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a monitoring agent must be designated in the appropriate jurisdiction. (Monitoring Group Supervisor's Signature) (Print Name and Title) (Date) (Monitoring Case Agent's Signature) (Date) (Print Name and Title) Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE ICE Form 73-03
ant's Contact Information 4. Applicant's Daytime Telephone Number 5. Applicant's Mobile Telephone Number 6. Applicant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the following information concerning the interpreter: l.a. Interpreter's Family
itoring agent must be designated in the appropriate jurisdiction. —1 I (Monitoring Group Supervisor's Signature) (Date) (Print Name and Title) (Monitoring Case Agent's Signature) (Date) (Print Name and Title) Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE ICE Form 73-03
ntact Information 4. 5. 6. A licant's Da time Tel hone Number A licant's Mobile Tele hone Number E-mail A licant's Address --/N/24o Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the following information concerning the interpreter: 1.a. Interpreter's Family
e Agent, a monitoring agent must be designated in the appropriate jurisdiction. (Monitoring Group Supervisor's Signature) (Print Name and Title) (Monitoring Case Agent's Signature) (Print Name and Title) (Date) Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE ICE Fenn 73-03
Signature (mmiddiyyyy) ► Applicant's Contact Information 4. a Number 5. A limes Mobile Tel hone Number 6. A licant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the following information concerning the interpreter: 1.a. Interpreter's Family
a monitoring agent must be designated in the appropriate jurisdiction. (Monitoring Group Supervisor's Signature) (Date) (Print Name and Title) (Monitoring Case Agent's Signature) (Print Name and Title) Request for Continued Presence FOR OFFICIAL USE ONLY / LAW ENFORCEMENT SENSITIVE ICE Font 73-031 (4/11)
Signature (mm/dd/yyyy) ► Applicant's Contact Information 4. a Number 5. A limes Mobile Tel hone Number 6. A licant's E-mail Address Part 5. Contact Information, Certification, and Signature of the Interpreter Interpreter's Full Name Provide the following information concerning the interpreter: 1.a. Interpreter's Family
a monitoring agent must be designated in the appropriate jurisdiction. (Monitoring Group Supervisor's Signature) (Date) (Print Name and Title) (Monitoring Case Agent's Signature) (Date) (PrintRame and Title) Request for Continued Presence FOR OFFICIAL USE ONLY! LAW ENFORCEMENT SENSITIVE ICE Form 73-031
tforingthit 4. Interpreter's Daytime Telephone Number 5. Interpreter's E-mail Address Fox= I-102 10/19/17 N Page 3 of 4 EFTA01699765 Part 5. Contact Information, Certification, and Signature of the Interpreter(continued) Interpreter Certification I certify that: I am fluent in English and ,which is the same language
Entities connected to both Monitoring Case and Contact Information, Certification
New York State Division of Criminal Justice Services
ORGANIZATIONFederal, State
ORGANIZATIONPreparer
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONNational Crime Information Center
ORGANIZATION
Homeland Security
ORGANIZATIONAlbany
LOCATION
Jeffrey Epstein
PERSONMonitoring Group
ORGANIZATION
Department of Homeland Security
ORGANIZATIONthe Social Security Administration
ORGANIZATIONNew York Field Office
LOCATION
Michael C.Green
PERSONthe NYS Division of Criminal Justice Services
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONFederal Bureau of Investigation - New York
ORGANIZATIONU.S. Citizenship and Immigration Services
ORGANIZATIONHomeland Security Investigations
ORGANIZATIONBoard of Immigration Appeals
ORGANIZATION