U.S. PASSPORT RENEWAL APPLICATION FOR ELIGIBLE INDIVIDUALS C.-:.;noccrp.RTRAcA.Toz uolff40-0220DS9 Document EFTA00316246
Case File
efta-efta00316230DOJ Data Set 9OtherDARREN K. INDYKE
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta00316230
Pages
16
Persons
0
Integrity
No Hash Available
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
DARREN K. INDYKE
DARREN K. INDYKE, PLLC
575 Lexington Avenue, 4th Floor
New York, New York 10022
Telephone: (212) 971-1314
Telecopier: 646 350-0378
email:
May 25, 2016
VIA FEDERAL EXPRESS
G3 Global Services, LLC
Attn: Leydy Jimenez
388 Market Street
Suite 1520
San Francisco, CA 94111
Re:
Second Valid Passport
Dear Ms. Jimenez:
As directed by Hugo Nevarez of your San Francisco office, we have enclosed
the following documentation in connection with the request of our client, Jeffrey
Edward Epstein, for the re-issuance of his second valid U.S. passport:
1. An order form for Concierge Level Service;
2. A copy of the information page from Mr. Epstein's primary passport book;
3. An original second valid U.S. passport of Mr. Epstein, due to expire June
29, 2016;
4. Mr. Epstein's signed U.S. passport Form DS-82;
5. An envelope containing one (1) passport photograph of Mr. Epstein;
6. Four (4) completed and signed Letters of Authorization from Mr. Epstein;
7. A pre-printed Department of State, San Francisco Passport Agency form
regarding Mr. Epstein's request for Issuance of a 2 year passport which
has been signed by Mr. Epstein;
8. A letter signed by the general counsel of Mr. Epstein's employer
explaining the need for Mr. Epstein's second valid U.S. passport, including
confirmation of his upcoming travel plans; and
9. A letter signed by Mr. Epstein in support of his request for a second valid
U.S. passport
Please confirm receipt of this letter and the enclosed materials by email to
Darren K. Indyke, Esq. at
and advise if any further information or
materials are required in order to process Mr. Epstein's Concierge Level Service
EFTA00316230
request for a second valid U.S. passport. Please also note that processing should be
on a "Mission Critical" basis for which payment is provided on the enclosed order
form.
Sincerely,
clAwk,
Bebe Avdiu
Legal Assistant to Darren Indyke
Enclosures
EFTA00316231
Send to: G3 Global Services
Attn: Passport Department
388 Market Street. Suite 1520
San Francisco rA 44111
877.898.1203 I
SAN FRANCISCO
SECOND VALID PASSPORT
Your invoice will be sent to your contact email. • Check here if you require a hard copy included with your return delivery.
tayment
Information
0 Payment Via Check N:
g Payment Via Credit Card:
%se/MasterCard: BROB-11090 E10-000B
Exp. Date: 1 1 / 1 9 Security Code ERN
OR
American &pre=
Check puyahe to
GOON SerWas
_000.000000-00000
UP. Date:
/
Security Code: 9900
Name as it appears on the card:
Darren K. Indyke
Billing Address:
NY
Signature: ~CSL A.14 r1
0 Payment Via Approved Billing Terms
63 Customer Number. Billing. P.O., Project or Reference Coder::
Concierge Service Requests,
Total Fees from Applicable Fees Page
FEE
It Travelers
TOTAL
Concierge Fee $175.00
$175.00
US Government Fee $170.00
$170.00
63 Service Fee $275.00
$275.00
Passport Protection Plan $40.00 X
$40.00
Return Delivery Fee $5.00
Subtotal $665.00
Add 5% for credit card convenience fee $37.20
Total Payment Enclosed $702.20
Traveler Inforniation
Traveler 1 Name: Jeffrey Edward Epstein
Traveler 2 Name:
Date of Birth: 01/20/1953
Date of 8irth:
Passport Service
Service:
lt)Je Second Valid Passport (Book Only)
Second Valid Passport (Book and Card)
Processing Speed x. Mission Critical
Priority i Expedited
Details
Date of US Departure: ANTICIPATED 06/_/2016
I I must have my passport no later than: 06/__/2016
Other visa or passport services requested:
Notes:
Contadt Informi
Name: Darren K. Indyke
Contact Email (required):
Daytime Phone:
Company Darren K. Indyke, PLLC
Mobile Phone:
Return Delivery Address
Name Darren K. Indyke
Street Address:
MY: New York
Comfant Darren K. Indyke, PLLC
State NY
IIp code:l oon
:CO AO ODAIDOMI 31VO
0
z
0
Cm
Daytime Phone: 212 971 1314
Mobile Phone:
EFTA00316232
t
m
Send to: G3 Global Services
Attn: Passport Department
388 Market Street, Suite 1520
San Francisco, CA 94111
877.898.1203 I SanFranciscoeg3visas.com
SAN FRANCISCO
SECOND VALID PASSPORT
There is No Substitute for Experience.
Special Services
4t.i Concierge Service $175.00
,ot Passport Protec...an Ran $40.00
US Govemment Fees_
Second Valid Passport (Book Only)
Second Valid Passport Book and Passport Card
Mission Critical 3 Business Days
Service Type
Passport Renewal
0%275.00
assport Processing
•0 S170.00
0$200.00
Priority 7 Business Days
- 3$195.00
Expetited 12 Business Days
0$110.00
Return Delivery Fee -
O FedEx Express Saver
$19.00
O FedEx First Overnight*
$84.00
3 Business Day Delivery
Delivery Next Business Day by 8:30AM
O FedEx Standard Overnight
$29.00
O FedEx Saturday Delivery*
$44.00
Delivery Next Business Day by 3PM
_ Delivery by 3PM
O Same Day Delivery*
FedEx International Delivery'
Delivery by FedEx or
Please Call
Including Puerto Rico
Please Call
Commercial Airline
Delivery Times Vary by Location
FedEx or UPS Account Number Provided
O FedEx or UPS Return Airbill Included
$5.00
No Charge
455692741
*These services may not be available for an delivery locations.
r
Passport Protection Plan
moo eta
If your passport is lost, stolen, or damaged, G3 will replace it without charging our standard service fee.
G3's Passport Protection Plan includes the following benefits:
Application Creation: Our experts will create your paperwork for you to ensure that it meets the requirements of
the passport agency, allowing you to avoid delays and additional stress.
Expedited Passport Processing: Your new passport will be issued at our expedited processing speed. If
desired, you may upgrade to a faster service by paying the price difference at the time of claim.
Personal Attention: Upon receipt of your materials, we will hand-carry your documents to the passport agency.
then pick up your completed passport and review it for accuracy.
Long Term Validity: Your Passport Protection Plan is in force unti the day your passport expires.
International Support: if your passport is lost, stolen, or damaged while you are outside of the US, G3 will create
your passport applications and provide you with scans of your lost passport so you can have your passport issued
in person at the nearest US Embassy or Consulate.
G3's Industry-Leading Standard of Service: Our experienced staff will provide persona communication and in-
depth knowledge to ease your mind and resolve your concerns.
Posoiott Protocton Plan does not envoi t$ Cowmen Fees. shircing fees, o felixement 0 herd visas Ottestions? Cortbit
Send Completed Order Form and All Required Documents To:
C,
0
G3 Global Services, Attn: Passport Department, 388 Market Street, Suite 1520, San Francisco, CA 94111 .4
415.762.8268 Phone 1 877.898.1203 Toll Free 1415.762.8269 Fax I [email protected]
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UNITED STATES OF AMERICA
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EFTA00316235
U.S. PASSPORT RENEWAL APPLICATION FOR ELIGIBLE INDIVIDUALS cmealconlaie
Please Print Legibly Using Weak ink Only
ISTIMATED !PROM CUIN
Attention Read WARNING
Please select the document(s)
al U.S. Passport Book
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U.S.
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Cia 28 Page Book (Standard)
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for
Passport
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Mrs
page 1 of instruchans
which you are applying:
Card
Both
Poirot eicaubon see eve 1 of =Oaf&
Pape Book (Nonstandard)
aq ple0Palveldllspenott anddleCcoanoteol
1. Name Last
no Hop DOTS Code
EPSTEIN
End. •
Exp.
First
Mkldb
JEFFREY
EDWARD
2. Date of Birth (ma-W*10W
3. Sex
A Mace of Birth (Ory & State din the U.S., Or City d Cooney as A a presently known)
M
F
01
20
1953
X
NEW YORK, NY
5 Social Security Number
6. Email Address (e.g my_emangdontnin con)
IIMPI
[email protected]
8. Mailing A
.
.
. P.O.
Box. or URB.
7. Primary Contact Phone Number
6100 RED HOOK QUARTER, B3
Address Lire 2 Clearly label neartMent. Company, Suite, Unit. Striding. Floor. In Care Of or Attention if applicable. (e.g.. In Cora Of - Jane Doe, Apra 100)
City
State
Tap Code
Country. if outside the United States
ST THOMAS
VI
00802
9. List all other names you have used. (Examples' Birth Name. Maiden. ProwouS Manlove. Legal Name Change Attach additional pages if needed)
B
10. Passport Book and/or Passport Card Information
Your name as ported on your most recent U.S. passport book and/Or PassPeft card
JEFFREY EDWARD EPSTEIN
Moot recent passport book number
Issue date (mrnitidtyy)y)
516923892
06/30/2014
Most recent passport card number
Issue date (inintlayyyy)
11. Name Change Information Complete if name is afferent than last U.S. passport book or passport cord
Chanced by Marne*
Pi0ce of Name Change (CrisrState)
Date MunkkiiIWY/
Cheeped by Can Omer
PPaio :viola a conttorl copy (Photocopies sae not accepted!)
CONTINUE TO PAGE 2
►
YOU MUST SIGN AND DATE THE APPLICATION IN THE DESIGNATED AREA BELOW
declare under penalty of parr: ny az of the loiewing. .0 I am a cozen or non-otzen natorol or the tinged Saes and have not. lance acquenaUScazenahe or riatonaity.
Cedeffiltd any et W. nch Wee %MOW 'Ads of Condemn' on poste fos of tie ostnictiOns of ess applicator! (sons cipletotoiy atistor nail n doomed), 2) me statements made
on Me apple:Men aro true and come: 3) 1 nave not knozmoy and vnalully made bile Polocnonts a or.kitleil raise sissiointoin
support or tut aA•eaeon.
tne Octoroon
sub need Val U's areszeten s a genuine. current photograph of me, and 5) I have read and tederstood Sr wane on page one of the intim:lions oa ea emanation lorm
,_
L
5 -DS - 1
_.
*OPIUM'. Isfiff .4,
Os
FOR ISSUING OFFICE ONLY
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Data el lam sperd'acc booze
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From
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Date Filed/Cart
For tssun206:2 Or*
Pik Fee
Cd Fee
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POOPS*
Orme
OS-82 08-2013
Pagel of 2
EFTA00316236
Name of Applicant (Last Pirst & Afddlo)
EPSTEIN, JEFFREY EDWARD
12. Height
13. Hair Color
14. Eye Color
15. Occupation
sec. inn. GRAY
BLUE
BANKER
_ .
17. Additional Contact Phone Numbers
I-
C441
wav
Date of Birth (reolkiWYWY)
01/20/1953
16. Employer or School Of Wptcabiet
SOUTHERN TRUST COMPANY
Hone
CW
vett
18. Permanent Addmss: I/P.O. Box is esled under Marling Address gril fealties= Is ditleient from Meiling Oddest
StmetIRFD S or URE (No P.O.
AllaittnentAJnit
City
Stale
rip Code
19. Emergency Contact - Awed* (be intonnetton ofa person not ttoyeang 144th you to be contacted h the owns of an emergency
Nano
Address' StreettRFD # or.
Box
DARREN INDYKE
City
20. Travel Plans
State
Zip Code
Departure Date (Intriddlyyyy)
Return Date (mtniddfyyyy)
Countries to be waited
ApartmenttUnit
Phone Number
Relationship
ATTORNEY
STOP! YOU HAVE COMPLETED YOUR APPLICATION
BE SURE TO SIGN AND DATE PAGE ONE
~l1IlIIIIII !!!VIII!
DS-82 08-2013
Paoe 2 of 2
EFTA00316237
-
\astidet.
EFTA00316238
GO TO RUSSIA
877-898-1203
Letter of Authorization
Please carefully read the information below before completing this Letter of Authorization.
An individual's personal information cannot be released by the U.S. government to another party without
the written consent of the individual under the provisions of the Privacy Act of 1974 (5 USC 552a). As a
result, an employee at a U.S. passport agency cannot discuss the details of your passport application with
a third party without your written consent.
Please check all that apply:
/
I authorize the company stated below to submit my passport application to a passport agency and
pick up the passport from a U.S. passport agency on my behalf.
71 authorize the passport agency to disclose to the company listed below any requests for further
documentation and/or information that that may arise in connection with my passport application,
and I authorize the company to respond to such requests under my direction.
0 I do not authorize the passport agency to disclose to the company listed below any requests for
further documentation and/or information that may arise with my passport application. I want the
passport agency to contact me directly should an issue arise with my passport application that
concerns matters other than the date on which the passport will be ready for pick-up from the
passport agency.
Applicant Information
(Note: All of the information below may ONLY be filled out by the applicant, parent, legal
guardian, or person legally acting in loco parentis)
Applicant Name: et
-f raNi ,30712ai
N.A_VACN
(Last Name, First Name, Middle Name
Applicant Phone No:
I
Courier Company Name: 6G TO IC iSS LA
Applicant Signature:
Date: 0 --3 -05
—
ILD
(MM/DD/YYYY)
(If the applicant is under the age of 16, a parent, legal gu
an, or person legally acting in loco parentis
must sign)
EFTA00316239
GO TO RUSSIA
877-898-1203
Letter of Authorization
Please carefully read the information below before completing this Letter of Authorization.
An individual's personal information cannot be released by the U.S. government to another party without
the written consent of the individual under the provisions of the Privacy Act of 1974 (5 USC 552a). As a
result, an employee at a U.S. passport agency cannot discuss the details of your passport application with
a third party without your written consent.
Please check all that apply:
EA authorize the company stated below to submit my passport application to a passport agency and
pick up the passport from a U.S. passport agency on my behalf.
/
authorize the passport agency to disclose to the company listed below any requests for further
documentation and/or information that that may arise in connection with my passport application,
and l authorize the company to respond to such requests under my direction.
0 I do not authorize the passport agency to disclose to the company listed below any requests for
further documentation and/or information that may arise with my passport application. I want the
passport agency to contact me directly should an issue arise with my passport application that
concerns matters other than the date on which the passport will be ready for pick-up from the
passport agency.
Applicant Information
(Note: All of the information below may ONLY be filled out by the applicant, parent, legal
guardian, or person legally acting in loco parentis)
Applicant Name: 0- 73-rei
-cerr2F\.,t Ent.,O(12.N
(Last Name, First Name, Middle Name)
Applicant Phone No:
(Area Code-XXX-XXXX)
Courier Company Name: a)
1O 2LISSDor
Applicant Signature:
Date: O7 —a5 —001(0
(MM/DD/YYYY)
(If the applicant is under the age of 16, a parent, legal guardian, or person legally acting in loco parentis
must sign)
EFTA00316240
G3 VISAS & PASSPORTS
Tel. 888.883.8472
passportseg3visas.com
Letter of Authorization
Please carefully read the information below before completing this Letter of Authorization.
An individual's personal information cannot be released by the U.S. government to another party without
the written consent of the individual under the provisions of the Privacy Act of 1974 (5 USC 552a). As a
result, an employee at a U.S. passport agency cannot discuss the details of your passport application with
a third party without your written consent.
Please check all that apply:
SI/ I authorize the company stated below to submit my passport application to a passport agency and
pick up the passport from a U.S. passport agency on my behalf.
Et/ I authorize the passport agency to disclose to the company listed below any requests for further
documentation and/or information that that may arise in connection with my passport application,
and I authorize the company to respond to such requests under my direction.
I do not authorize the passport agency to disclose to the company listed below any requests for
further documentation and/or information that may arise with my passport application. 1 want the
passport agency to contact me directly should an issue arise with my passport application that
concerns matters other than the date on which the passport will be ready for pick-up from the
passport agency.
Applicant Information
(Note: All of the information below may ONLY be filled out by the applicant, parent, legal
guardian, or person legally acting in loco parentis)
Applicant Name: C
irit.3731-FraTti riScA-iPeb
(Last Name, First Name, Middle Namei
Applicant Phone No:
(Area Code-XX X-X XXX)
Date: 05-05-0,:oicn
(MM/DD/YYYY)
CourierCompany Name: C.23 UISPS
PrTZPOETS
Applicant Signature:
(If the applicant is under the age of 16, a parent, legal guardian, or person legally acting in loco parentis
must sign)
EFTA00316241
G3 VISAS& PASSPORTS
Tel. 888.883.8472
[email protected]
Letter of Authorization
Please carefully read the information below before completing this Letter of Authorization.
An individual's personal information cannot be released by the U.S. government to another party without
the written consent of the individual under the provisions of the Privacy Act of 1974 (5 USC 552a). As a
result, an employee at a U.S. passport agency cannot discuss the details of your passport application with
a third party without your written consent.
Please check all that apply:
l97 I authorize the company stated below to submit my passport application to a passport agency and
pick up the passport from a U.S. passport agency on my behalf.
authorize the passport agency to disclose to the company listed below any requests for further
documentation and/or information that that may arise in connection with my passport application,
and I authorize the company to respond to such requests under my direction.
0 I do not authorize the passport agency to disclose to the company listed below any requests for
further documentation and/or information that may arise with my passport application. I want the
passport agency to contact me directly should an issue arise with my passport application that
concerns matters other than the date on which the passport will be ready for pick-up from the
passport agency.
Applicant Information
(Note: All of the information below may ONLY be filled out by the applicant, parent, legal
guardian, or person legally act ng in loco parentis)
Applicant Name: ERSTEINI. cir.-r2Ek.4 EN-on Cb
(Last Name, First Name, Middle Name) )
Applicant Phone No
(Area Code-XXX-XXXX)
Courier Company Name: C--)3 \ITS'AS 9'
Applicant Signature:
(If the applicant is under the age of 16, a parent, legal
must sign)
Date: CD--e-M) &GI (di
(MM/DD/YYYY)
PAS'SPoetS
or person legally acting in loco parentis
EFTA00316242
United States Department of State
TO: U.S. Department of State
San Francisco Passport Agency
RE: Request for issuance of a second 2 year passport
I, the undersigned, am the bearer of valid U.S. passport
number 51 (oci D38c1(9.
(number)
issued on
:D-JD,620q,
(date)
In view of the restrictive entry policies of one of the countries that I will be
visiting, or prolonged processing delays required to obtain visas for my
current travel, it is impossible for me to complete my trip utilizing my
current passport.
Consequently, I am requesting the issuance of a second passport to facilitate
my travel to the countries provided on my passport application.
I
understand that one passport will be limited for two years and that I may
reapply at the end of that period if my need to travel to the aforementioned
countries continues.
Should either passport be lost or stolen, I will report the circumstances
immediately to the Passport Office or the nearest U.S. Embassy/Consulate.
NAME: 7e-ficcr-€4 Ev:4-e
(Please 'Print‘Name Legibly)
SIGNATURE:
EFTA00316243
DARREN K. INDYKE
DARREN K. INDYKE, PLLC
575 Lexington Avenue, 4th Floor
New York, New York 10022
Telephone: (212) 971-1314
May 25, 2016
U.S. Passport Office
Department of State
To Whom It May Concern:
Jeffrey Edward Epstein is the President of Southern Trust Company, Inc., an international
financial firm, and travels internationally with great frequency. As a consequence, his
passport is with him when he travels abroad, and he cannot obtain visas for the trips that
are planned while he is out of the country, which causes undue hardships and much
inconvenience. In addition, on extremely short notice, he is frequently requested to
schedule international trips with itineraries to multiple destinations requiring him to
obtain multiple visas at the same time, which is simply not possible on such short notice
without a second passport. It was for these reasons that the U.S. Passport Office
previously issued Mr. Epstein a second passport. However, that second passport will
expire on June 29, 2016.
Mr. Epstein anticipates an extremely rigorous international travel schedule. In the
immediate future, he is scheduled to travel to France on June 13, 2016, and we also
anticipate him being required to travel on June 20, 2016 to Belarus for business mailers.
He will therefore need to obtain a visa for Belarus, and likely other countries, while
traveling with his current passport in his possession, and respectfully requests that a
second valid U.S. passport again be issued to him. We understand that the passport will
only be valid for a limited period. If you have any questions, please feel free to call me at
212-971-1314.
Should either Mr. Epstein's original 10-year passport or, if issued, his limited validity
(second valid) passport be lost or stolen, he will report the circumstances immediately to
the Passport Office in Washington, DC, or, if abroad, to the nearest U.S. Embassy or
Consulate.
Thank you for your assistance with this matter.
Incerely,
Darren K. Indy e
General Counsel to
Southern Trust Company, Inc.
EFTA00316244
SOUTHERN TRUST COMPANY, INC.
6100 Red Hook Quarter, B3
St. Thomas, USVI 00802
May 25, 2016
U.S. Passport Office
Department of State
To Whom It May Concern:
I am the President of Southern Trust Company, Inc., an international financial firm, and
travel internationally with great frequency. As a consequence, my passport is with me
when I travel abroad, and I cannot obtain visas for the trips that are planned while I am
out of the country, which causes undue hardships and much inconvenience. In addition,
on extremely short notice, I am frequently requested to reschedule international trips with
itineraries to multiple destinations requiring me to obtain multiple visas at the same time,
which is simply not possible on such short notice without a second passport. It was for
these reasons that the U.S. Passport Office previously issued me a second passport.
However, that second passport will expire on June 29, 2016.
I anticipate an extremely rigorous upcoming international travel schedule. In the
immediate future, I am scheduled to travel to France on June 13, 2016, and also anticipate
travel on June 20, 2016 to Belarus for business matters. I will therefore need to obtain a
visa for Belarus, and likely other countries, while traveling with my current passport in
my possession, and respectfully request that a second valid U.S. passport again be issued
to me. I understand that the passport will onl be valid for a limited period. If you have
any questions, please feel free to call me at
Should either my original 10-year passport or, if issued, my limited validity (second
valid) passport be lost or stolen, I will report the circumstances immediately to the
Passport Office in Washington, DC, or, if abroad, to the nearest U.S. Embassy or
Consulate.
Thank you for your assistance with this matter.
Sincerely,
EFTA00316245
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View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Domain
passportseg3visas.comDomain
sanfranciscoeg3visas.comEmail
[email protected]Email
[email protected]Email
[email protected]Flight #
AS9Phone
(212) 971-1314Phone
1 877.898.1203Phone
1415.762.8269Phone
16923892Phone
212 971 1314Phone
212-971-1314Phone
415.762.8268Phone
5192537737Phone
5692741Phone
646 350-0378Phone
877-898-1203Phone
877.898.1203Phone
888.883.8472Wire Ref
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