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. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other information on this form is voluntary, but failure
R ISSUING OFFICE ONLY O PPT BK CORO PPT BK SM O PPT CD CM O PPT CD Sal 0 Marriage Certificate Date of MarriagelPlace Issued: o Court Order Date Filedtoun: From To' O Other 0 Attached: 1111111 11111 Date !)111 SS' gft 111 11 For Issuing Office Only —0 , Bk Fee _ Cd Fee EF Postage
. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other information on this form is voluntary, but failure
UING OFFICE ONLY El PPT BK CM 0 PPT BK SM 0 PPT CD C/R 0 PPT CD Sal O Marriage Certificate Date of MarriagelPlace Issued: o Court Order Date Filedtoun: From To: El Other: O Attached: 1111111 11111 Dale 111III 111{111,111 111 11 For Issuing Office Only —0 , Bk Fee Cd Fee. EF Po
. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other information on this form is voluntary, but failure
ING OFFICE ONLY EI PPT BK CM 0 PPT BK SIR 0 PPT CD C/R O PPT CD SIR O Marriage Certificate Date of Marriage+Place Issued: O Court Order Date Filedtoun: From To' 0 Other. K Attached: For Issuing Office Only —0 , Bk Fee Cd Fee. EF Postage Other 1111111 11111 Date DS-82 08-2013
. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other information on this form is voluntary, but failure
ISSUING OFFICE ONLY K PPT BK CM 0 PPT BK SIR K PPT CD C/R O PPT CD SfR O Marriage CerMicate Date of MarriagelPiace Issued: O Court Order Date Filedtoun: From To: O Other O Attached: 1111111 11111 Date IIUIIII~IIIHI 111I111 111 11 For Issuing Office Only —0 , Bk Fee Cd Fee. EF Pos
. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other information on this form is voluntary, but failure
ISSUING OFFICE ONLY 0 PPT BK CM 0 PP7 BK SAR K PP7 CD C/R O PP7 CD SIR O Marriage Certificate Date of MerriagelPiece Issued: ID Court Order Date Filedtoun: From To' 0 Other K Attached: 1111111 11111 Date 111,111 DSS2 3(s_ 111 11 For Issuing Office Only Bk Fee _ Cd Fee EF Postage O
. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other information on this form is voluntary, but failure
SUING OFFICE ONLY K PPT BK CORO PPT BK SIR K PPT CD C/R 0 PPT CD SfR O Marriage Certificate Date of MarriagelPiace Issued: O Court Order Date Filedtoun: From To' 0 Other. K Attached: 1111111 11 1 11 Date 111101111111111 1111111 111 11 For Issuing Office Only —to 8k Fee_ Cd Fee. E
. citizens and non•citizen nationals abroad. More information on the Routine Uses for the system can be found in System of Records Notices State•05. Overseas Citizen Services Records and State-26. Passport Records. DISCLOSURE: Providing your Social Security number and the other information on this form is voluntary, but failure
UING OFFICE ONLY El PPT BK CORO PPT BK SIR 0 PPT CD C/R 0 PPT CD SfR O Marriage Certificate Date of MarriagelPiace Issued: O Cowl Order Date Filedtoun: From Toe 0 Other O Attached: 1111111 11111 Date 111101111111111 1111111 111 11 For Issuing Office Only —le Bk Fee Cd Fee EF Po
Entities connected to both Overseas Citizen Services Records and Filedtoun
Leon Black
PERSON
Jeffrey Epstein
PERSON
Philadelphia
LOCATIONPassport Records
ORGANIZATIONthe Federal Claims Collection Standards
ORGANIZATIONSTATE DEPARTMENT FACILITY
ORGANIZATIONJane Doe
PERSON
Birth
PERSONNational Passport Processing Center
ORGANIZATIONTHE TRADITIONAL PASSPORT BOOK
ORGANIZATIONU.S. PASSPORT RENEWAL APPLICATION
ORGANIZATION
BERMUDA
ORGANIZATIONA U.S. PASSPORT ISSUED
ORGANIZATIONTHE U.S. PASSPORT CARD
ORGANIZATIONINTERNATIONAL AIR TRAVEL
ORGANIZATIONOffice of Program Management and Operational Support
ORGANIZATIONU.S. Embassy
ORGANIZATION
the Internal Revenue Service
ORGANIZATIONSystem of Records
ORGANIZATIONDarren Indyke
PERSON