Case File
efta-01654377DOJ Data Set 10OtherEFTA01654377
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01654377
Pages
3
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
FinCEN
Financial Crimes Enforcement Network
Unitai Scams Department attic Traauty
FBAR Transcript
BSA: 31000110602437 and DCN:
Filing Information
Filing Type(s) Initial Report
Filing Date 08/18/2017
Received Date 08/18/2017
Entry Date 08/21/2017
Report for Calendar Year 2016
Submission Method Electronic batch filing
Submitted by Authorized Third
Party
Yes
Filer Information
Filer Role Foreign account filer
Filer TIN
Identification Type SSN/ITIN
Identification Number
Type of Filer Individual
Filer Last Name or
Organization Name
EPSTEIN
Filer First Name JEFFREY
Filer Middle Name E
Filer Date of Birth 01/20/1953
Filer Address
Address Type Foreign account filer address
Street Address 6100 RED HOOK QUARTER B3
6100 RED HOOK QUARTER B3 - Enhanced
City ST THOMAS
ST THOMAS - Enhanced
State VI
VI - Enhanced
ZIP Code 00802
00802 - Enhanced
Country US
US - Enhanced
Financial Interest in 25 or
More Accounts
No
Signature Authority in 25 or
More Accounts
No
Information on Financial Account(s) Owned Separately
Account 1 of 2
Report For Calendar Year 2016
Page 1
The enclosed ,formation was colected and disseminated under provisions of the Bank Secrecy Act (the SSA) and U.S. Deportment of the Treasury regaations implementing the BSA. See 31 U.S.C.
5311. et seg.. 31 CFR Chaplet X. The nformation is sensitive ri nature and is to be heated accordingly. The information may be used only Ice a purpose con ustent with aern-nal tax. or regulatory
investigation or proceeding. or in the conduct of ntelligence or counterntelligence activities. including analysis, to protect against nternational terrorism. See 31 U.S.C. 5311. The information cannot be
lusher released. disseminated. disclosed. or transmitted without prior approval of the Director of Financial Cranes Enforcement Netwakor he authorized delegate. Suspicious activity reports filed under
the BSA must be heated ?nth particular care given that they contain unsubstantiated allegations of passable aiminal activity. akin to ccofidenhal informant tips. Unauthorized release of infamaton
collected raider the OSA may result in aiminal or civil sanction:.
L£fZ090110001£ VSEI
EFTA01654377
FinCEN I Financial Crimes Enforcement Network
United Mato ()Tamen, a the ftextuty
FBAR Transcript
BSA: 31000110602437 and DCN:
Information on Financial Account(s) Owned Separately
Filer Role Foreign account filer
Filer TIN
Identification Type SSN/ITIN
Identification Number
Type of Filer Individual
Filer Last Name or
Organization Name
EPSTEIN
Account Type Bank
Account Number or Other
Designation
0293300000061444
Maximum value of Account
During Calendar Year Reported
$213,618
Name of Financial Institution
in which the Account is Held
BNP PARIBAS
Financial Institution Address
Address Type Foreign account financial institution address
Street Address 16 BOULEVARD DES ITALIANS
16 BOULEVARD DES ITALIANS - Enhanced
City PARIS
PARIS - Enhanced
ZIP Code 75009
75009 - Enhanced
Country FR
FR - Enhanced
Account 2 of 2
Report For Calendar Year 2016
Filer Role Foreign account filer
Filer TIN
Identification Type SSN/ITIN
Identification Number
Type of Filer Individual
Filer Last Name or
Organization Name
EPSTEIN
Account Type Bank
Account Number or Other
Designation
0293300000062351
Maximum value of Account
During Calendar Year Reported
$219,742
Name of Financial Institution
in which the Account is Held
BNP PARIBAS
Financial Institution Address
Address Type Foreign account financial institution address
Street Address 16 BOULEVARD DES ITALIANS
16 BOULEVARD DES ITALIANS - Enhanced
Page 2
The er,
i rmatico was coiected and disseminated under provision: of the Bank Secrecy Act (the OSA) and U.S. Deportment of the Treasury reguLations implementing the BSA. See 31 U.S.C.
531'. e
'CUR Chaplet X. The mformation a sensitive n nature and is to be treated accadingly. The information may be used only for a purpose consistent with acrrnma tax. or regulatory
investigation or proceeding. or in the conduct of ntelligence or counterntelligence activities. includng analysis. to protect against ntemational terrorism. See 31 U.S.C. 5311. The information cannot be
lusher released, disseminated. disclosed. or transmitted without prior approval of the Director of Fnancial Crates Enforcement Netwakor he authorized delegate. Suspicious activity reports filed under
the BSA must be treated mth particular care given that they contain unsubstantiated allegations of passable criminal activity. akin to confidential informant tips. Unauthorized release of information
collected wider the OSA may result in criminal or civil sanclicns.
LEVZ090 L000 LC VS9
EFTA01654378
FinCEN I
Financial Crimes Enforcement Network
L•nired States Department ti the rtaouty
FBAR Transcript
BSA: 31000110602437 and DCN:
Information on Financial Account(s) Owned Separately
City PARIS
PARIS - Enhanced
ZIP Code 75009
75009 - Enhanced
Country FR
FR - Enhanced
Signature
Signature Date 08/18/2017
Third Party Preparer Use Only
Preparer's Last Name HASSON CPA
Preparer's First Name DAVID
Preparer's MI M
Preparer's TIN
Identification Type PTIN
Identification Number
Phone Number
Preparing Firm's Name SHR, CPA S LLC
Preparing Firm's TIN
Identification Type EIN
Identification Number
Preparer's Address
Address Type Third Party Preparer Address
Street Address 3000 MARCUS AVE STE 3W4
3000 MARCUS AVE STE 3W4 - Enhanced
City LAKE SUCCESS
NEW HYDE PARK - Enhanced
State NY
NY - Enhanced
ZIP Code 11042-1009
11042-1009 - Enhanced
Country US
US - Enhanced
Page 3
The enclosed nformaticn was colected and disseminated under provisions of the Bank Secrecy Act (the SSA) and U.S. Department of the Treasury reguLations imptementing the BSA. See 31 U.S.C.
5311, et see. 31 CFR Chaplet X. The mformation a sensitive m nature and is to be treated accadingly. The information may be used only for a purpose con ustent with acrrnma tax. or regulatory
investigation or proceeding. or in the conduct of mtelligence or countermtelligence activities. inclueng analysis, to protect against mtemational terrorism. See 31 U.S.C. 5311. The information cannot be
further released. disseminated. disclosed. or transmitted without prior approval of the Director of Financial Crates Enforcement Network or his authorized delegate. Suspicious activity reports ftled under
the BSA must be heated ?nth particular care given that they contain unsubstantiated allegations of passiale criminal activity, akin to confidential informant tips. Unauthorized release of information
collected under the BSA may result in criminal or civil sanction:.
LEVZ090 L000 LE VS9
EFTA01654379
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