Case File
efta-efta01111782DOJ Data Set 9OtherRegistration No: 353899
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Unknown
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DOJ Data Set 9
Reference
efta-efta01111782
Pages
6
Persons
0
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Registration No: 353899
Person Number: 73274
FDLE SEXUAL PREDATOR/OFFENDER REGISTRATION FORM
Agency Name: Palm Beach County SO
***** Note: Your next ReRegistration month is July of 2011 *****
Registration For: January 2011 - SEXUAL OFFENDER
Reason For Registration
El Initial Registration
0
Scheduled ReRegistraban
O Intonnattan Update
O Early/ ate ReRegistration
Registrant Information
Name:
JEFFREY E EPSTEIN
*SSN: =MI
DOB: 01120/1953 Race:
White
Sex: Male
(First Middle Last. Suffix)
'Disclosure of your Social Secure), Number (SSN) is mandatory pursuant to Florida law. sertlons 77621.943.0435, 944.807, 085.481, FS.. end federal law. 42 USC 16901. et
seq. Use of your SSN is for the purposes of identificatian.FDLE may share the information with the other agencies let the same purpose.
FL DL or ID Card #: E123425530200
Height. 6' 00'
Weight: 180 lbs
Hair
Grey
Eyes:
Blue
Place of Birth: United States Of America (usa)
Comely on Probation/Parole:ado
O Yes
Probation Type:
O State
O Federal
O
County
Sins
City
Officer Name:
Phone: ( )
Officer Name:
Phone: ( )
Officer Name:
Phone: (
)
County
Out of State Travel Information (Complete if permanent, temporary, or transient address is out of state)
Permanently leaving Florida to establish a residence in another stale
0
Temporarily leaving Florida to visit another state
0
Moving from another state to permanently establish a residence in Florida
Visiting from another state and establishing a temporary address in Florida
1 .) 41 )cHa- —
C." ho
t)/
Other (please describe):
will be at temp address tram
Date of Departure:
Date of Arrival Imereem. c thothi
e.X
Previous Permanent Address
Current Permanent Address
6100 Red Hook Ouarter4Sle 83
(Address Lino I)
(Address Line 1)
Little St James Island* 4._
(Address Line 2)
(Address Line 2)
St Thomas
VI
00802
(Coy)
County:
(SIMs)
(a)
End Date:
(City)
(Stale)
(Zip)
County: St Thomas
Stan Date: 07/19/2010
01 do NOT have a permanent address at this time.
Page 1 of 6
201141.16102209 AM
EFTA01111782
Registration No: 353899
Person Number: 73274
Temporary Addresses • I do NOT have a temporary address
Please noto: The registrant has reported additional temporary addresses not displayed here.
1. 49 Zorro Ranch Rd
Stanley
—
From:
NM
87056-9743
(Zg)
To:
(Street Address)
(City)
County: Santa Fe
Dates you will be at this address:
(State)
2. 22 Avenue Foch 2dd
Pads
TY
00000
(Street Address)
(Coy)
County-. Paris
Dates you will be al this address:
I
From:
(State)
(Zip)
To:
3. 9 E 71st St
New York
NY
10021.4102
(Street Address)
(City)
County: New York
Dates you will be at this address: From:
(State)
(Zip)
To:
.
-
-
358
a
r3vt
eat g- Pst• -•
Co • Stil
334>f
Transient Addresses 0 I do NOT have a transient address
1.
Dates you will be at this address: From:
(State)
(Street Address or location)
County:
(City)
(Zip)
To:
2.
(Street Address or location)
County:
(City)
Dates you will be at this address: From:
(State)
(Zip)
To:
3.
(Street Address or location)
County:
(City)
Dates you will be at this address: From:
(State)
(Zip)
To:
Employment
ii l am currently unemployed.
1. Employer: 8.8se- v ivzocinA ,--p.v.4_ (avian: 40c.
Occupation. Owner
sten Date:
Address: 6100 Redhook Quarter Ste 93
SI Thomas
YY
00802
(Street Address)
County:
LISYirgin Islands
(City)
Contact Person:
(Stale)
(Zip)
2. Employer:
Occupation:
Start Date:
Address:
(Street Address)
County:
(Grey)
Contact Person:
' (Stew)
(Zip)
r
3. Employer.
Occupation:
Start Date:
Address:
(StreetAddress)
County:
(City)
Contact Person:
(State)
(Zip)
Page 2 ol 6
2011-01.1810:27.09 Akf
EFTA01111783
Registration No: 353899
Person Number: 73274
Mailing Address
0 -157no as Permanent
0
Same as Temporary
Phone Numbers Please note: The registrant has reported addiiiontl
phones not displayed here.
D I do NOT have or use any home or mobile phone numbers
a.iiar -1-e
1
2
3
4
5
Phone Number.
Phone Type:
Sles-
SISIMIS (c2 ton ietO kirk
V'
(Address tine a.
t .&
t" — 3
Home
(Address Une 2)
V I
caw -:)_.
timakik- SA-1w MALLS
Ste.
aeilli.•
Motile
(IT) i eriAit:rVA
ttptA iell
(S
iSle)
(7-0)
Canty:
End Cele:
imilolliller
Fax
Vehicles
El I do NOT own or use a vehicle. RV. trailer or mobile home.
Please note: The registrant has reported additional vehicles not displayed here.
1. 2005
Cadillac
& rola:e.:I raidet_
&wk.
Truck
(Year)
0:141 ct 4tre.
(Make)
.FL
This vehicle is:
(hlodei)
0
NOT used as a residence
(Color/Cora-Scheme)
0
Used as a residence
(White Typo)
(License Tap II)
(Mete)
2. 2002
Mercedes-benz
500 Series
Black
Auto
(Yew)
C165-413
(Make)
FL
This vehicle is:
(Model)
El NOT used as a residence
(Cokir/Color Scheme)
0
Used as a residence
(Vehicle Type)
(Lioanse Tap a)
(Sate)
3. 2010
Chevrolet
Surburben
Black
Truck
(Veer)
(Make)
This vehicle Is:
(Model)
9
NOT used as a residence
(Cora/Color Scheme)
0
Used as a residence
(Vehicle Type)
Passe Tags)
(Slag)
4. 2006
Bentley
Amage
Black
Auto
(UM)
V75205
(Make)
FL
This vehicle Is:
(Model)
9
NOT used as a residence
(Cdor/Oolor Scheme)
0
Used as a residence
(Vehicle Type)
(License Tag a)
(State)
Vessels
0
I do NOT own a vessel or houseboat.
Please note: The registrant has reported additional vessels not displayed here.
1. 2010
Other
White
(Year)
(Vesse: Type)
This vessel is:
(Color/Coto Scheme)
(Name of Vessel)
0
Used as a residence
a NOT used as a residence
(Registration in
2. 2000
Other
White
(Year)
(Vessel Type)
This vessel IS:
(ColodColor Scheme)
El NOT used as a residence
(Name of Vessel)
['Used as a residence
(Registration a)
3. 2006
Jet-ski
Black
(Year)
(Vesse Type)
12451506
This vessel is:
(Color/Color Scheme)
9
NOT used as a residence
(Name of Vessel)
0
Used as a residence
(Registration ff)
4. 2008
Other
White
Little C
(Year)
(Vessel Type)
WJ1F10168808
This vessel is:
(Color/Color Scheme)
9
NOT used as a residence
(Name of Vessel)
0
Used as a residence
(Registration N)
Page 3 of 6
2011-01-113 1022:00Am
EFTA01111784
Registration No: 353899
Person Number: 73274
Campus Activity
0 I am NOT a student. employee. or volunteer at a university or Institution of higher learning.
S":
1. O
Student El Empoyoo O Vo.otec,
University/School Name:
Start Dale'
End Date:
Campus:
Address:
(Street Address)
County:
Employer:
(CaY)
'
Contact
(Stale)
(Zip)
2. El Student O
Employee O Weteiteei
University/School Name:
Start Date:
End Date:
Campus:
Address:
(Street Address)
County:
Employer.
(City)
Contact:
(State)
(Zip)
3. O Student O Employee O Wfunteet
University/School Name:
Start Date:
End Date:
Campus:
Address:
(Street Address)
County:
Employer
(City)
i
Contact:
(State)
(Zip)
Cyber Communication Accounts
O i do NOT Lict, any email addresses or Instant Message screen namos.
Email Addresses
2.
3
4.
i
5.
!Want Message Screen Names
Name:
2.
3.
4.
Provider:
OW
.r-
ISM
oak
5.
Adjudication Information
Dale Adjudicated
Curie
Location or Adjudication/Conviction
Victim Information
1.
'
(S
—t—
a —
te)
' W)
'
(Stale)
O Minor O Acto
Gender.
2.
(County)
O klil°r O
Adult
Gender:
3.
(County)
O
Minor O
Adult
Gender:
____.
4.
(County)
O Minor O
Adult
Gender
(County)
,
(State)
Were you or are you subject to registration or community notification in another state?
aYes 0
No
If Yes. in what state?
Page 4 of 6
20.3611a22.49.AM
EFTA01111785
Registration No: 353899
Person Number: 73274
NOTICE OF SEXUAL PREDATOR AND SEXUAL OFFENDER OBLIGATIONS
As a Sexual Predator (F.S. 775.21) or Sexual Offender (F.S. 943.0435; 944.607; or 985.481) I understand that I am required
by law to abide by the following:
Permanent residence" means a place where the person abides, lodges, or resides for 5 or more consecutive days.
"Temporary residence" means a place where the person abides, lodges, or resides. including but not limited to, vacation,
business. or personal travel destinations in or out of this state, for a period of 5 or more days in the aggregate during any
calendar year and which is not the person's permanent address or, for a person whose permanent residence is not in this
state, a place where the person is employed, practices a vocation, or is enrolled as a student for any period of time in this state.
"Transient residence" means a place or county where a person lives, remains, or is located for a period of 5 or more days in
the aggregate during a calendar year and which is not the person's permanent or temporary address. The term includes, but
is not limited to, a place where the person sleeps or seeks shelter and a location that has no specific street address.
FAILURE TO COMPLY WITH ANY OF THE FOLLOWING REQUIREMENTS
IS A FELONY OF THE THIRD DEGREE (UNLESS OTHERWISE NOTED).
1. I MUST report ingerson to the local Sheriffs Office within 48 hours of establishing or maintaining a residence in this state,
within 48 hours of release from custody and/or supervision of Department of Corrections (DOC), Department of Children
and Family Services (DCFS), or Department of Juvenile Justice (DJJ), or in the county of conviction within 48 hours of
conviction if not under custody and/or supervision of DOC to register my temporary, transient, or permanent address and
other information specified in statute. {F.S. 943.0435(2)(a); 775.21(6)(e)1).
2. At initial registration, I MUST provide the following information to the department: name, date of birth, social security number,
race, sex, height, weight, hair and eye color, photograph, home telephone number and any cellular telephone number, any
electronic mail address and any instant message name required to be provided pursuant to paragraph s.943.0435(4)(d)
F.S., address of legal residence, address of any current temporary residence, if no permanent or temporary residence, any
transient residence within the state, dates of any current or known future temporary residence within the state or out of state,
occupation and place of employment, date and place of each conviction, fingerprints, and a brief description of the crime
or crimes committed. {F.S. 943.0435(2)(b): 775.21(6)(a)1}.
3. Within 48 hours after the initial report required as stated in requirement #2 above, I MUST report in person to the drivers
license office of the Department of Highway Safety and Motor Vehicles (DHSMV) and provide proof of initial registration
as a sexual offender or predator to secure or renew a valid Florida driver's license or identification card displaying one
of the following designations: -775.21, F.S." or "943.0435, F.S.", unless a driver's license or identification card with such
designation was previously secured or updated. The sexual offender shall submit to the taking of a photograph for use by
the department in maintaining current records of sexual offenders. {F.S. 943.0435(3); 775.21(6)(f)).
4. Each time my driver's license or identification card is subject to renewal, or within 48 hours after any change in my permanent,
temporary, or transient residence or change in name made by marriage or other legal process, I MUST report in.pArffisie to a
driver's license office to update my driver's license or identification card and ensure that the driver's license or identification
card displays the designations as identified in requirement #3. {F.S. 943.0435(4)(a); 775.21(6)g1).
5. If I am enrolled, employed or carrying on a vocation at an institution of higher education in Florida, I MUST provide the name,
address and county of each institution including each campus, enrollment or employment status. including each change
in enrollment or employment status, i.e. commencement or termination, [parson at the Sheriff's Office; OR, for a sexual
offender on supervision with the Florida (DOC) or (DJJ), this information must be reported to the sexual offender's probation
officer, within 48 hours after any change in status. {F.S. 943.0435(2)(b)2; 775.21(6)(a)b}.
6. I MUST report any electronic mail address or instant message name, prior to using such, during registration/reregistration
or by providing all updates through the online system maintained by the Florida Department of Law Enforcement.
{F.S.943.0435(4)(d); 775.21(6)(g)4}.
7. If I vacate a permanent, temporary, or transient residence, and do not have another permanent, temporary, or transient
residence, I MUST report in_person to the Sheriffs Office in the county where I am located within 48 hours. {F.S.943.0435(4)
(b); 775.21(6)(g)21.
8. If I report that I have vacated a permanent, temporary, or transient residence and then remain at that residence, I MUSTreport
in_person to the Sheriffs Office where I reported vacating my residence. Failure to report this information is a felony of the
second degree. {F.S. 943.0435(4)(c); 775.21(6)(g)3}.
Page 5 a 6
2011-01.18 10:22S9_Abi
EFTA01111786
Registration No: 353899
Person Number: 73274
9. I understand that my address will be verified by county, state or local law enforcement agencies. {F.S.
943.0435(6);775.21(8)}.
10. If I intend on establishing a permanent. temporary, or transient residence in another state or jurisdiction other than the State
ofFlorida, I MUST report in person to the Sheriffs Office of the county of my current residence within 48 hours before the
date that I intend to leave this state to establish residence in another state or jurisdiction. {F.S. 943.0435(7): 775.21(6)(i)}.
11. If I intend to establish a permanent, temporary, or transient residence in another state or jurisdiction other than the State
of Florida and later decide to remain in this state, I MUST report in person to the Sheriffs Office to which I reported
my intention of leaving the state within 48 hours after the intended departure date. Failure to report this information is a
felony in the second degree. {F.S. 943.0435(8); 775.21(6)(j)}.
12. I MUST report in person either twice a year (during the month of my birth and during the 6th month following my birth
month) or four times a year (once during the month of my birth and every 3rd month thereafter), depending upon my offense/
designation, to the Sheriffs Office in the county in which I reside or am otherwise located to reregister. {F.S. 943.0435(14)
(a): 775.21(8)(a)}.
NOTE: All Sexual Predators, Sexual Offenders convicted for offenses specified in F.S 943.0435(14), and Juvenile
Sexual Offenders required to register per F.S 943.043591)(a)1.d are required to reregister four times a year. All other
Sexual Offenders are required to reregister twice a year.
0
I AM REQUIRED TO REREGISTER
TWO TIMES A YEAR; I MUST
REREGISTER AS NOTED BELOW.
{Sexual Offenders (943.0435),
unless otherwise notified by FDLE}
Month
of Birth
I must
reregister In:
Jan
Jan & July
Feb
Feb & Aug
Mar
April
May
June
Mar & Sept
April & Oct
May & Nov
June & Dec
Month
of Birth
I must
reregister In:
July
Jan & July
Aug
Feb & Aug
Sept
Mar & Sept
Oct
April & Oct
Nov
May & Nov
Dec
June & Dec
El I AM REQUIRED TO REREGISTER FOUR TIMES A
YEAR; I MUST REREGISTER AS NOTED BELOW.
{Sexual Predators (775.21) and Sexual Offenders
(985.481), unless otherwise notified by FDLE}
Month
of Birth
Jan
Feb
Mar
I must reregister
in the months of:
Jan, April, July & Oct
Feb. May, Aug. & Nov
Mar, June, Sept & Dec
April
May
June
April. July, Oct & Jan
May, Aug, Nov & Feb
June. Sept, Dec & Mar
Month
of Birth
I must reregister
in the months of:
July
Jan. April. July & Oct
Aug
Feb. May, Aug. & Nov
Sept
Mar, June, Sept & Dec
April, July. Oct & Jan
Oct
Nov
May. Aug, Nov & Feb
June, Sept, Dec & Mar
Dec
13. If I live in another state, but work or attend school in Florida, I MUST register my work or school address as a temporary
address within 48 hours by reporting in person to the local Sheriffs Office.{F.S. 943.0435(2); 775.21(6)(a)1b).
14. 1 MUST respond to any address verification correspondence from FDLE within three weeks of the date of the
correspondence. (F.S. 943.0435(14)(c)4; 775.21(10)(a)).
15. If I am employed, carry on a vocation, am a student, or become a resident of another state, I am on notice that I may have
a requirement to register under the laws of that state.
16. I MUST maintain registration for the duration of my life. {F.S. 943.0435(11); 775.21(6)(1)).
PLEASEBLEAP_C_AREBILLYJEIEEQBE SIGNING
As a Sexual Predator (Florida Statute 775.21) or Sexual Offender (Florida Statute 943.0435. 944.607, or 985.481), I
am required by law to abide by the requirements listed on this form. BY SIGNING BELOW, I ACKNOWLEDGE THAT
I HAVE READ OR HAVE BEEN READ THE REQUIREMENTS ON THIS FORM, AND THAT I UNDERSTAND THESE
REQUIREMENTS. Under penalty of perjury I declare the above is true and correct.
YOU ARE REQUIRED TO REREGISTER EACH YEAR AT THE SHERIFF'S OFFICE IN THE MONTHS OF
January AND July.
Registrant:
Signature Required
Printed Name: JEFFREY E EPSTEIN
Page 6 of 6
Witnessed by Reporting Officer:
CA (34
J-
Date: OaMeglOct
Printed Name: CIORPIPOOFf Ct.
• OFFICIAL DOCUMENT
DO NOT DESTROY'
***** NOTE: Your next ReRegistratIon month Is July of 2011.
linsderit
Signature Required
Date: gaitsyski
1...
ZffIl-01-18 1O2.109AM
EFTA01111787
Technical Artifacts (6)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Phone
(943.0435Phone
12451506Phone
16102209Phone
3425530200Phone
621.943.0435Phone
943.0435Forum Discussions
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