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own ►YEW yo 3.d. State 3.e. ZIP Code Ny 10278 31 Province 3.g. Postal Code 3.h. Country N I reb 517:116 Preparer's Contact Information 4. Preparer's Daytime Telephone Number 5. Preparers Fax Number 6. Preparer's E-mail Address 7.a. IR I am not an attorney or accredited representative but h
active investigation is underway by a law enforcement agency that requires the assistance of this subject. Certification for Continued Presence by Requesting Law Enforcement Agency FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE EFTA00173130 oy2.1-12-o 2-o r S afure [df Authonzinti giedl] Elate Printed Ntine [of Authori
vince 3.g. Postal Code 3.b. Country 2lo PED62AL PLAZA Flr. K NEW yotk 3.e. ZIP Code 10278 UNIT-6Th SikreS Preparer's Contact Information 4. Preparer's Daytime Telephone Number 5. Preparer's Fax Number 6. Preparer's E-mail Address 7.a. xi I am not an attorney or accredited representative but
active investigation is underway by a law enforcement agency that requires the assistance of this subject. Certification for Continued Presence by Requesting Law Enforcement Agency FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE EFTA00173740 Signature [of Authorizing Official] Date Printed Name [of Authorizing Official]
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
active investigation is underway by a law enforcement agency that requires the assistance of this subject. Certification for Continued Presence by Requesting Law Enforcement Agency FOR OFFICIAL USE ONLY I LAW ENFORCEMENT SENSITIVE EFTA01731217 Signature [of Authorizing Official] Date Printed Name [of Authorizing Official]
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
active investigation is underway by a law enforcement agency that requires the assistance of this subject. Certification for Continued Presence by Requesting Law Enforcement Agency FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE EFTA01684002 Signature [of Authorizing Official] Date Printed Name [of Authorizing Official]
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
active investigation is underway by a law enforcement agency that requires the assistance of this subject. Certification for Continued Presence by Requesting Law Enforcement Agency FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE EFTA01699756 Signature [of Authorizing Official] Date Printed Name [of Authorizing Official]
Entities connected to both Preparer and Requesting Law Enforcement Agency

Jeffrey Epstein
PERSONAlbany
LOCATION
United States
LOCATION
Homeland Security
ORGANIZATIONMonitoring Group
ORGANIZATION
Department of Homeland Security
ORGANIZATIONthe Social Security Administration
ORGANIZATIONNew York Field Office
LOCATION
Michael C.Green
PERSONthe NYS Division of Criminal Justice Services
ORGANIZATIONFederal, State
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONContact Information, Certification
ORGANIZATIONMonitoring Case
ORGANIZATIONNational Crime Information Center
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONU.S. Citizenship and Immigration Services
ORGANIZATIONICE-011 Immigration and Enforcement Operational Records
ORGANIZATIONHomeland Security Investigations
ORGANIZATION