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0. !he above listed information is true l Oa. Oa1.e and correct. Applicant's Signatl!re rb)(6) (b)(7)(C) I b)(6); (b)(7)(C) PRIVACY AC~ NO~ICB Authority for Collecting Information: E.O . 10450; 5 USC 1303-1305; 42 USC 2165 and 2~55; 22 USC 2585 and 2519; a nd 5 USC 3301 Pvrpo99f and Oaes : Ir.!ormation provided on this form w
(6) (b)(7)(C) I b)(6); (b)(7)(C) PRIVACY AC~ NO~ICB Authority for Collecting Information: E.O . 10450; 5 USC 1303-1305; 42 USC 2165 and 2~55; 22 USC 2585 and 2519; a nd 5 USC 3301 Pvrpo99f and Oaes : Ir.!ormation provided on this form wil~ be furnished to individuals in order to obtain information re
Uzi) • if outside the 10. The above listed information is true and correct. Applicant's 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
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
outside the 10. The above listed information is true and correct. Applicant's Signature %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
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
d country if outside the U.S.A) WM • 10. The above listed information is true and correct. 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
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
y and country if outside the U.S.A) 10. The above listed information is true and correct. 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
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
Entities connected to both Authority for Collecting Information and USC 2585

Jeffrey Epstein
PERSON
United States
LOCATIONFederal, Municipal County
ORGANIZATIONFederal Bureau of Prisons
ORGANIZATIONPark Row
LOCATIONNational Crime Information Center
ORGANIZATION
Metropolitan Correctional Center
ORGANIZATIONInmate Legal Activities
ORGANIZATIONthe Mitigation Specialist/ Doctors
ORGANIZATION
Sarah Kellen
PERSONMorse
PERSONthe State of New York
LOCATIONO'Brien
PERSONthe Legal Department
ORGANIZATIONSarah M. Sacks
PERSONNEW YORK STATE DEPARTMENT OF STATE
ORGANIZATIONSociety National Office
ORGANIZATIONMotel Nittalijey
ORGANIZATIONBennett M. Epstein
PERSONfarvey E.
PERSON