Epstein Secrets

0010 3.g. Postal Code O Respondent (ICE, CBP) 3.h. Country Information About Applicant, Petitioner, United States Requestor, or Respondent 4. Daytime Telephone Number 5.a. hand) \aim: (tam Name) S. 5.b. Given Name (First Name) Fax Number Middle Name L 6. Addresc 6. Name of Company or Organization Of aPPi

time Telephone Number Mobile Telephone Number Email Address (if any) Other Information Identification Number (FEIN) 1 Individual IRS Tax Number U.S. Social Security Number (if any) Fonn l•129 01/17/17 Y Page I of 36 EFTA00309117 Part 2. Information About This Petition (See instructions for fee information)

Date Receipt Remarks 26 Federal Plaza City or Town (ILSPI VP rode Lank -A Apt. Ste. Flr. Number 0 0 El State ZIP Code NY New York 6. Daytime Telephone Number 7. Fax Number 102711 Form 1-914. Supplement B Edition 12/C0/21 Page I EFTA00156636 Part 2. Agency Information (continued) 8. Agency Type El

ddle Name (if any) Date of Birth (ddirrun/yyyy) 4. Gender or Sex El Male El Female El Other Alien Registration Number (A-Number) (if any) P. A- U.S. Social Security Number (SSN) (if any) .r Part 2. Agency Information 1. Name of Certifying Agency Federal Bureau of Investigations 2. Name of Certifying Offici

Date Date Reloc Rec'd Date Date Receipt Remarks 26 Federal Plaza City or Town New York IMPS ZIP Co* Loging2 Apt. Ste. Flr. State NY 6. Daytime Telephone Number 7. Fax Number Number ZIP Code 10278 Form 1-914. Supplement B Edition 12/02/21 Page EFTA01653122 Part 2. Agency Information (continued) 8. A

me (if any) 3. 5. 6. Date of Birth (dd/mm/yyyy) 4. Gender or Sex K Male ❑X Female K Other Alien Registration Number (A-Number) (if any) ► A- U.S. Social Security Number (SSN) (if any) Part 2. Agency Information I. Name of Certifying Agency Federal Bureau of Investigations 2. Namc of Certifying Official

Describe the nature of your disability and/or impairment and the accommodation you are requesting.) Part 4. Information to Contact You 1. 3. 5. Daytime Telephone Number 2. 4. Work Telephone Number (if any) Evening Telephone Number Mobile Telephone Number (if any) Email Address (if any) Part 5. Information Abou

would like to use in the spaces provided below. Family Name (Last Name) O Yes O No Given Name (First Name) Middle Name (if applicable) _J 5. U.S. Social Security Number (if applicable) 6. USCIS Online Account Number (if any) ► 7. Gender El Male I] Female 10. Country of Birth 8. Date of Birth (mm/ddi