ly. Inarsect Registrant: Witnessed by Reporting Officer. Signature Reqwed Printed Name: JEFFREY E EPSTEIN Date: 01/10/7013 Printed Name: Page Bate Signature Required Date: 01/10/2013 • OFFICIAL DOCUMENT DO NOT DESTROY' NOTE: Your next ReRegistration month is July of 2013. 2914-0501 2.0107