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PEOUS NO SCARS AND BERES LEAVE BLANK REF LZIT rocinFINCERIVAAEN EINIAATECOvrAy R Tit*. MOTT FODA CNCEffitt TAKEN SAAA.TAASOutte EFTA01699750 FEDERAL BUREAU OF INVESTIGATION UNITED STATES DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SERVICES DIVISION, CLARKSBURG, WV 26306 PERSONAL IDENTIFICATION To obtain classifi
ature Interpreter's Mailing Address 3.a. Street and Name 3.b. K Apt. 3.c. City or 3.d. State 3.f. Province 3.g. Postal 3.h. Country Number K Ste. Town Preparer's 1.a. 1.b. 2. Preparer's Full Name Preparer's Family Name (Last Name) K Flr. Preparer's Given Name (First Name) 3.e. ZIP C
III Page 1 of 7 EFTA01699786 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. 5.b. Street Number and Name 5.e. Apt. K Ste. K Flr. 5.d. City or Town 5.e. State Naze) uor- 5.f. ZIP Code I 00105 6. Is your current mailing address the same as your physical address?
rst Nam 3.c. Middle Na 4. Date of Birth (nun/dd/yyyy) 5. Gender O Male Ela Female Part 2. Agency Information 1. Name of Certifying Agency Federal Bureau of Investigations Name of Certifying Official 2.a. Family Name (Last Name) 2.b. Given Name (First Name) 2.c. Middle Name 3. Title and Division/Office of Certif
Head of Certifying Agency 4.a. Family Name (Last Name) 4.b. Given Name (First Name) 4.c. Middle Name 5.a. Street Number and Name 5.b. K Apt. K Ste. K FIr. 5.c. City or Town 5.d. State 5.f. Province 5.g. Postal Code 5.h. Country 4.f. ZIP Code Other Agency Information 6. Agency Type O
the Lead Case Agent): (First, Last) Supplemental Information: 2. Daytime telephone number 3. Fax number (include area code) Requesting Agency: Federal Bureau of Investigation Ext. Group Supervisor's name (First, Last) Daytime telephone number (including area co ct. Fax number Victim-Witness Specialist's/Coordinators name (
31228 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. In Care Of Name (if any) 5.b. Street Number and Name 5.c. Apt. K Ste. 5.d. City or Town 5.e. State ■ 51 ZIP Code 6. Is your current mailing address the same as your h sical address? NOTE: If you answered "No" to
the Lead Case Agent): (First, Last) Supplemental Information: 2. Daytime telephone number 3. Fax number (include area code) Requesting Agency: Federal Bureau of Investigation Ext. Group Supervisor's name (First, Last) Daytime telephone number (including area Co Fax number Victim-Witness Specialist's/Coordinators name (First
84013 Part 2. Information About You (continued) Your U.S. Mailing Address 5.a. In Care Of Name (if any) 5.b. Street Number and Name 5.c. Apt. K Ste. 5.d. City or Town 5.e. State ■ 51 ZIP Code 6. Is your current mailing address the same as your h sical address? NOTE: If you answered "No" to
Entities connected to both FBI and K Ste

Jeffrey Epstein
PERSON
United States
LOCATION
Homeland Security
ORGANIZATION
Woody Allen
PERSON
Department of Homeland Security
ORGANIZATIONAlbany
LOCATION
Mao Zedong
PERSONNew York Field Office
LOCATIONU.S. Citizenship and Immigration Services
ORGANIZATIONHomeland Security Investigations
ORGANIZATION
Birth
PERSONCurren
PERSONFederal, State
ORGANIZATIONthe NYS Division of Criminal Justice Services
ORGANIZATIONthe Social Security Administration
ORGANIZATIONthe United
LOCATIONNew York State Division of Criminal Justice Services
ORGANIZATION
Michael C.Green
PERSONNational Crime Information Center
ORGANIZATIONFederal Bureau of Investigation - New York
ORGANIZATION