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levant reports and findings. Include relevant dates, etc. Attach additional sheets, if necessary. Applicant was recruited, harbored, and obtained by Jeffrey Epstein and others for purposes of a coercive sexual relationship. On numerous occasions, Jeffrey Epstein coerced, threatened, and forced Applicant into su
of him committing sex acts with or unto her. Applicant shared pictures of injuries she sustained as a result of physical abuse/encounters with Mr. Epstein. 3. Has the applicant expressed any fear of retaliation or revenge if removed from the United States? If yes, explain. Attach additional sheets, i
pplicant was recruited, harbored, and obtained by Jeffrey Epstein and others for purposes of a coercive se
ned as a result of physical abuse/encounters with Mr. Epstein. 3. Has the applicant expressed any fear of ret
3. Date of Binh (dd/mm/yyyy) 4. Gender or Sex 02/21/1985 K Male Female K Other 5. Alien Registration lo• A- Number (A-Number) (if any) 6. U.S. Social Security Number (SSN) (if any) Part 2. Agency Information I. 2. 3. 4. 5. 6. Name of Certifying Agency Federal Bureau of Investigations Name of Cenif
levant reports and findings. Include relevant dates, etc. Attach additional sheets, if necessary. Applicant was recruited, harbored, and obtained by Jeffrey Epstein and others for purposes of sexual slavery. On numerous occasions, Jeffrey Epstein coerced, threatened, and forced Applicant into submission for pur
ubmission for purposes of him committing sex acts with or unto her. Applicant shared pictures of injuries she sustained as a result of sex acts Mr. Epstein's subjected her to. 3. Has the applicant expressed any fear of retaliation or revenge if removed from the United States? If yes, explain. Attach a
pplicant was recruited, harbored, and obtained by Jeffrey Epstein and others for purposes of sexual slaver
f injuries she sustained as a result of sex acts Mr. Epstein's subjected her to. 3. Has the applicant expres
ddle Name (if any) Date of Birth (ddirrun/yyyy) 4. Gender or Sex El Male El Female El Other Alien Registration Number (A-Number) (if any) P. A- U.S. Social Security Number (SSN) (if any) .r Part 2. Agency Information 1. Name of Certifying Agency Federal Bureau of Investigations 2. Name of Certifying Offici
22 RE: : Continuous physical presence in the United States for criminal investigation Dear USCIS: cooperated in a federal investigation regarding Jeffrey Epstein and Ghislaine Maxwell. In or about February of 2021, counsel, Erica Dubno, informed our office of intent to depart briefly from the United States
of him committing sex acts with or unto her. Applicant shared pictures of injuries she sustained as a result of physical abuse/encounters with Mr. Epstein. 3. las the applicant expressed any fear of retaliation or revenge if removed from the United States? If yes, explain. Attach additional sheets, i
cooperated in a federal investigation regarding Jeffrey Epstein and Ghislaine Maxwell. In or about Febru
ned as a result of physical abuse/encounters with Mr. Epstein. 3. las the applicant expressed any fear of ret
me (if any) 3. 5. 6. Date of Birth (dd/mm/yyyy) 4. Gender or Sex K Male ❑X Female K Other Alien Registration Number (A-Number) (if any) ► A- U.S. Social Security Number (SSN) (if any) Part 2. Agency Information I. Name of Certifying Agency Federal Bureau of Investigations 2. Namc of Certifying Official
SE ONLY / LAW ENFORCEMENT SENSITIVE ICE Form 73-031 (4111) Page 4 of 4 EFTA00173135 FOR OFFICIAL USE ONLY/ LAW ENFORCEMENT SENSITIVE PART D: 1 Jeffrey Epstein abused over several years, beginning when she was 18 years old. It was during the course of this abuse that Epstein brought into some of his massa
T SENSITIVE PART D: 1 Jeffrey Epstein abused over several years, beginning when she was 18 years old. It was during the course of this abuse that Epstein brought into some of his massages to participate in sex acts with other girls. Epstein controlled every aspect of life—including her physical app
L USE ONLY/ LAW ENFORCEMENT SENSITIVE PART D: 1 Jeffrey Epstein abused over several years, beginning whe
(mrn/dcl/yyyy) ► Count of Birth 4.a. In Care Of Name 9. Country of Citizenship 4.b. Street Number and Name SLovit-11\- 4.c. Apt. 2 Ste. 10. U.S. Social Security Number (if an ) K Flr. 0 4.d. City or Town NEW t i ORIC Entry Information 4.e. State 4.f. ZIP Code 100toS 11. Date of Last Entry into the U
USE ONLY / LAW ENFORCEMENT SENSITIVE ICE Form 73-031 (4111) Page 4 of 4 EFTA00173745 FOR OFFICIAL USE ONLY/ LAW ENFORCEMENT SENSITIVE PART D:1 Jeffrey Epstein abused over several years, beginning when she was 18 years old. It was during the course of this abuse that Epstein brought into some of his massa
NT SENSITIVE PART D:1 Jeffrey Epstein abused over several years, beginning when she was 18 years old. It was during the course of this abuse that Epstein brought into some of his massages to participate in sex acts with other girls. Epstein controlled every aspect of s life—including her physical a
AL USE ONLY/ LAW ENFORCEMENT SENSITIVE PART D:1 Jeffrey Epstein abused over several years, beginning whe
d. City or Town 6.e. State 0 6.f. ZIP Code Other Information 7. Date of Birth (mm/dd/yyyy) ► 8. Count of Birth 9. Count of 'fizen hi 10. U.S. Social Security Number if an City or Town NEAN otkg Entry Information State NY 4.1. ZIP Code 11. Date of Last Entry into the United States Is your current U
USE ONLY / LAW ENFORCEMENT SENSITIVE ICE Form 73-031 (4/11) Page 4 of 4 EFTA01699761 FOR OFFICIAL USE ONLY/ LAW ENFORCEMENT SENSITIVE PART D:1 Jeffrey Epstein abused over several years, beginning when she was 18 years old. It was during the course of this abuse that Epstein brought into some of his massa
NT SENSITIVE PART D:1 Jeffrey Epstein abused over several years, beginning when she was 18 years old. It was during the course of this abuse that Epstein brought into some of his massages to participate in sex acts with other girls. Epstein controlled every aspect of -s life—including her physical
AL USE ONLY/ LAW ENFORCEMENT SENSITIVE PART D:1 Jeffrey Epstein abused over several years, beginning whe
Town 6.e. State O Flr. O 6.1. ZIP Code Other Information 7. Date of Birth (nmildcliyyyy) 10. 8. un of Birth 9. Coun of Citizenshi 10. U.S. Social Security Number if an Entry Information 11. Date of Last Entry into the United States (mni/dellyyyy) ► oi/a/e301° 12. Place of Last Entry into the Unite
Entities connected to both Jeffrey Epstein and U.S. Social Security
Leon Black
PERSON
Ghislaine Maxwell
PERSON
Joi Ito
PERSON
United States
LOCATION
FedEx
ORGANIZATION
Department of Justice
ORGANIZATIONFBI
ORGANIZATIONNew York Field Office
LOCATION
Maine
LOCATIONAlbany
LOCATION
Homeland Security
ORGANIZATION
Slovakia
LOCATION
Department of Homeland Security
ORGANIZATION
Birth
PERSONU.S. Citizenship and Immigration Services
ORGANIZATIONHomeland Security Investigations
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONFederal, State
ORGANIZATIONthe Social Security Administration
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATION