EFTA00809187.pdf

IIIIIVIIIIIIIII~UIIIo'0332 100000 171403 ll111' ST Sex Offender STATE Registry To: JEFFREY EPSTEIN LITTLE ST JAMES April 10,2017 6100 RED HOOK QUARTER. 83 Offender ID: 33216 ST THOMAS VI 00802 From: Sex Offender Registry Unit, NYS Division of Criminal Justice Services RE: Annual Address Verification Sex Offender Registry Annual Address Verification Form The Sex Offender Registration Act (SORA) requires you to review, update, and sign this Annual Address Verification Form and mail this form back to the Division of Criminal Justice Services within 10 days from receipt of this form. You must do this whether or not you have reported updated information to parole, probation or a law enforcement agency. If you attend, are enrolled at, reside at, or are employed at any institution of higher education, you must provide that information on this form. You must also report your intemet service provider(s), all screen names, all e-mail addresses and all other information listed on the form. If you are a level 2 or 3 sex offender, you must report the name and address of all employers. INSTRUCTIONS: • Review each line of information on this form carefully. • If you find any information that is incorrect or outdated, cross out incorrect or outdated Information with a single line. • Enter any corrections or any new/additional information In the blank boxes provided. THIS FORM MUST BE SIGNED AND ALL PAGES RETURNED EVEN IF NONE OF THE INFORMAT ION HAS CHANGED. FAILURE TO RETURN ALL PAGES OF THIS FORM WITHIN 10 DAYS OF RECEIPT IS A FELONY AND MAY RESULT IN THE ISSUANCE OF A WARRANT FOR YOUR ARREST. Please contact the Sex Offender Registry at 518-417-3384 with any questions about this form. OFFENDER INFORMATION LAST NAME FIRST NAME MIDDLE SSN EPSTEIN JEFFREY E Maio cortnigni <-- here OTHER NAMES EPSTEIN,JEFFREY EDWARD Enter any aliases, nick names or other names used in the following section. Page . 1 el 11 EFTA00809187  IIIIIU IIIIIIIIIIIIIIIIIRIIIIID:"2 100000117 403 PHYSICAL ATTRIBUTES BIRTHRATE HEIGHT WEIGHT HAIR • EYES GLASSES 01 /2011953 600 180 Gray Blue Mahe erection <-• here SCARS/MARKS/TATTOOS Enter any other scars/marks/tattoos. PR MARY ADDRESS Primary address is the address where you live most of the time. NUMBER/STREET/AFT CITY LITTLE ST JAMES, 6100 REO HOOK CUARTEREO ST THOMAS Make carettan I <— Iwo STATE ZIP COUNTY COUNTRY VI 00802 US maw corrocthes <— here Phone a el this aftess Erdee phone 11 correct's(' here --->c. , ?? i..:; ,,,_\, 7\ch e,:t E, ,v- Name of Collage f Unlvoislly Cji AA • i j(1-10 ' 7-,-::\CITiOn"( N',. 1M C\ Page • 2 of 11 EFTA00809188  1000001171403 ID33 SECONDARY ADDRESS Secondary Address is the address where you live some of the time. NUMBER/STREET/APT CITY 358 EL BRILLO WAY PALM BEACH Make women, e— here STATE ZIP COUNTY COUNTRY FL 33460 US NLalos orrecuons <— here More 0 at this address . ,. ‘ Enter phOre 0 cur:000n her ...<‘ ,k 1_, \.\ c_m:..•i 1 1 Name of College / Universty, NUMBER/STREET/APT CITY GREAT ST JAMES. Make carer:tons 2 SA. -'. Lix'i li 1 :. hhere STATE ZIP COUNTY COUNTRY yi US make Cerreetoes C:)( cc` c— here Phone pat ails address. I Enter phone l aNfeCtIOn here .--, Q. /..>(,) Name of College I Uneersity: ..:c‘.....1,:\AA.nc,,,,.,,eci I NUMBER/STREET/APT CITY Make cartectOnS 3 iccQ _ (. .e_ here ri,\Ipi-i ,„? :_:.--)(7•.tr, _--v olec* /3,-tcl ell( cl) STATE ZIP COUNTY COUNTRY FN Make corrections c.— here Prone Nat re address Enter phone p conemon Ito --->Se ,-, ,r) ,,L, f...„-,I C. t-r -I - Trli 1 \i .k.-, I Name of College / Lin:versify, NUMBERISTREET/ApT CITY 9 E 71ST ST NEW YORK Make carmen 4 4—. Mee STATE ZIP COUNTY COUNTRY NY 100214102 New York US Make eOrrectione c.— hen. ptx,ne # et m6 address Enter phone II correction here •"' -i: :, >e_ ir ,, \ ‘ cr•vr )er i Name of College / University. NUMBER/STREET/APT CITY 49 ZCRRO RANCH RD STANLEY Make cenectoters 5 <— here STATE ZIP COUNTY COUNTRY NM 67056 US Male corrections <— here Pi-one U at was address Eller phone N cofforech here ••••• • -.(c) I - H i ( ,kc \, (.. c I Name of College I University: Enter any additional Secondary Address in the following section NUMSERMTREET/APT CITY 1 STATE ZIP COUNTY COUNTRY Enter phone p here - - a If the above address is on the campus of a College or Uriversity.onter its name Pogo -3 or 11 EFTA00809189  IIIIII111 1111 011,11 111 1)1 11°3" 111 NUMBER/STREET/APT CITY 2 STATE ZIP COUNTY COUNTRY Eiger chono a here • > If the above address is on the campus of a College or Uravers ilyontor Its name PO BOX ADDRESS PO Box Address is allowed if mail cannot be delivered to the prima ry address. PO Box Address must be approved by the Post Master and Law Enforcement. Enter any PO BOX Information in the following section PO BOX CITY i STATE ZIP COUNTY COUNTRY EMPLOYMENT INFORMATION EMPLOYERS NAME NUMBER/STREET/APT ECUTHERN TRUST COMPANY INC SOUTHERN TRUST COMPANY 6100 RED HOOK QUARTO:UM 1 Make corrections <— bore CITY STATE ZIP COUNTY COUNTRY ST THOMAS VI UO280 US Make corrector's c.— mre Name of College / Univorsay: En er any additional employment information in the following section EMPLOYERS NAME NUMBER/STREET/APT 1 CITY STATE ZIP COUNTY COUNTRY If the above address is on the campus of a Cottage or UnNorsilyenter Its name EMPLOYER'S NAME NUMBER/STREET/APT 2 CITY STATE ZIP COUNTY COUNTRY If the above address is on the campus of a Collage or Univorsity,onter Its name HIGHER EDUCATION INFORMATION Higher education includes any 2 or 4 year colleges or any trade or vocational schools. Enter any additional education information in the following section SCHOOL NAME NUMBER/STREET/APT 1 CITY STATE ZIP COUNTY COUNTRY Dates of Alleedance. Ernoloynent or Enrollme nt From Date Chock one To Oree 0 Enrolled • Empeoyed • Attend/le Page - 4 of EFTA00809190  III 0000 ill1i,111,11111 1O.33 SCHOOL NAME NUMBER/STREET/APT 2 CITY STATE ZIP COUNTY COUNTRY Dales of Allen:Isnot Errcloymenl or Enna/net% Checkz one From Dale To Date MI Emoted CI Erpoyed II AIIending Page - 5 all EFTA00809191  AMOChed 000001171403 VEHICLE INFORMATION -P-)L. CCIS cirri AutALitO CYLIDAteS1 aack Information of any vehicle that you own or drive. YEAR MAKE MODEL COLOR LIC PLATE STATE 2007 Hummer Hummer II Black CPK643 NM Make coemettens 4— hem 2002 Mercedes-Benz 503 Series Black NHL5.52 NM Make COnedlons L- Mee 2010 Chevrolet Suburban Black TED218 VI heik.carecoons 1968 Aircraft Unknown N908JE VI Make etatabons p)oeitna ' —0 ---1 See. .A2ric-rtect. 1968 2583TC VI MakeMee:63n —e()( %_., Lcne. - r'--. 9111V\e ‘_ <— hole 2008 29071C VI Mn. cam/ions Proe.c* 2x; o 1 2005 0730TC VI Make cot/coons COO e ‘-brn l2 i ' 4._ bete 2011 4105TC VI Make cone:tens \ infinhn \i MOOR - 1<e <•-pre 2011 41061C VI Make COltOCL01111 \ K 'AcIfII V ICA \I )( t R(1) A - 1Ce) <- here 1999 2709TC VI Make ON/OCti:41$ ‘ \Mr( ' • 4••• ISO 2008 Land Rover Range Rover Black M10718 NM Make conectOns 2013 Dodge Caravan Black TEM492 VI Make collections 2013 Ford Expedition Black 522RZZ NM Make =cottons 2001 N331JE Make coot/Mons P 1 Liiii..,',Iel.:‘, -0,-( See N-vrictec. 1988 N212JE NY Make oittectan ,.. . t -) - V 1 VI- Sk ( - erten ()-7 -1 V fr-j \CM( k e•iee_ Av‘rtheri 2012 46411C VI Make 000Ction• i 2A- 1111- 11C- If( i7-en ry, X.) 2015 Chevrolet Suburban Black NAL159 NM Make carectorte 4 -hue 2015 General Motor Corp. Yukon Black TET575 VI Map canteens 4.- hem —2046— Chevrolet Suburban Black HCP5713 NY Make eoneCtema (C) O UM s - hate 2013 4772TC VI Make Camels/. I (4 ) IC4 \ S Page • 8 of 11 c- here ours C/Innle TCIA /Oa EFTA00809192  1111 11111111111111ID3"16 1000001171403 See A4-100-tid - Enter any additional vehicle information in the following section I PCC rind tocircroci- YEAR MAKE MODEL COLOR LIC PLATE STATE cam. Cadillac Esc.ok-xcie. BlX.L NHL-32.I IN\ On (905 erne yuvnn ?)kccr_ 15112t114 -\-:L. a01(D Chevrolet _gt Aburhnn Bloch 1-r3rsK55 C L ICR°1 ft 3ArsUlt 031 (4" 3.5L-R--rc 'FL (900-i 11 skreern 6550 IN3t-At5Lrn see c DRIVER'S LICENSE INFORMATION DRIVERS LICENSE NUMBER ISSUING STATE 0000025874 VI Hake correction <— htee C000000074316 VI Make Oeueetan c— here Enter any additional drivers license information in the following section DRIVER'S LICENSE NUMBER ISSUING STATE Page - 7 of 11 EFTA00809193  INTERNET INFORMATION See A-k-kachej-Inkerne + Qua-keci I111111111111nu 1,11"' relCaffrer ic‘CrI and C11 1 1•K)Aes 1 P(PIO SERVICE PROVIDER SERVICE PROVIDER AT&T ORANGE TELECOM Wk. arrechons <— Mee COMCAST yak* cortecfcms g— hen THE WARNER Mahe creak.% <—• hen —PINTEREER--- Wake conectort See, getow * c_ IIeTe --thiono---- Mall CCITOCIo” 4e 42De\ow 4- .... here --GRANT-WATCA4---. Mike conector4 See Mow -Yr `Nero --GOGGL-E-MAPS-- Mate coroectbns See getow * c— hem CHOICE COMMUNICATIONS Maknonelhans 4— hem FREE TELECOM Make COUICONIS <— NOW VERIZON Make Corioctions e— WO *See A-k-coned- Okher Interne-1- Peco.inkInformaiion ore -vre. Niot m reciocctd\okme b‘scepritnuect use oc Accoun-ks Se* for- -wereqy SCORee. P(b\AC\-e( Page • 8 of 11 EFTA00809194  ID:33216 II SCREEN NAME SCREEN NAME TREJEFFREYEPSTEINFOUNDATION *Akkomamocton 4-. Mm JEFFREYEPSTEIN Make countores <--line JEFFREYEPSTEINORG Make earoceons C... hem THE JEFFREY EPSTEIN VI FOUNDATION %Inky C0/10a011li h. heto JEFFREYEPSTEINFOUNDATION Make cones-bans JEFFREY_EPSTEIN Make catectons JEFFREYEPSTEIN i Maki: Co riet!CoS <-- here MATTER JEFFREY_EPSTEIN make coneaons <-.Imo JEFFREYEPSTEINI2 Make moment <-- here JEFFREYEPSTEIN2 make Montan <— here JEFFREY EPSTEIN VI FOUNDATION 1.4.0i0 COICOCWII• <-. ha* JEFFREY EPSTEIN Slake corroctionS <-- here INSTAGRAM JEEPROJECT Flake reunions <-- An JEEPROJECT Slake corrections JEFFREY-EPSTEIN TA4TTER JEFFREY EPSTEIN SKYPE make "...non. roemACCI-tionnmoill.CU() FACETIME Wee Winton 4.-- here Pogo -9a11 EFTA00809195  •f ID:33216 c,„_2;zci(\oi,-fsc= InfatittilCaAgailiClolY~Qo~'p(~1\(11~t— 1000001 71403 OC Cf na 14/A oT Se inCluc t193 -WWI, ilt, wnto M set r- A 3Ce‘lo below Jac rt (Atrial • COM E-MAIL ADDRESS and ]eel 1n coM E-MAIL ADDRESS JEEPROJECTOYAHOO.COM <— Make certain here JEEVACATIONOMESOM <— Make COrttellons here JEEVACATIONOGMAILaN <— Niue cones tore here [email protected] (.— MAYAO corrections hero [email protected] <— Make COnecUOre NM JEEYACATIONIOME,COM <— Mate correctoons hero COLUMBRQEWASUOyAlignp2A <— Make oarrellOns here gagetkeSIENCRISMSali c— Make correctrOns here JEFFREY@REMEYEPSZEIN_PRG <-- Mate coterctions NM JEEYACATIONaGMAIL.COM <.-- Make ootrectionl hero 1.1111.ESDEFFOYA11OO.C0M c._ make COrreCbens here Enter any additional Internet information in the following sectio n f SERVICE PROVIDER SCREEN NAME E-MAIL ADDRESS SIGNAL Levet *3 Coregruncatton Gen-tutus LtnY, keettt inec OX\cynt I. orm I CERTIFY THAT THE INFORMATION ON THIS FORM IS COMPLETE AND ACCURATE. I HAVE CROSSED OUT ALL INFORMATION THAT IS INCORRECT OR OUTD ATED. I HAVE ADDED ALL CORRECTIONS AND ALL NEW INFORMATION. I UNDiagr-TAND THAT FAILING TO PROVIDE THIS INFORMATION OR PRO LSE INFORMATLONTS A FELONY. Teticreti Ecs-t-etn Ltlict\11 Sex Offender's Signature Sex Offenders Date Name(print) THIS FORM MUST BE SIGNED AND ALL PAGES RETURNED EVEN IF NONE OF THE INFORMATIO HAS CHANGED. FAILURE TO RETURN ALL PAGE N S OF THIS FORM WITHIN 10 DAYS OF RECEIPT FELONY AND MAY RESULT IN THE ISSUANCE IS A OF A WARRANT FOR YOUR ARREST. Return to: Division of Criminal Justice Services - SOR 80 South Swan St Albany, NY 12210 Page - 10 of 11 EFTA00809196  H)IlIIlllhI) ' I)HI)II 11)川 ID332 16 1C3000J. 71403 $卜／ ／극EW YORK Sex Offender 乙入君It Registry New York State Division of Criminal Justice Services Michael C. Green lExecutive Deputy Commissioner Notice of Important Document ENGLISH 心pa加1 陛三多多多多쁘ragnit fl ;: 1Este document이晦Itien. 戚而de此雨III把nto·尸！ blta de respu心tap而de Spanish 1밑ar en una querena Pena.1rbi riecesna una traauccion gratuna, name at ' 1111 tviucnas gractus. m 筒休字 1迭是H 价要求限期回篁的法律文件. 不予回立可能尋致被刑事指控汭 ；果 Simplified "無需要免妥的硼澤件 ' 滑致屯 “ 澍澍 " , C川nese }Creyol Ayisycn 1 帥啣：i ci帥毗g뺏 gen dole艸蜘艸雨艸： 卿onn sa느 Haitian Crc이C 1口亡asyon Msi.Krirntnel.i w DC째Cflt C1lKS 'Oflgratis,tanpnrownan [II presente 6 un docurnen뜨 legate urgente. La inancata.rispos相' pu6 da1 Itallano 느 r 1山Imento penate. ret una iraauzione 으ratutta. cinami ii numero I " " Italian 尸＝ Orazie. '