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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
. Your Current Immigration Status or Category (for example, B-2 visitor, F-I student, parolee, deferred action, or no status or category) E2 26. Student and Exchange Visitor Information System (SEVIS) Number (if any) ► N- Information About Your Eligibility Category 27. Eligibility Category. Refer to the Who May File Form 1-765 section
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
25. Your Current Immigration Status or Category (for example, B-2 visitor, F- I student, parolee, deferred action, or no status or cate o ) 26. Student and Exchange Visitor Information System (SEWS) Number (if any) ► N- 28.c. Employer's E-Verify Company Identification Number or a Valid E-Verify Client Company Identification Number 29.
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
. Your Current Immigration Status or Category (for example, B-2 visitor, F-I student, parolee, deferred action, or no status or category) E 26. Student and Exchange Visitor Information System (SEVIS) Number (if any) ► N- Information About Your Eligibility Category 27. Eligibility Category. Refer to the Who May File Form I-765 section o
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
. Your Current Immigration Status or Category (for example, B-2 visitor, F-I student, parolee, deferred action, or no status or category) E 26. Student and Exchange Visitor Information System (SEVIS) Number (if any) ► N- Information About Your Eligibility Category 27. Eligibility Category. Refer to the Who May File Form I-765 section o
Entities connected to both Preparer and Student and Exchange Visitor Information System

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