EFTA00313895.pdf

Registration No: 1026221 Person Number: 73274 FDLE SEXUAL PREDATOR/OFFENDER REGI STRATION FORM Agency Name: Palm Beach County SO Note: Your next ReRec;stration month is July of 2018 Registration For: January 2018 - SEXUAL OFFENDER CCS User Name: jepsteln Reason For Registration O informabon Update Registrant Information Name: JEFFREY E EPSTEIN .SS DOB: 0112W1953 Race: White Mtddle Last Suffix) Sex Male lascionee er your Sods Soarer Number (SSN) s mania, pursuant to Rada tat sectons 77521.9 alp. Use of sour WI Is for the ;purposes of identacaban. 410435. 044.607.9035.481. FS., and federal ars, 42 FIX:Emmy Mew the Homan ash tee other agoras USC 16901. et for the gams purpose. FL DL or ID Card g- E123425630200 Height 6' 00 weight 180 Ds Hair Grey Eyes: Blue Place of 8km Immigration Status' Not MOW* Currently on ProbabonCargie: 0 No O Yes PtObatian Type: O Stan Officer Name: Phone: ( ) Sum O Federal Officer Name: Phone: ( ) City ❑ County Officer Name: Phone: ( County Out of State Travel Information (Complete If perma nent, temporary, or transient address is out of state) Pe•-nanently leaving Florida to establish a residen ce in an t Date of Departao 0 Temboranly leaving Florida to visit another state/co untry 9 Moving from anolhe- state to permanent), establish a residence in Florida r:ateolArtival: 9 Veiling from anothe- stale and establishing a temporary address in Florida ❑ Other (please descrbe) Current Permanent Address Future Permanent Address 6100 Red Hook Openers Ste B3 (Address tine 1) (Address tin 1) LIM St James I stands (Address Lite 2) (Adckees lira 2) St Thomas VI 00802 (COO (Stew) (Zip) (Gay) ' (Oa) (2, 0) Cooly: St Thomas End Dap: Casty: Stet Dew 0 I do NOT have a permanent address at ads lime. Page 1 of =frotee e07:17 AM EFTA00313895