EFTA01100089.pdf

1000000378499 State of New York DWision or Criminal Justice Services 4 Tow Place Albany. NY ¶2203-3764 - ^*" ."1"--- SINGLP 120 2 1 SP 0.440 001 To: JEFFREY EPSTEIN April 11, 2011 6100 RED HOOK QUARTERS, SUITE 63 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 3 sex offender, you must report the name and address of all employers. INSTRUCTIONS: 1) Review each line of information on this form carefully. 2) If you find any information that is incorrect or outdated, cross out incorrect or outdated information with a single line. 3) Enter any corrections or any new/additional information in the blank boxes provided.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 INFORMATION 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 518-457-3167 with any questions about this form. OFFENDER INFORMATION LAST NAME FIRST NAME MIDDLE SSN EPSTEIN JEFFREY EDWARD 896449346• 's correcivnb GiO 4413AS <-.." OTHER NAMES ERSTEIRJEFFREY EDWARD Enter any aliases, nick names or other names used in the following section. Page • 1 - el 6 EFTA01100089  IIIII~IIIIIIIIIIIIII III II 1000000378499 1D:33216 PHYSICAL ATTRIBUTES BIRTHDATE HEIGHT WEIGHT HAIR EYES GLASSES 01 /20 /1953 600 180 Gray Blue Meke correceons <--- here SCARS/MARKS/TATTOOS Enter any other scars/marks/tattoos. PRIMARY ADDRESS Primary address is the address where you live most of the time. NUMBER/STREET/APT CITY 8443ITIelleretTerttART-ER-6-iiia ST THOMAS Make corrections c-- 1 t_s3- I I odR.2,1V6a4 &Jo y-keys, 5::,'-ie 6-3 here STATE ZIP COUNTY COUNTRY Make VI 00802 US CPTOCUOIIS Phone.: et this adores .yelittyer56-843021— Enter phone N correctionhere -2 ac- MettzecNneia Name of College /University: TELEPHONE NUMBER Enter the phone number where you can be reached in the following section. 533 23-7 3-7 Page 2 - of 6 EFTA01100090  ID:33216 III 1000000378499 I SECONDARY ADDRESS Secondary Address is the address where you live some of the time. NUMBER/STREETIAPT CITY 9 E 71ST ST NEW YORK 1 STATE ZIP COUNTY COUN1RY Make NY 100214102 New York SS ronertz. • Phone ft at this address: I Enter phone I/ here A404 - Loci Werect ne- Name of Colege / University: NUMBEFUSTREET/APT CITY 358 EL BRILLO WAY PALM BEACH Make corremaks 2 ...... Iwo STATE ZIP COUNTY COUNTRY 35480 us ao FL ow/ethane C.— here Phone Net MN address: Enter phone N correction here. .7-, .5.c e- Altcri.a.k. 4 Name of Colege I University: NUMBER.STREEPAPT CITY . Mae some 3 as AN)tv‘0f...Fothr, AectAimr.-4- aaa PariS c— hem STATE ZIP . COUNTY COUNTRY FN Make OCMICtaCcs <— Phone I M this Saes.: Enter phone ki traction See Tett, In eel Name of College / University: NUMBEFUSTREET1APT CITY 49 ZORRO RANCH RD I STANLEY Make commons 4 <— he STATE ZIP l . COUNTRY Mike NM 87056 I US canteens <. Mee Phone * at this Schur Enler phone 5/ Inct sitco Name of College f Uriversity: Enter any additional Secondary Address in the following section NUMBERISTREET/APT CITY i .1 STATE ZIP COUNTY COUNTRY Enter phone /I hens —a II the above address bon the campus of a College or UnNersktenter its name NUMEIERISTREETMPT CITY 2 STATE ZIP COUNTY COUNTRY Enter phones Moe —• If the above address is on the campus of a College or Universeyenter its name Page • 3• of EFTA01100091  ID:33216 1000000378499 PO BOX ADDRESS PO Box Address is allowed if mail cannot be delivered to the primary 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 1 STATE ZIP COUNTY COUNTRY EMPLOYMENT INFORMATION Enter any additional employment information in the following section EMPLOYER'S NAME NUMBER/STREET/APT .1 RY -tO AO O. 7 -11-O Si t CO P...O.C.voi .t,- col DO gel k-1O.3kQ.cork-Ivs i S„.., .Tt. 3-3 CITY STATE ZIP COUNTY COUNTRY I. . O tn, ..c. \ JI ‘ CC'S° 2.. L.) --S Enter phone 0 here --> If the above address is on the ca mous o. a oltege or nr/ers ,y,en.er its name EMPLOYER'S NAME NUMBER/STREET/APT 2 CITY STATE ZIP COUNTY COUNTRY Enter phone a hero--> If the above address is on the campus of a College or University.enter its name HIGHER EDUCATION INFORMATION Higher education includes any 2 or 4 year colleges or any trade or vocational schools. En er any additional education information in the following section SCHOOL NAME NUMBER/STREET/APT 1 CITY STATE ZIP COUNTY COUNTRY Enter phone It here --> SCHOOL NAME NUMBER/STREET/APT 2 CITY STATE ZIP COUNTY COUNTRY Enter phone a bore —> VEHICLE INFORMATION Information of any vehicle that you own or drive. Enter any additional vehicle information in the following section YEAR MAKE MODEL COI OR LIC PLATE STATE Sex At A - c c Le ji Page 4 . of 6 EFTA01100092  ID 33216 IIIIIIIIIIIIIIII II VIII 1000000378499 DRIVER'S LICENSE INFORMATION Enter any additional drivers license information in the following section DRIVER'S ISSUING STATE LICENSE NUMBER \J INTERNET INFORMATION SERVICE PROVIDER SERVICE PROVIDER AT&T Make wantons <-. nom FREE make COrreaons C.- hone -..GRAUGE-TEL-ECGM- - Make Can:Cons <— hero nen V\ 3 e -re1c co Vs" COMCAST Make ccernions SPRINT Make caractons TIME WARNER Make antic-tom <— hero EMAIL ADDRESS E-MAIL ADDRESS Make correctFr.s Kay, , .:Ev,A,c..:,TioN ,F smE O01.? LUfeCI 'GIs Ma"» care ,Dne e— here Page - 5 - of 6 EFTA01100093  ID:33216 1111111111111 II184 1 10000003719 Enter any additional internet information in the following section SERVICE PROVIDER SCREEN NAME E-MAIL ADDRESS I CERTIFY THAT THE INFORMATION ON THIS FORM IS COMPLETE AND ACCURATE. I HAVE CROSSED OUT ALL INFORMATION THAT IS INCORRECT OR OUTDATED. I HAVE ADDED ALL CORRECTIONS AND ALL NEW INFORMATION. I UNDERSTAND THAT FAILING TO PROVIDE THIS INFORMATION OR PROVIDING FALSE INFORMATION IS A FELONY. Sex Offender's Sex Offender's Date Signature Name(print) THIS FORM MUST BE SIGNED AND ALL PAGES RETURNED EVEN IF NONE OF THE INFORMATION 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. Return to: Division of Criminal Justice Services - SOR 4 Tower Place Albany, NY 12203-3764 Page - 6 - of 6 EFTA01100094  ATTACHMENT TO ANNUAL ADDRESS VERIFICATION FORM JEFFREY EPSTEIN AUTOMOBILES, BOATS, AIRCRAFT & TELEPHONE NUMBERS AUTOMOBILES License State Vin # Plate Registered Color Propea 1 2004 Cheverolet Suburban USVI Black LSJ 2 2005 Cadillac Escalade USVI Black LSJ 3 2010 Cheverolet Suburban USVI Black LSJ 4 2002 Mercedes Benz 8500 Florida Black Florida 5 2005 Cadillac Escalade Florida Black Florida 6 2007 Hummer H2 New Mexico Black New Mexico 7 2000 Chevrolet Suburban New Mexico Black New Mexico 8 2006 Bentley Arnage RL Florida Black New York 9 2010 Cheverolet Suburban NY Black New York Boat Registration Hull ID BOATS Names Number Number 1 1999 35' Ribtec with Yamaha Engine Nana LSJ 2 1984 40' Logical Catameran Lady G LSJ 3 2000 34' Calypso Pirogue Calypso LSJ 4 2006 Yamaha FX 1100A-EB n/a LSJ 5 2010 39' Midnight Express Cuddy Cabin Mid Express LSJ 6 2000 33' Donzi Cuddy Revelation Florida 7 2007 Yamaha FX 1100-FR n/a LSJ 8 2006 31' Cape Horn PRD LSJ 9 1998 55' Midship Marine Lady K LSJ 10 2008 36' Procat Little C LSJ 11 Miss Ava - 1968 73' LMC-8 (barge) Big N LSJ Registration Tail Number Airports - for all locations AIRCRAFT 1 1968 Boeing 727 N908JE The Cyril E. King airport in St. Thomas 2 1974 Guffstream G-IIB N909JE West Palm Beach International & Boca Raton Airport 3 1999 Bell 407 N491GM Santa Fe Municipal Airport & Albquerque International, New Mexico 4 2008 Sikorsky S-76 C++ N722JE John F Kennedy International Airport, Newark International Airport & Teterboro, NJ plus East 34th Street Heliport - 34th Street & FDR Drive, Wall Street Heliport - Pier 6 & FDR Drive & VIP Heliport - West 30th Street & 12th Ave LANDLINES 1 JEE lines LSJ 2 JEE lines LSJ 3 JEE lines LSJ 4 JEE lines LSJ 5 staff lines LSJ 6 staff lines LSJ staff lines LSJ staff lines LSJ 9 staff lines LSJ 10 staff lines LSJ 11 staff lines LSJ 12 staff lines LSJ 13 staff lines LSJ 14 staff lines LSJ 15 staff lines LSJ EFTA01100095 16 staff lines LSJ 17 staff lines LSJ 18 staff lines LSJ 19 staff lines LSJ 20 staff lines LSJ 21 staff lines LSJ 22 staff lines LSJ 23 staff lines LSJ 24 staff lines LSJ 25 staff lines LSJ 26 stafflines LSJ 27 staff lines LSJ 28 staff lines LSJ 29 staff lines LSJ 30 staff lines LSJ 31 staff lines LSJ 32 staff lines LSJ 33 staff lines LSJ 34 staff lines LSJ 35 staff lines LSJ 36 staff lines LSJ 37 staff lines LSJ 38 staff lines LSJ 39 staff lines LSJ 40 staff lines LSJ 41 staff lines LSJ 42 staff lines LSJ 43 staff lines LSJ 44 staff lines LSJ 45 staff lines LSJ 46 staff lines LSJ 47 staff lines LSJ 48 staff lines LSJ 49 staff lines LSJ 50 staff lines LSJ 51 JEE line Florida 52 Staff line Florida 53 Staff line Florida 54 Staff line Florida 55 Staff line Florida 56 Staff line Florida 57 Staff line Florida 58 Staff line Florida 59 fax Staff line Florida 60 Staff line Florida 61 JEE line New Mexico 62 JEE line New Mexico 63 JEE line - 2007 Hummer New Mexico 64 JEE line - 2000 Suburban New Mexico 65 Staff line New Mexico 66 Staff line New Mexico 67 Staff line New Mexico 68 fax Staff line New Mexico 69 Staff line New Mexico 70 Staff line New Mexico 71 Staff line New Mexico 72 Staff line New Mexico 73 Staff line New Mexico 74 Staff line New Mexico 75 Staff line New Mexico 76 Staff line New Mexico 77 Staff line New Mexico 78 Staff line New Mexico 79 Staff line New Mexico EFTA01100096 80 JEE line New York 81 Staff line New York 82 Staff line New York 83 Staff line New York 84 Staff line New York 85 Staff line New York 86 Staff line New York 87 Staff line New York 88 Staff line New York 89 Staff line New York 90 Staff line New York 91 Staff line New York 92 Staff line New York 93 Staff line New York 94 Staff line New York 95 Staff line New York 96 Staff line New York 97 Staff line New York 98 Staff line New York 99 Staff line New York CELLPHONE 1 EFTA01100097