3
Shared Docs
3
Same-Page
3 / 3
Mentions
loco parentis) Applicant Name: 0- 73-rei -cerr2F\.,t Ent.,O(12.N (Last Name, First Name, Middle Name) Applicant Phone No: (Area Code-XXX-XXXX) Courier Company Name: a) 1O 2LISSDor Applicant Signature: Date: O7 —a5 —001(0 (MM/DD/YYYY) (If the applicant is under the age of 16, a parent, legal guardian, or p
d countries continues. Should either passport be lost or stolen, I will report the circumstances immediately to the Passport Office or the nearest U.S. Embassy/Consulate. NAME: 7e-ficcr-€4 Ev:4-e (Please 'Print‘Name Legibly) SIGNATURE: DATE: 5-as- 1 (0 EFTA00316243 DARREN K. INDYKE DARREN K. INDYKE, PLLC 575
or person legally acting in loco parentis) Applicant Name: CMIE : 711Q 3EFT2a Fuerne__ (Last Name, First Name, Middle Name) Applicant Phone No: Courier Company Name: Date: 05-a5 xDKo (MM/DD/YYYY) 60 IT) (-LISS /A Applicant Signature: (If the applicant is under the age of 16, a parent, legal guardian, or p
d countries continues. Should either passport be lost or stolen, I will report the circumstances immediately to the Passport Office or the nearest U.S. Embassy/Consulate. NAME: Tecfreq Fp-4e kn (Please Print.Name Legibly) SIGNATURE: DATE: -7:35 I CD EFTA00316225 Hrnll 1.3 (12. C;tritt At hy: 3ort let 3
acting in loco parentis) Applicant Name: (Last Name, First Name, Middle Name) Applicant Phone No: Date: (Area Code-XXX-XXXX) (MM/DD/YYYY) Courier Company Name: Please handwrite "Go To Russia" here. Applicant Signature: (If the applicant is under the age of 16, a parent, legal guardian, or person legall
d countries continues. Should either passport be lost or stolen, I will report the circumstances immediately to the Passport Office or the nearest U.S. Embassy/Consulate. NAME: (Please Print•Name Legibly) SIGNATURE: DATE: EFTA00296339 GO TO RUSSIA 877-898-1203 Letter of Authorization Please carefully read t
Entities connected to both Courier Company Name and U.S. Embassy/Consulate

FedEx
ORGANIZATIONAttn: Passport Department
ORGANIZATION
Puerto Rico
LOCATION
Washington D.C.
LOCATION
Jeffrey Epstein
PERSON
United States Department of State
ORGANIZATIONthe U.S. Passport Office
ORGANIZATIONExpedited Passport Processing: Your new
ORGANIZATIONDarren Indyke
PERSON
American Express
ORGANIZATIONU.S. Embassy
ORGANIZATIONSouthern Trust Company
ORGANIZATIONFedEx Express Saver
ORGANIZATIONUS Embassy or
ORGANIZATIONFedEx International Delivery'
ORGANIZATION
United States
LOCATIONU.S. Department of State
ORGANIZATION