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ature Interpreter's Mailing Address 3.a. Street and Name 3.b. K Apt. 3.c. City or 3.d. State 3.f. Province 3.g. Postal 3.h. Country Number K Ste. Town Preparer's 1.a. 1.b. 2. Preparer's Full Name Preparer's Family Name (Last Name) K Flr. Preparer's Given Name (First Name) 3.e. ZIP C
III Page 1 of 7 EFTA01699786 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. 5.b. Street Number and Name 5.e. Apt. K Ste. K Flr. 5.d. City or Town 5.e. State Naze) uor- 5.f. ZIP Code I 00105 6. Is your current mailing address the same as your physical address?
s O No (If yes, please attach completed U.S. Citizenship and immigration Services FORM 1-765; Application for Employment Authorization, and 1-102, Application for Replacement/Initial Nonimmigrant Arrival/Departure Document) Note: Information contained in question # 7-is not required for a victim to receive Continued Prese
31228 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. In Care Of Name (if any) 5.b. Street Number and Name 5.c. Apt. K Ste. 5.d. City or Town 5.e. State ■ 51 ZIP Code 6. Is your current mailing address the same as your h sical address? NOTE: If you answered "No" to
s O No al yes, please attach completed U.S. Citizenship and Immigration Services Forms I-765, Application for Employment Authorization, and I-102, Application for Replacement/Initial Nonimmigrant Arrival/Departure Document.) Note: Information contained in question #7 is not required fora victim to receive Continued Presen
84013 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. In Care Of Name (if any) 5.b. Street Number and Name 5.c. Apt. K Ste. 5.d. City or Town 5.e. State ■ 51 ZIP Code 6. Is your current mailing address the same as your h sical address? NOTE: If you answered "No" to
ID No (If yes, please attach completed U.S. Citizenship and Immigration Services Forms 1-765, Application for Employment Authorization, and 1-102. Application for Replacement/Initial Nonimmigrant ArriveDeparture Document.) Note; Information contained in question #7 is not required for a victim to receive Continued Presenc
Entities connected to both K Ste and Application for Replacement

Homeland Security
ORGANIZATIONFBI
ORGANIZATIONMonitoring Group
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONPort of Entry
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONContact Information, Certification
ORGANIZATION
Jeffrey Epstein
PERSONNational Crime Information Center
ORGANIZATIONMonitoring Case
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONAlbany
LOCATION
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
ORGANIZATIONPreparer
ORGANIZATION