Epstein Secrets

TION DATE: 12-31.2016 Please Print Legibly Using Black Ink Only LSTiMATED BURDEN: 40 MIN Attention: Re

t fee charge to your credit card. the U.S. Department of State will take action to collect the delinquent fees from you under 22 C.F.R. Part 34. and the Federal Claims Collection Standards (see 31 C.F.R. Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104-134), if the fees remain unpaid after 180 days and

ION DATE: 12-31.20113 Please Print Legibly Using Black Ink Only [STRIATED BURDEN: al) MIN Please El U

t fee charge to your credit card. the U.S. Department of State will take action to collect the delinquent fees from you under 22 C.F.R. Part 34. and the Federal Claims Collection Standards (see 31 C.F.R. Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104-134), if the fees remain unpaid after 180 days and

ATION DATE: 1241.2016 Please Print Legibly Using Black Ink Only [STRIATED BURDEN:40 MIN Attention: Rea

t fee charge to your credit card. the U.S. Department of State will take action to collect the delinquent fees from you under 22 C.F.R. Part 34. and the Federal Claims Collection Standards (see 31 C.F.R. Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104-134), if the fees remain unpaid after 180 days and

ATION DATE: 12-31.20M Please Print Legibly Using Black Ink Only ESTIMATED BURDEN:40 MIN Attention: Rea

t fee charge to your credit card. the U.S. Department of State will take action to collect the delinquent fees from you under 22 C.F.R. Part 34. and the Federal Claims Collection Standards (see 31 C.F.R. Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104-134), if the fees remain unpaid after 180 days and

ISCELLANEOUS SERVICES Please Print Legibly Using Black Ink Only CMS APPROVAL NO. 1405-0159 EXPIRATION

a passport fee charge to you credit card. the Department of State will take action to collect the delinquent fees from you under 22 CFR Part 34 and the Federal Claims Collection Standards (see 31 CFR Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104.134). if the fees remain unpaid after 180 days and no

TION OATE: 3 41-201° Please Print Legibly Using Black Ink Only ESTIMATED BURDEN: 40 MIN Attention: P

a passport fee charge to your credit card. the Department of State will take action to collect the delinquent fees from you under 22 CFR Part 34 and the Federal Claims Collection Standards (see 31 CFR Parts 900-904). In accordance with the Debt Collection Improvement Act (Pub.L. 104.134). if the fees remain unpaid after 180 days and no

DON DATE: I2-3I -20I6 Please Print Legibly Using Black Ink Only [STRIATED BURDEN: 40 MIN Attention: Re

t fee charge to your credit card. the U.S. Department of State will take action to collect the delinquent fees from you under 22 C.F.R. Part 34. and the Federal Claims Collection Standards (see 31 C.F.R. Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104-134), if the fees remain unpaid after 180 days and

ATION DATE: 1241.2016 Please Print Legibly Using Black Ink Only ESTIMATED BURDEN:40 MIN Attention: Rea

t fee charge to your credit card. the U.S. Department of State will take action to collect the delinquent fees from you under 22 C.F.R. Part 34. and the Federal Claims Collection Standards (see 31 C.F.R. Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104-134), if the fees remain unpaid after 180 days and

TION DATE: 12.31.2016 Please Print Legibly Using Black Ink Only [STARTED BURDEN:40 MIN Attention: Read

t fee charge to your credit card. the U.S. Department of State will take action to collect the delinquent fees from you under 22 C.F.R. Part 34. and the Federal Claims Collection Standards (see 31 C.F.R. Parts 900.904). In accordance with the Debt Collection Improvement Act (Pub.L. 104-134), if the fees remain unpaid after 180 days and