Send to: G3 Global Services Attn: Passport Department 388 Market Street. Slide ispo Pon Francisco. CA 941/1 8/.896.1203 I Sard-rancirmotr.v.Ivems coil, SAN FRANCISCO SECOND VALID PASSPORT Your invoice vNl be sent to your contact email. • Check here tt you require a hard copy included with your return delivery. Payment Information yea/Mastercard: 5 4 7 4 . 1 S 1 3 - 7 3 0 8 - 9 2 5 6 Sa. Date: " 19 Security Code: 3 5 7 on American Express: Exp. Date: / Security Code: Name as it appears on the card: Darren K. Indyke Bing Address: 575 Lexington Ave. 4th Floor ger NY Signathre: Slate NY Zip: 10022 P.-0/711i(:11- 7 - G3 Wanner Humber, Bang, P.O., flora or Retaonce Coon: X Go: E.,ervictl, '.crit noted FEE a Travelers TOTAL Concierge Fee SI'S.@ X = $175.00 US Government Fee 5170.00 X = $170.00 G3 Service Fee 5275.00 X = $275.00 PassponPracction Flan $40.00 x 540.00 Return Delivery Fee $84.00 Subtotal $744.00 Add 5% for credit card convenience fee $37.20 Total Payment Enclosed 5781.20 Traveler Infornlittinr1 Traveler 1 Name: Jeffrey Epstein Trader 2 Name: Date of 01/20/1953 Date ot BirM: Passport Service Service: x Second Valid Passport (Book Orin ' Second Void Passport (Book and Card) Processing Speed: c Mission Critical Priority &pelted Travel Details Date of US DeDadore: Other visa or passport services requested: Notes: I mast have my passport no later that 06127/2016 Contact Information Name: Darren Indyke Contact EmS (required) Daytime Phone Company: Mobie Phone: Return Delivery Address Name: Jeffrey Epstein Street Address 9 East 71st Street ate: New York Daytime Phone: 2127509895 COMPerly: State: NY Mobile Phone: Zap Cade 10021 LIMMIL2 EFTA00314133


