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IP Code N I D2 78 3.f. Province 3.g. Postal Code 3.h. Country 2a FED6_12AL PLA2A FIr. 0 Li N ran smerec Pireparer's Contact Information 4. Preparer's Daytime Telephone Number 5. Preparer's Fax Number 6. Preparer's E-mail Address 7.a. g I am not an attorney or accredited representative but h
ature Interpreter's Mailing Address 3.a. Street and Name 3.b. K Apt. 3.c. City or 3.d. State 3.f. Province 3.g. Postal 3.h. Country Number K Ste. Town Preparer's 1.a. 1.b. 2. Preparer's Full Name Preparer's Family Name (Last Name) K Flr. Preparer's Given Name (First Name) 3.e. ZIP C
III Page 1 of 7 EFTA01699786 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. 5.b. Street Number and Name 5.e. Apt. K Ste. K Flr. 5.d. City or Town 5.e. State Naze) uor- 5.f. ZIP Code I 00105 6. Is your current mailing address the same as your physical address?
Street Number and Name 3.b. Apt. K Ste. 3.c. City or Town 3.d. State 3.f. Province 3.g. Postal Code 3.6. Preparer's Contact Information 4. Preparer's Daytime Telephone Number 5. Preparer's Fax Number 6. Preparer's E-mail Address Preparer's Declaration By my signature, I certify, swear, or a
31228 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. In Care Of Name (if any) 5.b. Street Number and Name 5.c. Apt. K Ste. 5.d. City or Town 5.e. State ■ 51 ZIP Code 6. Is your current mailing address the same as your h sical address? NOTE: If you answered "No" to
Street Number and Name 3.b. Apt. K Ste. 3.c. City or Town 3.d. State 3.f. Province 3.g. Postal Code 3.6. Preparer's Contact Information 4. Preparer's Daytime Telephone Number 5. Preparer's Fax Number 6. Preparer's E-mail Address Preparer's Declaration By my signature, I certify, swear, or a
84013 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. In Care Of Name (if any) 5.b. Street Number and Name 5.c. Apt. K Ste. 5.d. City or Town 5.e. State ■ 51 ZIP Code 6. Is your current mailing address the same as your h sical address? NOTE: If you answered "No" to
Entities connected to both Preparer and K Ste

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