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. Amount 01 02 03 04 05 06 07 9. Total $ 10. Justification: Asset/Informant File No. Symbol No. PaymenVCode Name Period Covered to One Time Non-symbol Source Payment: True Name: DOB- / / SSAN: Date of Waiver: / i 11 Payment for reimbursable expense - forfeiture or drug related? Yes
e of the F13IFIQ procurement officer and telephonic authorization number (T- number), if appropriate. All advances and expenses must be approved by the Draft Approval Officer, who will complete the following parts of this form. APPROVAL OFFICER: 15 - Vendor Number and Vendor Group Number 16 - Classify the expense using
. Amount • 01 02 04 05 06 07 9. Total $ 10. Justification: Asset/Informant File No. Symbol No. Payment/Code Name Period Covered to One Time Non-symbol Source Payment: True Name: DOB: / / SSAN: Date of Waiver: / / 11. Payment for reimbursable expense - forfeiture or drug related? Yes
ame of the FBIHQ procurement officer and telephonic authorization number (T- number), if appropriate. All advances and expenses must be approved by the Draft Approval Officer, who will complete the following parts of this form: APPROVAL OFFICER: 15 - Vendor Number and Vendor Group Number. 16 - Classify the expense using
on' i t t l le kii vitt I l( % (11(1? lire. el I I I lee teli.k Asset/Informant File No. Symbol No. Payment/Code Name Period Covered to One Time Non-symbol Source Payment: True Name: b08: / Date of Waiver • :. _t_/ .. . . 11. Payment for r • &Lig related? _Yes 12. Requested by 13. Tele
me of the FBI 4Q procurement officer and telephonic authorization number (T- number), if appropriate. All advances and expenses must be approved by the Draft Approval Officer, who will complete the following parts of this form: APPROVAL OFFICER: IS - Vendor Number and Vendor Group Number. 16 - Classify the expense using
8. Amount 01 02 03 04 05 06 07 9. Total $ 10. Justification: Asset/Informant Ale No. Symbol No. Payment/Code Name Period Covered One Time Non-symbol Source Payment: True Name: DOB: / / SSAN: Date of Waiver: / / to 11. Payment for reimbursable expense - forfeiture or drug related?
ame of the FBIHQ procurement officer and telephonic authorization number (T- number), if appropriate. All advances and expenses must be approved by the Draft Approval Officer, who will complete the following parts of this form: APPROVAL OFFICER: 15 - Vendor Number and Vendor Group Number. 16 - Classify the expense using
,... • • r .., --•• • • , ••••V .14 9. Total $ 10. Justification: Assetanformant File No. Symbol No. Payment/Code Name Period Covered to One Time Non-symbol Source Payment: True Name: DOB: / / SSAN: _.. --- Date of Waiver: / / 11. Payment for reimbursable expense - forfeiture or drug rela
ame of the PRIMO procurement officer and telephonic authorization number (T- number), if appropriate. All advances and expenses must be approved by the Draft Approval Officer, who will complete the following parts of this form: APPROVAL OFFICER: 15 - Vendor Number and Vendor Group Number. 16 - Classify the expense using
Entities connected to both Time Non and the Draft Approval Officer

Jeffrey Epstein
PERSONField Office Use Only
ORGANIZATION
Ghislaine Maxwell
PERSONSupply Technician
ORGANIZATIONConfidential Services Unit
ORGANIZATION
Virginia Giuffre
PERSON
West Palm Beach
LOCATIONFBI
ORGANIZATIONDraft Office Declassify
ORGANIZATION
New York
LOCATIONJack Goldberger
PERSON
Santa Fe
LOCATION
Palm Beach
LOCATION
North Carolina
LOCATION
Wellington
LOCATIONLoxahatchee
LOCATION
John Connolly
PERSON
Andy Warhol
PERSON
Lake Worth
LOCATION
Starbucks
ORGANIZATION