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73-031 (4/11) Page 1 of 4 EFTA01684004 Part 4:,case irifOr.Matiok, •Note: Please complete all Information below. 1. Is the Victim currently in the United State 2. The Victim's current immigration status: 3. Is the Victim requesting Continued Presence based upon a pending civil action under 18 U.S.C. § 1595
t Name) 3.b. Given Name (First Name) 3.c. Middle Name 4. Class of Admission at Last Entry into the United States E2 5. Place of Last En into the United States City and State) Form 1-102 10/19/17 N Page 2 of 4 EFTA01684010 Part 4. Statement, Certification, Signature, and Contact Information of the Applicant
ID No (If yes, please attach completed U.S. Citizenship and Immigration Services Forms 1-765, Application for Employment Authorization, and 1-102. Application for Replacement/Initial Nonimmigrant ArriveDeparture Document.) Note; Information contained in question #7 is not required for a victim to receive Continued Presenc
73-031 (4/11) Page 1 of 4 EFTA01731219 Part 4:,case irifOr.Matiok, •Note: Please complete all Information below. 1. Is the Victim currently in the United State 2. The Victim's current immigration status: 3. Is the Victim requesting Continued Presence based upon a pending civil action under 18 U.S.C. § 1595
t Name) 3.b. Given Name (First Name) 3.c. Middle Name 4. Class of Admission at Last Entry into the United States E2 5. Place of Last En into the United States City and State) Form 1-102 10/19/17 N Page 2 of 4 EFTA01731225 Part 4. Statement, Certification, Signature, and Contact Information of the Applicant
s O No al yes, please attach completed U.S. Citizenship and Immigration Services Forms I-765, Application for Employment Authorization, and I-102, Application for Replacement/Initial Nonimmigrant Arrival/Departure Document.) Note: Information contained in question #7 is not required fora victim to receive Continued Presen
ENFORCEMENT SENSITIVE ICE Form 73-031 (4/11) Page 1 of 4 EFTA01699758 *Note: Please complete all information below. 1. Is the Victim currently in.the United States? El Yes O No 2. The Victim's current immigration status: In the U.S. on an E-2 Visa 3. is the Victim requesting Continued Presence based upon a pen
s O No (If yes, please attach completed U.S. Citizenship and immigration Services FORM 1-765; Application for Employment Authorization, and 1-102, Application for Replacement/Initial Nonimmigrant Arrival/Departure Document) Note: Information contained in question # 7-is not required for a victim to receive Continued Prese
Entities connected to both United States and Application for Replacement

Jeffrey Epstein
PERSONFBI
ORGANIZATION
Woody Allen
PERSON
Mao Zedong
PERSON
Homeland Security
ORGANIZATION
Department of Homeland Security
ORGANIZATIONAlbany
LOCATIONthe Social Security Administration
ORGANIZATIONFederal, State
ORGANIZATIONNew York Field Office
LOCATIONthe United
LOCATIONCurren
PERSONU.S. Citizenship and Immigration Services
ORGANIZATIONNational Crime Information Center
ORGANIZATIONPreparer
ORGANIZATIONthe Intelligence Community
ORGANIZATIONU.S. Immigration and Customs Enforcement
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONHomeland Security Investigations
ORGANIZATIONthe NYS Division of Criminal Justice Services
ORGANIZATION