Epstein Secrets

high schools 1. Name Address and phone number COOPER UNION 51 ASTOR PLACE NYC, 2123534195 Course of

for your trip to and stay In Russia? Independently 17. Marital status married single (never married) X divorced separated widowed i 18. Spouse's full name fl imsier separated. please nikale maiden name if applicable) 19. Spouse's date of birth (darnmlyy) 20. Spouse's place of birth "21.

gle (never married) X divorced separated widowed i 18. Spouse's full name fl imsier separated. please nikale maiden name if applicable) 19. Spouse's date of birth (darnmlyy) 20. Spouse's place of birth "21. Your father's full name SEYMOUR EPSTEIN "22. Your mothers full name PAULA EPSTEIN

schools _ T. Name edthess and phone number COOPER UNION 51 ASTOR PLACE NYC Cone or NWT PHYSICS Da

al status mailed O single (never monied) 0 din:ward EFseparsted n „mind 10. Spouse's fun name (resserlerreprons peasenseisadawieseinelicare) 19. Spouse's date of birth (arunvy) no s 20. Spouse's place of birth 7 -212y regs gi —21. Your lather's ha name PAULA EPSTEIN SEYMOUR EPSTEIN . I 23. Hove

0. Who will pay for your trip to and stay In Russia? SELF 17. MarItal status mailed O single (never monied) 0 din:ward EFseparsted n „mind 10. Spouse's fun name (resserlerreprons peasenseisadawieseinelicare) 19. Spouse's date of birth (arunvy) no s 20. Spouse's place of birth 7 -212y regs gi —21

high schools 1. Name Address and phone number COOPER UNION 51 ASTOR PLACE NYC, 2123534195 Course of

ver married) X divorced separated widowed , 18. Spouse's full name (il dinorced or separated. please iidioste maiden name if applicable) 19. Spouse's date of bIrth (ddimmyy) 20. Spouse's place of bInh "21. Your father's full name SEYMOUR EPSTEIN n22. Your mother's full name PAULA EPSTEIN 2

y for your trip to and stay In Russia? Independently 17. Marital status married single (never married) X divorced separated widowed , 18. Spouse's full name (il dinorced or separated. please iidioste maiden name if applicable) 19. Spouse's date of bIrth (ddimmyy) 20. Spouse's place of bInh

pt high =hoes Name Addles* and phone number COOPER UNION 51 ASTOR PLACE NYC 212-353-4195 Cann' stu

married O simple (never married) [:l aborted Enseparated n widowed O. ie. Sousa fun name (nerarotoir sersaled euseistassailassamespet era) I,9. Spouse's date of birth birth 20.Spouays place of SEYMOUR EPSTEIN ,PAYarrg5stu-Pgill ...„„,„ ^21. Your lather's full awns 23. Have you ever bee

high schools 1. Name Address and phone number COOPER UNION 51 ASTOR PLACE NYC Course of study PHYSIC

or your trip to and stay In Russia? Independently 17. Marital status married J single (never married) X divorced separated I widowed J 18. Spouse's full name Winced a separatat pleasSeale resift remellamictu) N A 119. Spouse's date of birth (0,..w) NA 20. Spouse's place of birth 1 A. "21.

Fl on December 30th, 1986. I eventually moved to Cooper City, FI, 30 miles north of Ft. Lauderdale. In n

reason detailed in the Comments below. Military Status: ( ) Yes or ( ) No tf yes, what branch? Marital Status: ( ) Married or ( ) Single Name of Spouse COMMENTS: Age Sex M F Race Height Weight Hair Glasses Y N I certify that I have no interest in the above action, am of legal age and ha