EFTA00040006.pdf

LA1% LNMRCENIE\ I MASI FIVE I N. l)rpartment of Justice oiled States .%larshals Sin ice Personal History of Defendant liken i to Federal custody by the following: Street Arrest (not from a correctional detention facility ) estrrit 1 sed (Must pros ide copy of yyrit) / 4141:'-'r O Custodial Arn:si (from a correctional detention facility) ❑ Prior Federal Arrest or Safi:keeper - Register u: O lyarckecper Location: Blind( \PIM \I INISIlt \ I \ I lit\ Last Name: 7- First Name: Middle Name: Sex: r Transgendcr flair: 6 Eyes: S/oct City of Birth: et Statett'ountry of Birth: 1:10 N: State Inn: Resident Address/City/State/ZIP: 9 ex* home Phone: Cell Phone: 1 lull RI ( v.! Agent Last Name gencv 0121: rivy9 Agent Phone N: I.ocation/Facility of Arrest: Court Docket 0: Al SA(s) Assigned: 01 I I NNI I NCR' Code Charge Description SitlArr/C.,11,/j Title/Code t.st. 7/ Known Detainers/%Varranis: O •i• - Agency: tAiusi pan lilt a rap) of am ;Mannn) eft' ( \I 'Inv. \\I) \ii 1)11 Lung Term Medical Conditions bean problem.. Jabot.. mama. Where uloth. IIIV. AIDS. SeimItIK. met O Psychiatric/Emotionally Disturbed ir.s.. mental health f011talli...ultid Al. etc.1: Injuries/Medical Ailments/Post-Op Recovery: D Do the shove conditions empire: Medical attention? N O 1' Medication? \ ❑ 1' Medical clearance by a licensed physician: Nit] \ ❑ 1' Is Defendant under the influence of drugs or alcohol: ism ❑ 1' Languages - F:nglivh: ❑ N .16❑ i.imited Other Language: N • i.ist: Security Cautions: C rrent or former military 0 Current or former I.I. corrections El Current or runner intelligence t or former public official ❑ Assault on LI: corrections ❑ SAM subjr:ct or candidate I gild,: liw diplomatic immunity ❑ Leadership mk ❑ Separation weds ilktecrine Mott I Ihreal to witness (Describe Moo/ O Ci /Describe below, ❑ Other !Describe helm.; TES Form USM-312 Page I or 3 Rev 11/17 EFTA00040006  LAW liNFORCEMIA Remarks: Date of Birth State Driver's License \\]O( l.\11 O -O1,1 \ I) \ REI I I\ Is, I 1111 tilti %.11;NII I( %NJ ()I Resident Address. City. State, ;Relationship Last Name Register N ZIP Code Phone Sea rh)I a rkflattOn (Specif)) Location State and Registration Color(s) chicle Style Plate Date License Number License State NI Est F %NI (11 S Ni \I111 Its Nliscellancuus Number r) (Selectfrom dropdroor mend or /we below; Remarks (e.g.. Issuing Matt or 1 sunlit. etc.) Occupation: Company/Employer Name: LO/ Cy Employment Address: ViRood' hive" Start Date: End Dale: Point of Contact: Rank Na me Account Type Attain Branch Address Phone N . Entry Discharge Br itch Rank Date Date Discharge 1) pe Nlilitar) Occupation Remarks t Ailitiltorral Inform:4 tion/RemarksicontinultiOn: Defendant Ricks: 4Requires rentarkr hermr Sex Offender: Escapee O Planned Murder C Arrest O Convielion O Organized ('rinte• O Protected Witness O Registered O Registration Violation O Intonational 'lerroeist ❑ Domestic Terrorist o Gang \limber' O Significant Criminal I listor) E Multiple Defendants O Math Penahy Case AES Form tiSk4,3i2 Page 2 or 3 Rev 11117 EFTA00040007  LAW ENFORCEMENT SENSITIVI. Criminal History (Select/ront dtrynhnen menu or type offense below) Arrest (a) Conviction (N) Remit e.g.. name of gang or criminal organization. tic.): Pc O Money Launderer O Kingpin O Violent ()Ifender I\ I I I(\ I I 14/ .1. /1 1(1 I Internet Source Remarks (e.g.. email address. website address, usernamc. etc.) NOTICE TO ARRESTING AGENTS: As a courtesy. the USMS may temporarily hold an arrestee received by nOn•USMS personnel in the cellblock until the arresting agents) make arrangements for the prisoners initial appearance before a United States Magistrate. A prisoner remains the responsibility of the arresting agency until remanded to the custody of the USMS b) the coons. When a counesy hold is allowed by the USMS to be housed in a USMS celiblock, a minimum alone agent from the arresting agency must be available to respond to the teak& in order to address any issues with their prisoner (e.g.. medkal. disciplinary ). If the arresting agency refuses to comply with USMS procedures. the courtesy bold may be refused. Meals are not provided by the ISMS. and remain the responsibility of the arresting agent(s). ARRF.STF.F. PROCT.SSING CHECKLIST ARRESTEE PROCESSING ClitTIO.IST For Attesting Officer OnlY For Personnel Only 141 . SNI•i ll 2 (Personal )(isn't). of lkfendant) D Confirm all arresting agent documentation is employs' and ‘ledical clearance Ilium licensed physician). it necessary inserted into prisoners fik opy of Arrest Warrant. if issued O 15.312 (Personal History of Defundam). rev/crew/.. urn/run/.Armor awoke /HSI/ M.O Copy of Complaint. Information. or Indictment. if completed ❑ I SM-552 (Prisoner Medical Records Release Form) • O Copy Of Uletainens). if issued comp/wed rignediroiriLms/hr inmActri 111.0 O Copy of Writ. if applicable CI I NNI-Ig (Federal Prisoner Property Receipt - tompleteil ❑ Correctional facility discharge papas. if applicable si)net, tun!datedht intake Ill Sll Ohl) O Correctional facility prisoner receipt. ilapplicable ❑ USNI-10 41 (Prisoner Remand). libelled Mel prisoner'sIlk ❑ Correctional facility medical summary. if applicable O USN1•130 (Prisoner Custody Akn Notice). if applicable - bnerreriinroprisoner's.file Prepared Sy - Name: O ED-249 (Fingerprint Card) - twit:wawa inserted into prisoner's O Prisoner Photograph (km. Booking Package) -114/ trued mar howler/it gilt piee7,6e/e (etechitte) (b) (6), (b) (7)(C) U Perm USIS1•312 I'aµc Rev l I/17 EFTA00040008  STATE 0530E WV SE0:00 54.7347,39703 isup,a7773,air 0.A5.3 Aulknace• STAN L3.3T rW11LLLL. 3.40037. a 5,0Foe 2P2TRIN, J2291222 EDWARD SCeonlint a inroad n7,73( Wan Neuter's:, aht Sun µuSF1\SY111 LA37 vat fig37 OWE. 744,00LE WAL EPSTRIN,JR20223 2 OATI, CI OATH eau CO Y.' let MCI MTIGHT *TICK: PLIS run 01/20/1953 N W 1273 115 SW SRO LI 1133.0 • n 7.740tt EFTA00040009  -..---. --V.... CRIMINAL JUSTICE INFORMATION SERVICES DIVISION, CLARKSBURG, WV 26306 PRI WAD • ACT Of I$71 I0L 953795 REQUIRES THAT FEDERAL STATE OR LOCAL AGENCIES INFORM •NOWIDLIALS WHOSE SOCIAL SECUIRTY NUMBER IS REQUESTED W ST/CH CITSCLOSJITE IS MANDATORY OR VOLUNTARY RASPS OF AUTHORITY FOR SUCH SOLICITATION. AND USES WHIGS WILL BE MADE OF IT JMVAN It FINGERPRINT DATE OF ARREST I OR, SUBMISSION YES 00 VT UNIIT/TITSVFACIARSHALS SERVICE 1111 CONTRIBUTOR A000155 kr_71•1 you. fly Nay 07/08/2019 tale •5 ADULT •II REPLY YES I— Ot/TREOf • —T SEND COP• TO DAIL Of CFI IWO •LACL OF BIRTH STATE OR COUNTRY, COUNTRY OP Cal 10 ,ENTER ORR MM OD v• MT 08 07/08/201, MiSCILLANI SCARS. . TATTOOS. •NO AMPUTATION{ PP 566672615 PP-516923892 PP-469911707 IL A000451 CITY STATE 9 SNOT 91S7 MOM VOldt WE 10011 VI OENTIFTGAT ON, NCR •HOTO ATIAMIMMIT 444 (b) (6), (b) (7)(C), (b) (7 PALM PAINTS TAKEN> TES C AGENCY OCCUPATION m Law., %LH 01 AHD SERIAL NO WOUCIR CHARGETC ON 0 ,100$••ION I 07/0e/2019 369S-Sex Offense 3 •0051,0%., •00.510ITA. ADDIT..ONAL iNFORMATkOmrEASTS FOR CALITIJN STATE BUREAU STAMP F02191RY. 5 T1 0,1)(TUEH U S GOVERNMENT PRINTING OFFICE OW3,20101309 43 EFTA00040010 DOCKET No. DEFENDANT AUSA DEF.'S COUNSEL ❑ RETAINED O FEDERAL DEFENDERS 0 OA O PRESENTMENT ONLY INTERPRETER NEEDED O DEFENDANT WAIVES PRETRIAL REPORT CI Rule 5 O Rule 9 O Rule 5(cX3) O Detention Hrg. DATE OF ARREST O VOL SURR. TIME OF ARREST DON WRIT O Other: TIME OF PRESENTMENT DAIL DISPOSITION O SEE SEP. ORDER ❑ DETENTION ON CONSENT W/O PREJUDICE O DETENTION: RISK OF FLIGHT/DANGER O SEE TRANSCRIPT O DETENTION HEARING SCHEDULED FOR: O AGREED CONDITIONS OF RELEASE O DEF. RELEASED ON OWN RECOGNIZANCE ❑$ PRB ❑ FRP O SECURED BY $ CASH/PROPERTY: O TRAVEL RESTRICTED TO SDNY/EDNY/ O TEMPORARY ADDITIONAL TRAVEL UPON CONSENT OF AUSA & APPROVAL OF PRETRIAL SERVICES O SURRENDER TRAVEL DOCUMENTS (& NO NEW APPLICATIONS) O PRETRIAL SUPERVISION: O REGULAR O STRICT O AS DIRECTED BY PRETRIAL SERVICES O DRUG TESTINGITREATMT AS DIRECTED BY PTS O MENTAL HEALTH EVAL/TREATMT AS DIRECTED BY PTS O DEF. TO SUBMIT TO URINALYSIS; IF POSITIVE, ADD CONDITION OF DRUG TESTING/TREATMENT O HOME INCARCERATION O HOME DETENTION O CURFEW O ELECTRONIC MONITORING O GPS O DEF. TO PAY ALL OF PART OF COST OF LOCATION MONITORING, AS DETERMINED BY PRETRIAL SERVICES O DEF. TO CONTINUE OR SEEK EMPLOYMENT [OR] O DEF. TO CONTINUE OR START EDUCATION PROGRAM O DEF. NOT TO POSSESS FIREARM/DESTRUCTIVE DEVICE/OTHER WEAPON O DEF. TO BE DETAINED UNTIL ALL CONDITIONS ARE MET O DEF. TO BE RELEASED ON OWN SIGNATURE, PLUS THE FOLLOWING CONDITIONS: ; REMAINING CONDITIONS TO BE MET BY: ADDITIONAL CONDITIONS/ADDITIONAL PROCEEDINGS/COMMENTS: O DEF. ARRAIGNED; PLEADS NOT GUILTY O CONFERENCE BEFORE DI. ON O DEF. WAIVES INDICTMENT ❑ SPEEDY TRIAL TIME EXCLUDED UNDER 18 U.S.C. § 316l(h)(7) UNTIL For Rule Man Cases: O IDENTITY HEARING WAIVED O DEFENDANT TO BE REMOVED O PRELIMINARY HEARING IN SDNY WAIVED O CONTROL DATE FOR REMOVAL: PRELIMINARY HEARING DATE: O ON DEFENDANT'S CONSENT DATE: ?5" UNITED STATES MAGISTRATE JUDGE, S.D.N.Y. WWI (onitnal) - COURT FILE PJ016- US. ATTORNEY'S OFFICE YiI IOW V S MARSHAL GRFPN PRETRIAL SERVICES AGENCY Rev 4 2)I TH • 2 EFTA00040011  UMW States Marshals Sarirke - LIMITED OFFICIAL USE Prepared on:0812912019 USM-129 Individual Custody/Detention Report I Name:EPSTEIN,JEFFFtEY EDWARD USMS Number. 76318-054 F1D: 10127184 I. IDENTIFICATION DATA USN'S NUMBER: 76318-054 HAMS: RPSTRIN,JEFFREY EDWARD ADDRESS: 9 EAST 71ST NEW YORK, NY PHONE: 10021 DOB: 01/20/1953 AGE: 66 PUB: BROOKLYN, NY C. / SEX: M RACE: N HAIR: BRO EYE: BLU HEIOOT: 6'00" WRIGHT: 185 SSN: " - (6 1)1 ( q(1 FBI NBR/UCH ALIEN NBR: OTHER NUMBER OTHER NUMBER TYPE ISSUE DATE EXP DATE REMARK Passport Number Passport Number US PASSPORT Originating Police or Identification NY SID $ Number Originating Police or Identification Number Passport Number 03/08/2019 03/07/2029 US PASSPORT * " SPECIAL CAUTIONS REMARKS SEPARATES AND MEDICAL Mental Concerns Suicidal Tendencies TB CLEARANCE STATUS ASSESSMENT DATE EXPIRED NOT CLEARED DNA TEST DATE TAKEN? DEPUTY RENARES/XIT 4 N/A No N/A FBI ARREST DETAINER DATE L/R ACTIVE? AGENCY REMARK .splisis.*. N PRISONER ALIAS ALIAS REMARK EPSTEIN,JEFFREY 6 II. CUSTODY INFORMATION Custody 1 I CUSTODY START DATE: 07/08/2019 END DATE: 08/10/2019 Printed by District: 54 "Limited Official Use" This Infonnabon is the Properly of the U.S. Marshals Sant* end Shall Not be Pubhely Released or Disseminated Without U.S. Marshals Service /Whacky. Page 1of 2 EFTA00040012  United States Marshals Service - LIMITED OFFICIAL USE Prepared ow 08/29/2019 USM-129 individual Custody/Detention Report Name:EPSIONdEFFREYEDWARD IUSMS Number: 76318-054 FID. 10127184 1 CUSTODY STATUS OFFICE START DATE: END DATE REMARK WT-CASE-RESOLVE 054 07/C8/2019 08/10/2019 RL SUICIDE 054 08/10/2019 08/10/2019 COURT CASE 1 DISTRICT OFFICE JUDOS US ATTORNEY DEFENSE ATTORNEY NY/S 500 PEARL ST. 19-CR-00490 (MANHATTAN) WARRANT ARREST DATE ARRESTING AGENCY ARREST LOCATION NUMBER Arrests FEDERAL BUREAU OF 07/08/2019 INVESTIGATION CONE OFFENSE REMARK DISPOSITION Offenses 18 USC 372 SEX TRAFFICKING 3699 Sex Offense Other CONSPIRACY COURT CASE STATUS START DATE END DATE REIARK ARREST 07/08/2019 07/08/2019 WT TRIAL 07/08/2019 08/10/2019 CASE -RESOLVED 06/10/2019 08/10/2019 INST INSTITUTION NAME ADMIT RELEASE BOARDED ACTION OR DISPOSITION NYM MCC New York 07/08/2017 08/10/2019 33 TOTAL DAYS BOARDED 33 (0 BID, 0 NED) III. MEDICAL CONDITION/TREATMENT HISTORY DATE SERVICE VENDOR SERVICE PROVIDED PROVIDED • /• • • **• Printed by District 54 ''Limited Official Usr This Infoonation Is the Property of the U S Marsha Semce and Shall Not be Pubicly Released or Disseminated Without U.S Marshals Service Authority Page 2012 EFTA00040013  L.S. Virgin Islands Ok1VEK,S g pi SE LTTTLE ST. JAMES ST THOMAS VI 00802 se. M .;....get 6.0" F • BLU :e.e 1/20/1953 E r e. 1 , 2O(2O24 ■ 3/6/2019 (b) (6), (b) (7)(C) .EFFREY E crPSTEIN PAM BCH, FL 3460-4730 DO8: 0140495,3 SEX M KOI 6.00 943 s:435 F 'DJI 3905210033 EFTA00040014  Endorsement(s) CLASS: A- Private ORANGE OR 0 DAYS OF ADCRESS REPLACEMENT LICENSE REWIRED = NAME CHANGE rivesbnv vl got ngt""4000, en pk$S truPs' W OP Kytty Flonde ratWis OR ouej erLort: ert r u^fat Yr. 52 noNOMNAM reaMmWs.MMA.A. EFTA00040015  I UnitedHealtheare Health Plan (80840 Member ID Member Group Number: 272605 JEFFREY EPSTEIN SOUTHERN TRUST COMPANY Payer ID 87726 OPIUM - Rx Bin. 610279 Office $20 ER 1200 Rx PCN- 9999 Urgeare STS Spec 130 Rx Grp UHC UnitedHealthcare Choice Plus Underwaen by Unileallealthcave Entrance COMPanY 1-800-MEDICARE (1-800-633-4227) NAME OF BENEFICIARY JEFFREY E EPSTEIN ' b" • I": l (6).(b) (7)(0 sec MALE EFFECTIVE GATE HOSPITAL (PART A) 01-01-2018 MEDICAL (PART B) 02y2018 SIGN asp HERE EFTA00040016  t£09.29E-008-I &Iwo hq p.mo Mau Jnott parttapai encl.! UJ njuOD aseaid 'V^ Ported 12)17 16 1 Ed AVSlilik claims, find We're here to help. Check benefits, view Members: question and more. a doctor, ask a www.myuhc.com Call anytime to speak Web: Advocate4me©uhc.corn with a %Me Email: 800-782-3740 Phone: 800-842-2065 www.UnitedHeatthcareOnline.com Mental Health. 877-1342-3210 or Providers:.ms: P.O.BOX 740800 A TA GA 303740800 Medical Cla Juan,PR 00936-8297 at170297, San PR - MAPFRE - PO p itaa 4MultiPan mApsite ' FuttitatkOle6.«:+ Pharmacists= 888-290-64 i Springs, AR 71903 Pharmacy Claims: OptumRx PO Box 29044 Hot ' ry your card with you when you're at:a, _et your hospital or doctor see your card when you ncu hospital, medical, or health services under Medicare. Your card is good wherever you live in the United State, WARNING: Issued only for use of the named beneficiary. ,ntentional misuse of this card is unlawful and may be punishable by fines, imprisonment, and other penalties. If found, drop in nearest U.S. Mail Box. Questions about Medicare , ot no c' • wok 4tent, • • visit Medicare.gov • call 1-800-MEDICARE Centers for Medicare & (1-800-633-4227); Medicaid Services Battimorta MD 21244.1850 (TTY: 1-877-486-2048) tt- CmSt1966 (04/201s) EFTA00040017 Local Boaters Option Registration Card Name: Number: BR- Mall U.S. Customs and Border Protection ANCE MEDICARE HEALTH INSUR NamelNombre JEFFREY E EPSTEIN Medicare fe Number Nu za Coverage startsiCobertura emple Entitled tolCon derecho a HOSPITAL (PART A) 01-01-2018 MEDICAL (PART B) 02-01-2018 EFTA00040018  To Report Arrival, Call: Puerto Rico 1-877-529--6840 or (787) 729-6840 Port of St. Thomas (340) 774-6755 Port of St. John (340) 776-6741 Port of St. Croix (340) 773-1011 You may be asked to show this card when you get health care services. Only give your personal Medicare information to health care providers, your insurers. or people you (rust who work with Medicare on your behalf. WARNING: Intentionally misusing this ce' may be considered fraud andior other violation of federal law and pumshable by law. Es posible clue le p'dan quo muestre esta tarjeta cuando reciba servicios de cuidado medico. Solamente de su informaciein persor de Medicare a los proveedores de salud. sus aseguradores o personas de su confianza clue trabajan con Medicare en su romtrf iADVERTENCIA! El mal use intencionai de esta tarjeta puede ser cons derado corno fraude y'u otra violacien de la ley federal y es sancionada por la ley. 1-800-MEDICARE (1.800.633.4227 / TTY: 1.877.486.2048): Medlcare.gov EFTA00040019  Mod AO 442 (09/13) Anest vhina AUSA Name Toluca, 212-837-2225 UNITED STATES DISTRICT COURT for the Southern District of New York United States of America v. ) Case No. Jeffrey Epstein Defendant 19Cithl 49a -I ARREST WARRANT To: Any authorized law enforcement officer YOU ARE COMMANDED to arrest and bring before a United States magistrate judge without unnecessary delay (Name ofPerson as? he antes& Jeffrey Epstein who is accused of an offense or violation based on the following document filed with the court: d Indictment O Superseding Indictment Cl Information Cl Superseding Information Cl Complaint Cl Probation Violation Petition Cl Supervised Release Violation Petition O Violation Notice Cl Order of the Court This offense is briefly described as follows: Tide 18, United States Code, Section 371 (sex trafficking conspiracy) Title 18, tinned States Coda, Sections 1591(a), (b)(2), and (2) (sex trafficking of minors) Date: 07/02/2019 City and state: New York, NY The Honorable Barbara Moses,l).S, Maglitrate Judge Printedmanse ands/fie Return This warrant was received on (done) , and the person was arrested on (date) at (sip andstate) Date: Mewing officer's signature Printednone and(ilk EFTA00040020  UNITED STATES DEPARTMENT OF JUSTICE UNITED STATES MARSHALS SERVICE SOUTHERN DISTRICT OF NEW YORK Before any arrntee can be ARFOTEE INFOR$ATION processed by the USMS any and all This form mum be complete medical probleniskoaditions must d for each arrestee sad given to the be declared. responding USMS personnel befo will be received for processing. re the a termite Arrester name: 7 2FroCi fi tdert.Ceig Does arreste have a prior arrest? Circle: NO If yes, please list the urestee's USMS number. If you cannot identify USMS number, please provide arrest information (IE: date, arresting agency, location) Arrestee's representation for this days proceeding: (Circle) Legal Aid If legal aid, has arrester met CIA with counsel? Circle: YES NO Does the arrester have any curre nt detainers? Circle: YES If yes, please list: Doe arrester have and tong to ..iedical condition or cond (to include: lei 1problems e bees, asth tuberculosis, HIV, AIDS, hepatitis mr etc)? Circle: YES Does arrester require medicati on/medical attention for this condition? Circle: Do you, as the arresting YES NO frailly possess at least one days dosage of Circle: YES the arres tee's medication? Explain: Does arresiee have/display/Loma any other medical aikr.:nts(IE: brok Circle: YES NO en bones, open wounds etc.)? Does arrester require medicati on/medical attention for this condition? Do you, as the arresting Circle: YES NO rrently possess ig least one days dosage of Circle: YES the arrestee's medication? Explain: Is the arrester a drug addict/us er? Circle: YES NO If yes, does this require any spec ial medical prog ram (IE: methadone treatment)? Explain: Do you. as the arresting agent,Efist,licab le, possess a medical cleanesce/ftt for confinement professional? Circle: YES NO) (Plea letter from a healthcare se attack) ARRESTEE PROCESSING CHECKLIST 11 ave you completed any and all USMS paperwork. To include: USMS 312 (Please 1W oat all (onus as completely as possible) Attache' a photo of arres:ce to paperwork. 3. Fingerprint cards °I for USMS file °I for the FBI for FPC classification /Filled out and attached the BOP-9. 5. Strip searched arrester. _6. Taken any A AGENCY: ING eVIT: sf(b) (6), (b) (7)(C )., (b) (7)(F ) CONTACT II WHILE IN THIS BUILDING: NOTE TO ALL ARRESTING AGENTS Bo advised, the USMS provides the COURTIS of t Inkling sad modals( nista prior to the arrm court appearance. However, theenine Soo ter's magistrate t rommidered a USMS printer arta a U.S. Mag said arrester to USMS custody. This me istrate Judge WANDS w that as the arresting agent. you most be to any cad all matters conarrakag you available at all tines to respond r arrester, as you are the responsible party. tinnedStores Wisher Stroke Polity and Prot-EthanMan ua .1.1-1.k) EFTA00040021  wawa states Marshals Service (USMS) PRISONER MEDICAL RECO RDS RELEASE FORM :?4:;raUCTIONC:osa,inn, ; is w tw ctstupivivi by tin: ISSIviS intake completed by the prisoner. Sec Officer. Sections ii ee !ii tion It may be completed by are to be or unwilling, but Section the USMS Intake Offica III must be signed by the prisone if the prisoner is unable signature block. All refusals r. If prisoner refuses to sign • should be immediately reported to , note that in the Prisoner Services Division. the Otf tce of Interagency Me The completed USM form 552 is to dical Services. be retained in the prisone r's files, Section I - USMS Prisoner Informa tion I. nisoner Name (Last. Firs t. MO 2 USMS Prisoner c .7 0/ - d tcJe Fre e 3. CY riet Name 103 t? / 4 Diann it 5 Cu,' gy ts o SPA T Ocr 7 Section I! - Prisoner Personal Data And Medlesi Information 6. Dale Of Birth lMolbaylYr) r 0 -- S 2- S. Medical Insurance Information Ay buitrawc comgany Same , ofoth.t.#1714 10 Motu Number Section III - Medical Consent And (b) (6), (b) (7)(C) Records Release I entity 'tot the inform:Wool have provided above is trac Iodic bat ofmy knowledg e. I hereby senhaire the United States Mar shal SCIVIDC to request review. and haw aec rne daring the time that I am in she aural) as to all medical records ofcaw ,ofdui agency. sod to all other medal recc providing me with appropriate medic:alarm e& deemed necessary for the perivulett to . Audicatingmedial bills for beakte earc purp oftit gaited Is Serviee.and for infectious disease galas provided la me while ir4d oses of ie custody Original —Prisoner File Copy to District File Cupy coon Transfer Iwg,11%.4.462 l 4 * 4•11 Arant/i4 4.111 EFTA00040022  United States Marshals Barnes • MUTED OFFICIAL USE Prepared on:07/0812019 Booking Package Photos OBBB FORUM 76310-050 FBI• cd Arra 7 2019 ORIt NYUBM0300 FBI Nuaber/UCNt Last Neat EPSTEIN First Rases JEFFREY Middle Name: EDWARD Best Pt Height:6'00" Bye Color: BLU Race Cods: W Weights185 LBS Bair Color: BRO DOB. 01/20/1953 View FRONT Date Taken:07/08/2019 "Limited Official Use" Th s Inforrration is the Properly of the U S Marsha Service and Shall Not be Publicly Released or Orsseminated Without U S Marshals Service Authority Page I of 3 EFTA00040023  United States Marshals Service - LIMITED OFFICIAL USE Prepxp.t on 07, nC. Booking Package Photos View : RIGHT Data Taken:07/08/2019 "Limited Oficial Use" This Informal:on is the Property oldie U.S. Marshals Sennce and Shall Nol be Publicly Released or Disseminated Wahout L.S Marshals Service Aurnoiny Page 2 ci 3 EFTA00040024  UMISSUSealeshaisSmoke-UMITEDGMCMLUSE Promised on.070492019 Booking Package Photos MINS NUMBER: 76318-054 Date of An 9 011: NYUSN0300 POI Mumber/0Cat Lest Name: PPSTRIN First Name: JEFFREY Middle Name: EDWARD Sex: N Reightr6'00• Eye Colors BLU Race Code: W Weights18S LBS Nair Colors BR0 000: 01/20/1953 "Limited Official Use" This Information is the Properly of the U.S Marshals Service and Shall Not be Publicly Released or Disseminated Without U.S. Marsha's Service Authority Page 3 of 3 EFTA00040025 POD Forms - LISM552 I Page 1 of POt. Corm! • PopeS • I S. Department of Juliet Fete Out :8/8/7018 aged States Marshals kis ice at$MM PRISONER MEDICAL RECORDS RELEASE FORM Dotoetnt Number: 84(6.1" 1 INSTRUCTIONS: Section 1. II & III is to be compkied by the USMS Intake Meets Sectitiel Ill new be stirred b) the peiminer I I %NI% t. I I. Prisoner %mine I Lul. Pint. LID: 2.1.511.5 Putout: 3. Dotter Birth (‘la Dail) •• it IPSTE 011.01KY COWARD 7011140.1 i,ions, 4. Disirks N: !L District Sante & (Dike 54 Scollotto 04100011404 400 SOO KM. ST I . .', ...o. 1nit 7. Italica' Insurance Coverage 0 Medical Insurance Irionnanoo Insermice Company Same: unites S.Mecn C) Same °floor Ph) Os Phone humility: Mm• MMOWit • B. hledkarr/Medicaid Co•erege! O 1M 0 %o 5..tlino Ili I 5 ,..I Hi 04% R.I. i.• C010.5 thOt the 1111001131100 I haw pukka Soren RUC to the best of ni) know Wye I hit+t awborire the Vniled Stars Marshals Semite to 404004. ICS leo. IOW Made access be all inestwal recoils of care pot Wed to me 40 tot: the lime teal ism in the custody of that erne). and mall other medical records droned necessar) for the purports of pros ;ding me with appropriate medical cxc. ilif toltoottog medical bills Co. hahh case semis prattled to me while in the custody *film United States Macshalt Seri and fe• infectious it maw ckaraiwts Stammerer:of Primmer: Dale: