIZATIONBennett M. Epstein
PERSONfarvey E.
PERSONNikolei Niftalijev
PERSON