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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
SECURITY U.S. Immigration and Customs Enforcement REQUEST FOR CONTINUED PRESENCE Part A.Informatlon on the; Vktlm;.` 1. Name: (Last) 2. Date of Birth (mo., day, yr) 5. Alias(es) 8. Passport Number 11. Social Security Number (First) 3. Country of Birth 6. Gender (check one) Male Female (Middle)
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
Y U.S. Immigration and Customs Enforcement REQUEST FOR CONTINUED PRESENCE 'POPfliffoYminifion'ronttO\Vatitt 1. Name: (Last) (First) 2. Date of Birth (mo., day, yr) 3. Country of Birth 5. Alias(es) 8. Passport Number 11. Social Security Number (Middle) 4. Country of Citizenship 6. Gender (check o
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
OF HOMELAND SECURITY U.S. Immigration and Customs Enforcement REQUEST FOR CONTINUED PRESENCE Part A: Victkn 1. Name: (Last) (First) 2. Date of Birth (mo., day, yr.) 3. Country of Birth 02/21/1985 5. Alias(es) 8. Passport Number 11. Social Security Number (Middle) 4. Country of Citizenship 6. Ge
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
ms Enforcement REQUEST FOR CONTINUED PRESENCE 1bartA: InforatatiOnon'theitiopm. N.3:7 -.72.44t''> ;a14cir iCPIAC:' 1. Name: (Last) 2. Date of Birth (mo., day, yr.) 6. Allas(es) 8. Passport Number 11. Social Security Number (First) 3. Country of Birth 6. Gender (check one) Male J Female (Midd
Entities connected to both Contact Information, Certification and Birth (mo.

Jeffrey Epstein
PERSON
Homeland Security
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
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONNational Crime Information Center
ORGANIZATIONParole and Law Enforcement Programs Unit
ORGANIZATIONRequesting Law Enforcement Agency
ORGANIZATIONMonitoring Group
ORGANIZATIONMonitoring Case
ORGANIZATIONHomeland Security Investigations
ORGANIZATIONU.S. Citizenship and Immigration Services
ORGANIZATIONBoard of Immigration Appeals
ORGANIZATION