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be completed by Federal, state. local, or tribal law enforcement agencies for victims under the Victims of Trafficking and Violence Protection Act (VTVPA). Public Law 106-386, as amended. PART 1. Victim Information I. Full Legal Name Family Name (Last Name) Given Maine (Pint Name) Middle Name (if
81 Page I EFTA00151754 Part 2. Agency Information (continued) 8. Agency Type Federal O State O Local O Tribal 9. Case Status O On-going El Completed 10. Certifying Agency Category O Judge Law Enforcement O Prosecutor O Other 11. Case Number 12. FBI or SID Number Part 3. Statement of Cla
be completed by Federal, state, local, or tribal law enforcement agencies for victims under the Victims of Trafficking and Violence Protection Act (VTVPA). Public Law 106-386, as amended. PART 1. Victim Information 1. Full Legal Name (First Name) Middle Name (if any) 2. Provide any other names y
e 1 EFTA00156551 Part 2. Agency Information (continued) 8. Agency Type El Federal El State ID Local El Tribal 9. Case Status El On-going El Completed 10. Certifying Agency Category El Judge El Law Enforcement El Prosecutor El Other 11. Case Number 12. FBI or SID Number Part 3. Statement o
be completed by Federal, state, local, or tribal law enforcement agencies for victims under the Victims of Trafficking and Violence Protection Act (VTVPA). Public Law 106-386. as amended. PART 1. Victim Information 1. Full Legal Name Family Name (Last Name) Given Name (First Name) Middle Name (if
e I EFTA00156636 Part 2. Agency Information (continued) 8. Agency Type El Federal El State ID Local El Tribal 9. Case Status El On-going El Completed 10. Certifying Agency Category El Judge El Law Enforcement El Prosecutor El Other 11. Case Number 12. FBI or SID Number Part 3. Statement o
Entities connected to both VTVPA and El Completed

Jeffrey Epstein
PERSONU.S. Citizenship and Immigration Services
ORGANIZATIONDelaration of Law Enforcement
ORGANIZATIONFBI
ORGANIZATIONDivision/Office of Certifying
ORGANIZATIONReloc Sent
LOCATION
Ghislaine Maxwell
PERSONU.S. Social Security
ORGANIZATIONSignature of Law Enforcement
ORGANIZATIONSignature of Supervisor
ORGANIZATIONEl State
LOCATION
United States
LOCATIONItem B.
PERSONEl Federal
ORGANIZATIONEl Tribal
ORGANIZATIONEl Law Enforcement
ORGANIZATIONDSC 1591(a
ORGANIZATIONDSC 2423(a
ORGANIZATION