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(mrn/dcl/yyyy) ► Count of Birth 4.a. In Care Of Name 9. Country of Citizenship 4.b. Street Number and Name SLovit-11\- 4.c. Apt. 2 Ste. 10. U.S. Social Security Number (if an ) K Flr. 0 4.d. City or Town NEW t i ORIC Entry Information 4.e. State 4.f. ZIP Code 100toS 11. Date of Last Entry into the U
FEB6E-AL PIA2ft Contact Information K Flr. 4. Interpreter's Daytime Telephone Number 3.c. City or Town NEW YORK 5. 3.d. State 3.e. ZIP Code Interpreter's Mobile Telephone Number (if any) N V Idris 3.f. Province 6. Interpreter's Email Address (if any) 3.g. Postal Code 3.h. Country Interpreter's Certification I certify
d. City or Town 6.e. State 0 6.f. ZIP Code Other Information 7. Date of Birth (mm/dd/yyyy) ► 8. Count of Birth 9. Count of 'fizen hi 10. U.S. Social Security Number if an City or Town NEAN otkg Entry Information State NY 4.1. ZIP Code 11. Date of Last Entry into the United States Is your current U
E-f\L PLAZIN Contact Information O Flr. 4. Interpreter's Daytime Telephone Number NEW YOIZW--- 3.c. City or Town 5. 3.d. State 3.e. ZIP Code Interpreter's Mobile Telephone Number (if any) NV 10276 3.1. Province 6. Interpreters Email Address (if any) 3.g. Postal Code 3.h. Country Interpreter's Certification I certify,
Town 6.e. State O Flr. O 6.1. ZIP Code Other Information 7. Date of Birth (nmildcliyyyy) 10. 8. un of Birth 9. Coun of Citizenshi 10. U.S. Social Security Number if an Entry Information 11. Date of Last Entry into the United States (mni/dellyyyy) ► oi/a/e301° 12. Place of Last Entry into the Unite
et Number and Name K Apt. K Ste. Contact Information K Flr. 4. Interpreter's Daytime Telephone Number 3.c. City or Town 5. 3.d. State 3.e. Interpreter's Mobile Telephone Number (if any) ZIP Code 3.f. Province 6. Interpreter's Email Address (if any) 3.g. Postal Code 3.h. Country Interpreter's Certification I certify,
Entities connected to both U.S. Social Security and Interpreter's Mobile Telephone Number
U.S. Citizenship and Immigration Services
ORGANIZATION
Jeffrey Epstein
PERSONNew York Field Office
LOCATION
Homeland Security
ORGANIZATION
Birth
PERSONPreparer
ORGANIZATION
Department of Homeland Security
ORGANIZATIONFederal, State
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONNational Crime Information Center
ORGANIZATIONAlbany
LOCATIONthe Social Security Administration
ORGANIZATION
Michael C.Green
PERSONthe NYS Division of Criminal Justice Services
ORGANIZATIONHomeland Security Investigations
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONMonitoring Group
ORGANIZATIONMonitoring Case
ORGANIZATION