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From: "Jeffrey E." <jeevacation@gmail.com>Case File
efta-efta01191036DOJ Data Set 9OtherFrom: "Jeffrey E." <jeevacation@gmail.com>
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta01191036
Pages
2
Persons
0
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Extracted Text (OCR)
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From: "Jeffrey E." <jeevacation@gmail.com>
To: Jeffrey Epstein <jeevacation@gmail.com>
Subject:
Date: Tue, 25 Aug 2015 18:31:34 +0000
Inline-Images: Screen_Shot_2015-08-25_at_2.29.16_PM.png; Screen_Shot_2015-08-
25_at_2.30.10_PM.png; Screen_Shot_2015-08-25_at_2.30.37_PM.png; Screen_Shot_2015-
08-25_at_2.30.25_PM.png
litnline image 2
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PART 1 > PASSPORT AND TRAVEL INFORMATION
PASSPORT / TRAVEL DOCUMENT
1
FAMILY NAME/SURNAME
OF YOU ONLY HAVE ONE NAME. PLEASE ENTER IT HERE
AND IN THE GIVEN NAME BOX)
2
GIVEN NAME(S) FORENAME(S)
(IF YOU ONLY HAVE ONE NAME. PLEASE ENTER IT HERE
AND IN THE FAMILY NAME BOX)
3
DATE OF BIRTH
4
PLACE OF BIRTH
5
GENDER
6
NATIONALITY
7
DO YOU CURRENTLY HOLD, OR HAVE YOU EVER HELD.
ANY OTHER NATIONALITY OR NATIONALITIES?
8
CURRENT PASSPORT OR TRAVEL DOCUMENT NUMBER
9
PLACE OF ISSUE
10
ISSUING AUTHORITY
11
DATE OF ISSUE
12
DATE OF EXPIRY
13
CURRENT LOCATION
14
ARE YOU A NATIONAL OF THE COUNTRY IN WHICH YOU
ARE APPLYING?
PLEASE ENTER DETAILS
IS THIS YOUR FIRST PASSPORT?
NATIONALITY
DOCUMENT NUMBER
ISSUING AUTHORITY
DATE OF ISSUE
DATE OF EXPIRY
IS THIS DOCUMENT LOST. STOLEN OR IN YOUR POSSESSION
EFTA01191036
36
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
DATE OF TRAVEL
COUNTRY VISITED
REASON FOR THE TRIP
31
HAVE YOU BEEN REFUSED A VISA FOR ANY COUNTRY
INCLUDING THE UK IN THE LAST 10 YEARS,
32
HAVE YOU BEEN DEPORTED. REMOVED OR OTHERWISE
REQUIRED TO LEAVE ANY COUNTRY INCLUDING THE UK
IN THE LAST 10 YEARS,
33
HAVE YOU EVER VOLUNTARILY ELECTED TO DEPART
THE UK?
34
ARE YOU, OR HAVE YOU BEEN SUBJECT TO, AN
EXCLUSION ORDER FROM THE UK,
35
HAVE YOU EVER TRAVELLED OUTSIDE YOUR COUNTRY '
OF RESIDENCE, EXCLUDING THE UK. IN THE LAST 10
YEARS?
EFTA01191037
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Email
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