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TION DATE: 12-31.2016 Please Print Legibly Using Black Ink Only LSTiMATED BURDEN: 40 MIN Attention: Re
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
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ION DATE: 12-31.20113 Please Print Legibly Using Black Ink Only [STRIATED BURDEN: al) MIN Please El U
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
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ATION DATE: 1241.2016 Please Print Legibly Using Black Ink Only [STRIATED BURDEN:40 MIN Attention: Rea
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
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ATION DATE: 12-31.20M Please Print Legibly Using Black Ink Only ESTIMATED BURDEN:40 MIN Attention: Rea
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
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ISCELLANEOUS SERVICES Please Print Legibly Using Black Ink Only CMS APPROVAL NO. 1405-0159 EXPIRATION
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check, it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
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TION OATE: 3 41-201° Please Print Legibly Using Black Ink Only ESTIMATED BURDEN: 40 MIN Attention: P
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be converted into an electronic funds transfer (EFT). This means we will copy your check and use the account inform
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DON DATE: I2-3I -20I6 Please Print Legibly Using Black Ink Only [STRIATED BURDEN: 40 MIN Attention: Re
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
2 mentions1 same-page
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ATION DATE: 1241.2016 Please Print Legibly Using Black Ink Only ESTIMATED BURDEN:40 MIN Attention: Rea
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
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TION DATE: 12.31.2016 Please Print Legibly Using Black Ink Only [STARTED BURDEN:40 MIN Attention: Read
$500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS office. NOTICE TO CUSTOMERS APPLYING OUTSIDE A STATE DEPARTMENT FACILITY If you send us a check. it will be convened into an electronic funds transfer (EFT). This means we will copy your check and use the account informa
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Mutual Connections (45)
Entities connected to both Leon Black and STATE DEPARTMENT FACILITY
Jeffrey Epstein
PERSON10,461 w/ Leon·9 w/ STATE
DI
Darren Indyke
PERSON1,339 w/ Leon·7 w/ STATE
United States
LOCATION927 w/ Leon·2 w/ STATE
George W. Bush
PERSON901 w/ Leon·2 w/ STATE
JD
Jane Doe
PERSON529 w/ Leon·9 w/ STATE
Philadelphia
LOCATION227 w/ Leon·9 w/ STATE
the Internal Revenue Service
ORGANIZATION83 w/ Leon·7 w/ STATE
Department of Homeland Security
ORGANIZATION77 w/ Leon·2 w/ STATE
Federal Reserve
ORGANIZATION46 w/ Leon·2 w/ STATE
Birth
PERSON22 w/ Leon·9 w/ STATE
BERMUDA
ORGANIZATION13 w/ Leon·8 w/ STATE
U.S. PASSPORT RENEWAL APPLICATION
ORGANIZATION12 w/ Leon·8 w/ STATE
U.S. Embassy
ORGANIZATION12 w/ Leon·7 w/ STATE
Overseas Citizen Services Records
ORGANIZATION9 w/ Leon·9 w/ STATE
National Passport Processing Center
ORGANIZATION9 w/ Leon·9 w/ STATE
the Federal Claims Collection Standards
ORGANIZATION9 w/ Leon·9 w/ STATE
Passport Records
ORGANIZATION9 w/ Leon·9 w/ STATE
A U.S. PASSPORT ISSUED
ORGANIZATION8 w/ Leon·8 w/ STATE
THE U.S. PASSPORT CARD
ORGANIZATION8 w/ Leon·8 w/ STATE
THE TRADITIONAL PASSPORT BOOK
ORGANIZATION8 w/ Leon·8 w/ STATE