Epstein Secrets

ined in any jail, prison or penal institution? ______ _ If so, complete the following: Type of Institution Location Dates of Confinement (State, Federal, Municipal County) Page 5 of 10 Revised 2/01/08 8. Have you ever been charged with a criminal offense? If yes, please briefly summarize circumstances and legal d

cant's Signature lOa. Date PRIVACY ACT NOTICE Authori ty for Co lle cting I nformation: E . O. 10450; 5 USC 1303-1305; 42 USC 2 1 65 and 2455; 22 USC 2585 and 2519; and 5 USC 3301 Purposes and Uses : Information provided on this form will be furnished to individuals in order to obtain information rega

4C 7. Have you ever been confined in any jail, prison or penal institution? If so, complete the following: Type of Institution J acation (State, Federal, Municipal County) A/or ri Pa to 2.O Ak) Pates of Confinement Page 5 of 10 Raised 241/08 EFTA00043252 8. Have you ever been charged with a criminal offense? I

Signature %ty4le 10a. Date /afrb PRIVACY ACT NOTICE Authority for Collecting Information: E.O. 10450: 5 CSC :303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 USC 3301 purposes end Uses: Information provided on this form will be furnished to individuals in order to obtain information regar

7. Have you ever been confined in any jail, prison or penal institution? BO If so, complete the following: Type of Institution J acation (State, Federal, Municipal County) Peoi. to 2.O Pates of Confinement Page 5 of 10 Raised 241/08 EFTA00057519 8. Have you ever been charged with a criminal offense? If yes, ple

ty4le (979,yi,;\ 10a. Date /afril PRIVACY ACT NOTICE Authority for Collecting Information: E.O. 10450; 5 CSC :303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 SSC 3301 purposes end Uses: Information provided on this form will be furnished to individuals in order to obtain information regar

4C 7. Have you ever been confined in any jail, prison or penal institution? If so, complete the following: Type of Institution J acation (State, Federal, Municipal County) A/or riParo42.0 Ak) Pates of Confinement Page 5 of 10 Raised 2101/08 EFTA00058127 8. Have you ever been charged with a criminal offense? If

t. Applicant's Signature lOa. Date PRIVACY ACT NOTICE Authority for Collecting Information: E.O. 10450; 5 CSC :303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 USC 3301 purposes end Uses: Information provided on this form will be furnished to individuals in order to obtain information regar

URT 7. Have you ever been confined in any jail, prison or penal institution? If so, complete the following: Type of Institution Location (State, Federal, Municipal County) Dates of Confinement Page 5 of 10 Revised 2/01/08 SDNY_00015496 EFTA00138428 8. Have you ever been charged with a criminal offense? If yes, p

Applicant's Signature 1 C;i1 . Date PRIVACY ACT NOTICE Authority for Collecting Information: E.O. 10450; 5 USC 1303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 USC 3301 Purposes and dans; Information provided on this form will be furnished to individuals in order to obtain information regar