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N: Bank Name Bank Address Bank Phone Number Nine Digit ABA Routing Transit Number Type of Account (Checking or Saving) Depositor Account Number Signature of Vendor's Authorizing Official Name & Title of Authorizing Official Please Return or Fax to: U.S. Attorneys Office Southern District of Florida 99 NE 4
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
N: Bank Name Bank Address Bank Phone Number Nine Digit ABA Routing Transit Number Type of Account (Checking or Saving) Depositor Account Number Signature of Vendor's Authorizing Official Name & Title of Authorizing Official Please Return or Fax to: U.S. Attorney's Office Southern District of Florida 99 NE 4
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
N: Bank Name Bank Address Bank Phone Number Number Nine Digit ABA Routing Transit Type of Account (Checking or Saving) Depositor Account Number Signature of Vendor's Authorizing Official Name & Title of Authorizing Official Please Return or Fax to: U.S. Attorney's Office Southern District of Florida 99 NE 4
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
: Bank Name Bank Address Bank Phone Number Nine Digit ABA Routing Transit Number Type of Account (Checking or Saving) Depositor Account Number Signature of Vendor's Authonzing Mina' Name & Title of Authorizing Official Please Return or Fax to: U S Attorney's Office Southern District of Fonda 99 NE 4 street
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
nk Name Bank Address Bank Phone Number . Nine Digit ABA Routing Transit Number I Type of Account (Checking or Saving) Depositor Account Number Signature of Vendor's Authorizing Official Name & Title of Authorizing Official Please Return or Fax to: U.S. Attorney's Office Southern District of Florida 99 NE 4
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 Signature of Vendor's and Hour Manger

United States
LOCATIONthe Return of Service
ORGANIZATION
Jeffrey Epstein
PERSON
Department of Justice
ORGANIZATIONFBI
ORGANIZATIONSouth Flagler Drive
LOCATION
Alexander Acosta
PERSONThe Debt Collection Improvement Act
ORGANIZATIONSignature of Records
ORGANIZATION
West Palm Beach
LOCATIONthe Southern District
LOCATION
George W. Bush
PERSONJanusz Banasiak
PERSON
Alfredo Rodriguez
PERSONReceiving Report
ORGANIZATION
U.S. Treasury
ORGANIZATIONClaudia Castellanos
PERSON
Western Union
ORGANIZATIONOLY-39
ORGANIZATION
Budget
ORGANIZATION