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ECLARATION OF SERVICE' I declare under penalty of perjury under the laws of the United Stales of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who m
3414 Special Procedures 2546 22 Remarks. 15 Date Received: OBJECT CLASS K Funds Available Date: Budget Officer: Copy Hour Clerical Tech Hour Manger or Supervisor Total Amount Claimed By Financial Institution Amount 16 Disallowance (See Attached) 17 Net to Financial Institution 19 Signat
ECLARATION OF SERVICE' I declare under penalty of perjury under the laws of the United Stales of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who m
enrollment form. Do not proceed with compliance: If cost will exceed Moll without prior approval of 0.25 11.00 17.00 Copy Hour Clerical Tech Hour Manger or Supervisor Budget Officer liatir0 FtlICIAIRL Fax any request to (305) 530-7670 12 Signature of Financial Institution Official: 13 Date Signed
DECLARATION OF SERVICE I declare under penalty of perjury under the laws of the United States of America that the foregoing Information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who m
ollment form. DO not proceed with compliance: If cost will exceed 5500 without prior approval el to 0.25 11.00 17.00 Copy Hour Clerical Tech Hour Manger or Supervisor Budget Officer Lazar* Felicia's.. Paz any request to (305)530-7679 12 Signature of Financial Institution Official: 13 Date Signed:
ECLARATION OF SERVICE' I declare under penalty of perjury under the laws of the United Slates of America that the foregoing information contained in the Return of Service and Statement of Service Fees Is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who m
Er enrollment form. Do pot proceed with compliance: If cost will exceed 6500 without prior approvalof 0.25 11.00 17.00 Cow Hour Clerical Tech Hour Manger or Supervisor Budget Officer. Loam Feliciano. Fax any request to (305)530-7679 12 Signature of Financial Institution Oficial: 13 Date Signed: T
DECLARATION OF SERVICE' I declare under penalty of penury under the laws or the United States Or America that the foregoing Information contatned in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1As to who may
lic Law 9S-620 (12 U.S.C. 3401.3422) Request Pursuant To: (arectate 0400 SECTION 22 Remarks IS Dos Recited: 0.25 1100 17.00 How Oedcal Tech Hour Manger or Superstar To - tal A mou iClaimed By I- inarnial Institution 16 oran...... Arsacht 17 -N et to Financial Institution 0.00 OBJECT CL
CLARATION OF SER VICE' I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who m
enrollment form. Do not proceed with compliance: If cost will exceed 5500 without prior approval of 0.25 11.00 17.00 Copy Hour Clerical Tech Hour Manger or Supervisor Budget OM/. 'Fax any request to 005)530.7679 12 Signature of Financial Institution Official: 13 Dat Signed: Total AmountClaimed
Entities connected to both the Return of Service and Hour Manger

Jeffrey Epstein
PERSON
United States
LOCATIONFBI
ORGANIZATION
Alexander Acosta
PERSON
Department of Justice
ORGANIZATIONSouth Flagler Drive
LOCATION
West Palm Beach
LOCATIONSignature of Records
ORGANIZATIONthe Southern District
LOCATION
George W. Bush
PERSONSignature of Vendor's
ORGANIZATIONJanusz Banasiak
PERSONThe Debt Collection Improvement Act
ORGANIZATIONVOICEMAILS
ORGANIZATION
Alfredo Rodriguez
PERSON
A. Marie Villafana
PERSONWPB FL
ORGANIZATION
Eric Trump
PERSONNesbitt Kuyrkendall
PERSON
Palm Beach Police Department
ORGANIZATION