UNCLASSIFIED

UNCLASSIFIED FBI Laboratory (:rte Record: 2020-01577-I I A: Combined Case and Case Record IA 'IA Cover Page The content listed below has been assembled from the Laboratory Information Management System (LIMS). Additional files, documents, or images associated with the forensic examinations conducted may be contained within physical IA packages. Fable of Contents Case Record Report C'aseReport2020-01577 Record #1.pdf Case Note Interface Report CAI Questioned Documents (AF) Case Note (128072).pdf Case Record Object Repository 2020-1577-1 Archived Record Images of Items 1 and 2.pdf Case Record Object Repository 2020-01577 #1 Record Images (B).pdf Case Record Object Repository 2020-01577 #1 Record Images (I6)pdf Case Record Object Repository 2020-01577 Endosures.pdf Case Record Object Repository 2020-01577 #2 Record Images (14-15).pdf Case Record Object Repository 2020-01577 #1 Notes.pdf Case Report CaseReport2020-01577.pdf Chain of Custody (Case) ChainOrustody2020-01577.pdf Case Communication Log CommunicationLog2020-01577.pdf 62 Case Communication Log Files 2020-01577 email attachment (1B 92).pdf 65 Case Communication Log Files 2020-01577 #1 Reply to acknowledgmentpdf 135 Case Communication Log Files 2020-01577 emails with SA 137 Case Communication Log Files 2020-01577 email attachment (1B 110).pdf 141 Case Communication Log Files 2020-01577 email attachment (1B 89).ptlf 143 Case Communication Log Files 2020-01577 #2 UNCLASSolf 145 Case Object Repository 2020-01577 #1 and #2 Lead 4.pdf 146 Case Object Repository 2020-01577 #1 and #2 LER Serial I83.pdf 148 Case Object Repository 2020-01577 QDUSELpdf 151 Case Object Repository 1 2 9 12 38 42 44 48 55 57 UNCLASSIFIED RelreENed: 09f17120201520 SDNY_00017829 EFTA00140925 UNCLASSIFIED FBI Laboratory 1A Cover Page 2020-01577 Shipping Invoke (Container Ctpdf Included Zipped Files 2020-01577-1 Check In Notmetf 2020-01577 #2 Check-In Notes.rtf 152 UNCLASSIFIED Rebawd: 00N71202015:20 SDNY_00017830 EFTA00140926 UNCLASSIFIED FBI Laboratory Lab #: 2020-01577 Case Record Report Case Record: 1 Criminal - Questioned Documents Date Submitted: In Unit Date: Examiner: S 7'0'0 S 10'0'0 Date Assigned: Date Completed: 9/17/2020 8/12/2020 Case Record Review(s) Verification: Completed Date 9/9/2020 9/9/2020 9/15/2020 Reviewer Action - Comment Requested: Accepted: I accept the review. Completed: Tom edge comparison verified Administrative: Completed Date Reviewer 9/16/2020 9/16/2020 9/16/2020 Action - Comment Requested: Accepted: I accept the review. Completed: Technical: Completed Date 9/9/2020 9/9/2020 9/15/2020 Reviewer Action - Comment Requested: Accepted: I accept the review. Completed: a Item 1 Item 2 Item 3 Item 4 Item 5 Item 6 * * * * * * * * as End of Report * * * * * * * * * * Page:1 of 1 UNCLASSIFIED Retrieved 907202115:05 Page: 1 of 153 - CaseReporI2020-01577 Record 11.pdf SDNY_00017831 EFTA00140927 UNCLASSIFIED FBI Laboratory Lab #: 2020-01577-1 Case Notes Questioned Documents Case Processing Created On: Created By: Scanning: Copy Instructions: Packet Request: Continents: Notes: 8/10/2020 11:57:58 AM Color 400 tit' Last Modified On: Last Modified By: Treat As: Special Instructions: 8/10/2020 MEM Please scan Item 3 known writing. Thank you. 8/1812020 LLC ESDA i4 SL44-ancl-i5-riegative strikethrough by IW via SL on i4 front (+), i5 back (+) 8/19/20209/9/20204:25:55 PM Latent None Item(s) Evidence Name Description Item Item 2 Item 3 Item 4 Item 5 Agency Number Electronic images of greeting card bearing handwriting Electronic image of envelope addressed to "Larry Nassar" Various documents submitted as bearing the purported known writing of Jeffrey Epstein E6516238, 1B39 Envelope addressed to "Larry Nassar" I A65 Greeting card bearing writing "..Dear L.N. As you..." IA65 Initial Assessment Cut/Torn Edge Electrostatic Detection Apparatus (ESDA) Handwriting Initial Assessment Cut/Torn Edge Exams Handwriting/Hand Printing Exams Indented Writing Performed By Emolo) et: Exam Date 08/18/2020 08/19/2020 08/20/2020 081012020 Case Processing Results Created On: Created By: 8/12/2020 9:30:59 AM Last Modified On: 9/2/2020 10:47:45 AM Last Modified By: Page 1 of 7 (*CLASSIFIED Retneyed: 9P 20201&31 Page: 2 of 153 - CNI Questioned Documents (AF) Case Note (128072).p SDNY_00017832 EFTA00140928 UNCLASSIFIED FBI Laboratory Lab #:2020.01577-1 Case Notes Questioned Documents Examiner Notes: Item 4: IW via ESDA accounted (from evidence packaging) - not retained 8/19/2020 8/20/2020 ESDA exams on portions of Item 3 Humidity verified (chamber used) - ESDA #3 used (M) See examiner notes for additional details 8/20/2020 CPC #4 scanner used for scans of Item 6 (ESDA lifts) 9/2/2020 Analyst Comments: Humidity verified (chamber used) - AEM 8/19/20 Positive indented Writing Item(s) Evidence Name Description Agency Number Item 3 Item 4 Various documents submitted as bearing the purported known writing of Jeffrey Epstein Envelope addressed to "Larry Nassar" E6516238, 1A65 1B39 Performed By Employee Exam Date 08/20/2020 09/02/2020 08/12/2020 08/19/2020 Scanner(s) Used: Scanner #4 (CPC. Room 2161) ESDA Resouce(s): ESDA #3 (ESDA Room, F1479288) I.xaminat inns Created On: Created By: Notes: 8/12/2020 5:28:37 PM 8/12/2020 - 8/13/2020 Item # Description Notes Item 1 Electronic images of greeting card containing handwriting • HW/HP mix • Electronic images OK—suitable for comparison Item 2 Electronic image of envelope addressed to "Larry Nassar" • HW/HP mix • Electronic images OK —suitable for comparison Last Modified On: 9/9/2020 4:31:46 PM Last Modified By: Page 2 of 7 UNCLASSIFIED Relayed: AS202018(31 Page: 3 of 153 - CHI Questioned Documents (AF) Case Note (128072).p SDNY_00017833 EFTA00140929 UNCLASSIFIED FBI Laboratory Lab #: 2020-01577-1 Questioned Documents Case Notes 8/12/2020 — 8/13/2020 8/19/2020 (including strike-through) Item ft Description Notes Item 3 Various documents submitted • Suitable for comparison (varying degrees) if as containing bearing the known writers verified (internal comparison purported known writing of of documents indicates multiple Jeffrey Epstein writers/writing styles): o Piece of paper beginning "AutHoR.. DONALD..." -original HP o Piece of paper beginning "JHONNY CONTReR45..."— original HP o Envelope labeled "Epstein Jeffrey 76318-054" - original HP o Page beginning "Comments..."— original HP (limited text) Pagelstai„;„, bearing "...AIR..." — original o HP (limited text, partial illegibility) o Page beginning "Davis kept me in a..."— original HP (portions suitable but other portions illegible &/OW) o Piece of paper beginning "DEPARTMENT OF JUSTICE.." -original HP & signature; non-original signatures, dates for staff entries • NOT suitable for comparison: o HP, HW present but limited• or appears to have been prepared by staff: - Two-page Bureau of Prisons Health Services document — original signatures - One page Notice of Discipline Hearing — original HP & signatures - Page beginning BP-S293.052..." — original HP & signatures - One page Incident Report — original HP & signature o No HW or HP present: - Four page Visiting Application - Diamond Audio Model DR-35C insert - Envelope &wahines bearing "EPSTEIN. JEFFREY Register No. 76318-054" - Three page Inmate Inquiry - Receipt beginning "Sales Invoice..." *limited quantity, complexity, &/or style (i.e. illegible signature) Page 3 of 7 UNCUsSSIRED Retrieved: 9PY20201831 Page: 4 of 153 - CNI Questioned Documents (AF) Case Note (128072).p SDNY_OOO17834 EFTA00140930 UNCLASSIRED FBI Laboratory Lab 2020-01577-1 Questioned Documents Case Notes 8/13/2020 8/19/2020 (including strike-through) 8/20/2020 (ESDA entries) 9/2/2020 (including associated strikeout) Item 3 1W via SL IW via ESDA Piece of paper beginning "AutHoR.. DONALD..." • Front & Back: (-) • Front & Back: (+) but illegible (too faint) o Retained to visualize torn edges Piece of paper beginning "JHONNY CONTReRAS..." • Front: (-) • Back: (+) unknown value o 2 separate entries, best read as "JEFF", "CON" • Front: (-) o Retained to visualize torn edges • Back: (+) o unaccounted, unknown value - best read as: "JEFF I WANt" and "OVeR" o accounted —from HP on front (includes "CON" entry observed via SO o Lift 02 retained (better quality) o Lift 01 discarded (same info as Lift 02) Envelope labeled "Epstein Jeffrey 76318-054" • Front & Back: (-) • No ESDA conducted Page beginning "Comments..." • Front & Back: (-) • Front &5-Backe (-) • Back: (+) but accounted — from front (discarded) Page eemtaining bearing "..AIR..." • Front & Back: (-) • Front: (-) • Back: (+) unaccounted, unknown value o 2 lifts retained Page beginning "Davis kept me in a.." • Front: (+) unknown value • Back: (+) but majority appear accounted from front (written after folded) • Front: (+) accounted — HP from front (written after folded) • Back: (+) accounted — HP from front & back (some written after folded) All lifts discarded Piece of paper beginning "DEPARTMENT OF JUSTICE..." • Front & Back: (-) • No ESDA conducted Two-page Bureau of Prisons Health Services document • Pages 1-2 fronts & backs: 0 • No ESDA conducted One page Notice of Discipline Hearing • Front: (+) but limited (check marks & line) • Back: (-) • No ESDA conducted Page 4 of? UNCLASSIFIED Retrieved: 9/91202016a1 Page: 5 of 153 CNI Questioned Documents (AF) Case Note (128072I.p SDNY_00017835 EFTA00140931 UNCLASSIFED FBI Laboratory Lab #: 2020-01577-1 Questioned Documents Case Notes 8/13/2020 ME 8/19/2020 (including strike-through) ME 8/20/2020M (ESDA entries) Item 3 IW via SL IW via ESDA Page beginning "BP- S293.052..." • Front & Back: (-) • No ESDA conducted One page Incident Report • Front & Back: (-) • No ESDA conducted Four page Visiting Application • Pages 1-4 fronts & backs: (-) • No ESDA conducted Diamond Audio Model DR- 35C insert • Front & Back: (-) • No ESDA conducted • Front & Back: (-) • No ESDA conducted Envelope L—a. ,,,,,,, 4- beartag "EPSTEIN, JEFFREY Register No. 76318-054" Three page Inmate Inquiry • Pages 1-3 fronts & backs: (-) • No ESDA conducted Receipt beginning "Sales Invoice..." • Front & Back: (-) • No ESDA conducted 8/19/2020 Item # Description Notes Item 4 Envelope addressed to "Larry Nasser" • Original HW/HP (suitable) • Sealing flap MA (angled, tearing of paper fibers) • Stamp = SA (scalloped edges, tacky adhesive), booklet/sheet type • IW via SL: o (+) front o (-) back & inside • IW via ESDA: o (+) outside — accounted (from evidence packaging); not retained o (-) inside Item 5 Greeting card bearing writing "...Dear LN. As you.. • Original HW/HP (suitable) • IW via SL: o (+) back — accounted ("X" from outside envelope) o (-) front & inside 9/9/2020 IM Limitations: • Verification of known • Comparability between questioned & known (style, wording, format) Page 5 of? UNCLASSIFIED Palmed: 9/9120201E:31 Page: 6 of 153 CNI Questioned Documents (AF) Case Note (128072).p SDNY_00017836 EFTA00140932 UNCLASSIFIED FBI Laboratory Lab #: 2020-01577-1 Case Notes Questioned Documents Examination Results: 9/9/2020 Results: • Meaningful HW comparisons could not be conducted between questioned Items 4 and 5 and Item 3, purported known writing of JEFFREY EPSTEIN, due to lack of verified known writing submitted for comparison that is comparable in style, wording, and format • HW instructions • IW of unknown value observed on 3 pages of Item 3 o ESDA lifts, used to visualize & retain IW, designated Item 6 (considered secondary) o 2 images representative of IW enclosed for your investigative assistance o No other IW of value observed on remaining pages of Item 3 or Items 4 & 5, using SL &/or ESDA • Should be noted that torn edges of Item 3 pages beginning "AutHoR.. DONALD..." and "JHONNY CONTReRAS..." were at one time attached • Sealing flap of Item 4 manufactured to be MA • Stamp affixed to Item 4 = SA, booklet-type stamp o Edges suitable for future cut edge exams; instructions • Additional assessments/observations made/recorded for possible future exams 9/9/2020 Remarks: • No questioned document exams on Items 1 & 2 since electronic image of original evidence Items 4 & 5 • Item J.& 2 = electronic (retained) • Items 3-5, 6 (secondary) returned separately Item(%) Evidence Name Description Item I item 2 Item 3 Item 4 Item 5 Agency Number Electronic images of greeting card bearing handwriting Electronic image of envelope addressed to "Larry Nassar" Various documents submitted as bearing the purported known writing of leffrey Epstein E6516.238, 1839 Envelope addressed to "Larry Nassar" IA65 Greeting card bearing writing "...Dear L.N. As you..." IA65 Page 6 of7 UNCLASSIFIED Retrieved: 9.F942020 16:31 Page: 7 of 153 - CNI Questioned Documents (AF) Case Note (128072).p SDNY_00017837 EFTA00140933 UNCLASSIFIED FBI Laboratory Lab #: 2020-01577-1 Case Notes Questioned Documents Item 6 Employee Questioned Documents Secondary Evidence (4 ESDA lifts) Exam Date 08/12/2020 08/19/2020 09/09/2020 08/20/2020 Page 7 oft UNCLASSIFIED Retneved: 9/972020101 Page: 8 of 153 CNI Questioned Documents (AF) Case Note (128072).p SDNY_00017838 EFTA00140934 Page: 9 of 153 - 2020-1577-1 Archived Record Images of gems 1 and 6£9L1000 ANDS Archived Record Images of Item I and Item 2 Item 1 UNCLASSIFIED 2020-01577-I 411 MQP MCI Algona Lid • 13 The 'Axes • 6-8 frathrolo, Seem • latbri N1 2WY nviunqpitillOMIONLOOM cant 0 2COILO RISAIOns Ud Imager Geltr IrroginMOlon Mfrs Preis, in On UNCLASSIFIED 8/10/20 MEM Page I of 3 EFTA00140935 1 11 3,31 41t I 4:-)6 t .13 $--'44tt 4 I wax 10 0159-2020-1 Imawa n Mme I and SONY 00011840 EFTA00140936 Page: 11 of 153 - 2020-1577-1 Archived Record Images of Items 1 and 111L1000 ANDS Archived Record Images of hem I and hem 2 UNCLASSIFIED Item 2 202001577-I mitit.t se #"0 neasida... aryreArytegif 9 Pia Air /QV /Oa 6 7 7744.9 a-A----" O Se /1 MA CI INMATE NAME AND RECITER NUMBER ARE REWIRED TO O UNAUTHORIZED I PROPERLY 17 PIIENT NO APPROVAL Fl . TE.51FRESkilkNie n ° O UNK/HORIZED P k)rer.erjely.MEIGHINO 1)63i.S.5 OF REQUIRE AUTHOR/2A NO LONGER AT THIS ADDRESS. AMrL6 es.75a-9706Ciu UNCLASSIFIED ufFafignril , g5 75-6 8110/20 MEM Page 3 of 3 Irc EFTA00140937 2020.01577 #1 UNCLASSIFIED Record Images Page I of 3 Inmate Inquiry Inman Reg e: 76318054 r orient Institution Nets York MCC hunanr \unite EPSTEIN. MI 1:Itt 1 Homing I nit: NYM-II-A Report Date: 077302019 I it ing Quarters: 1101.01111. Report lime: 4:22:03 PM Com' Informatioil I Account Balanont I Commi.aun I littort (\eureka:in Reitrirtiont :ltmm General Information Administratite Hold Indicator No No Poster of Attorney: No Net er Waive NSF Fee: No Max Allotted Deduction 100 PIN: 7732 PAC a: 139248706 Re. alitbtion Date: 25Ih FRP Participation Status: Unassigned Arrived From: 'transferred To: Account Creation Date: 7/62019 Local Account Actit ation Date: 7/7/20193:11:24 AM Son Codes: Last Account Update: Account Status: Phone Balance: 7/242019 12:14:38 PM Artist $0.00 ' Pre-Release Plan Information Target Pre-Release Account Balance: $0.00 Pre-Release Deduction ire Income Categories to Deduct From J Pm roll FRP Plan Informalloa FRP Plan Type Expected Amount Everted Rate Outside Source Funds Account Balances Account Balance: 5198.42 Pre-Release Balance: $0.00 Debt Encumbrance: 50.00 SPO Encumbrance: $0.00 Other Encumbrances: 50.00 Outstanding Negotiable Instruments: $0.00 https://10.33.56.106/truwebilnmatelnquiryCombined.aspx 7130/20 I 9 II Ir I 11 I 1 11111111ITItIl 2020-01577 ITEM 3 -FBI-- LABORATORY UNCLASSIFIED 1 0126 Page: 12 of 153 2020O1577 #1 Record Images (i3).pdl SDNY 00017842 EFTA00140938 2020-01577 #1 UNCLASSIFIED Record Images Page 2 of 3 Administrative Hold Balance: $0.00 Available Balance: $198.42 Nauman 6 Months Deposits: $200.00 National 6 Months Withdrawals: $1.38 As ailable Funds to he considered For ll'RP Payments: ($230.00) National 6 Months Avg Daily Balance: $181.311 Local Max. Balance • Prat 30 Days: $200.00 Average Balance • Pm. 30 Days: $181.38 Commissary• History Purchases Validation Period Purchases: 50.00 VIE) Purchases: $1.58 lad Sales Date: 7/24/201912:14:38 PM SP° I 'formalism SPOs this Month: 0 SPO $ this Quarter WOO Spending Limit Info Spending Limit Override: No Weekly Revalidation: No Bi•Wcekly Revalidation: Yes Spending Limit $130.00 Expended Spending Limit: $0.00 Remaining Spalding Limit: SI 50.00 Commissary Restrictions Spending Limit Restrictions Restricted Spending Limit $0.00 Restricted Expended Amouni: 50.00 Restricted Remaining Spending limit: $0.00 Restriction Stan Date: /VA Restriction End Date: N/A Item Restrictions List \ame list Type Scan Date Lad Date Active https://10.33.56.106/truwebfinmatelnquiryCombined.aspx 7130/2019 15111'f'I'TTl'i'I'1't•I't'I't' 20 20-01 577 ITEM 3 amcall&-A" UNCLASSIFIED 2 of 26 Page: 13 of 153 - 2020-01577 in Record Images 03/P0f SDNY_00017843 EFTA00140939 H2C .Ars a:, I LL 3.roid I.....r.i hups://10.33.56.106/truweb/InmatelnquiryCombined.aspx 7/30/2019 2 020-0 ITEM 3 UNCLASSIFIED 3 of 26 Page: 14 of 153 - 2020-01577 #1 Record Images 03).pdf SDNY_00017844 EFTA00140940 2020.01577 11 UNCLASSIFIED Record Images UNCLASSIFIED 4 of 26 Page: 15 of 153 - 2020-01577 N1 Record Images (i31.pdf SONN100017845 EFTA00140941 2020-01577 el UNCLASSIFIED Page: 16 of 153. 2020.01577 el Record Images 03).p11 UNCLASSIFIED Record Images 5 of 26 SDNY_0001 7846 EFTA00140942 2020.01577 al UNCLASSIFIED Record Images 0 0 egg • LO) Ogesen c)°O I Made-MCSpicacon • - m•-• DiaillOrod MaoTOCtinabOy == = UNC_ASSIFEED Page. 17 01 153 . 2020.01577 al Record Images (i3).pdf Sof 26 SDNY_00017847 EFTA00140943 2020-01577 al UNCLASSIFIED Record Images f1v}ffO2 • - botJALb GO 'NI aS • LOWeraso,-; vopecieniel. Skim JA46- c•471 Y-ei•JyAfrA VeNS+FA IS CEJeNicje- UNCLASSIFIED 7 of 26 Page: 18 of 153 202041577 SI Record Images cr3).pdl SDNY_00017848 EFTA00140944 2020-01577 El UNCLASSIFIED Record Images UNCLASSIFIED 80126 Page: 19 of 153.2020-01577 at Record Images (13).pdf SDNY_00017849 EFTA00140945 Record Images -nu' /5 44e (THO NI co KITP,GRAS rirar g 9 SZCA0c3 felt Him ezei 2020-C:ST, :TEM UNCLASSIFIED Page: 20 of 153 - 2020-01577 01 Record Images 03).pdf 9 of 26 SDNY_00017850 EFTA00140946 20204)1577 It1 UNCLASSIFIED Record Images Comments Comments: I 3114 =it° https://10.33.56.106/truwebanmatelnquiryCombined.aspx lilt.:577 ITEM 3 Page 3 of 3 8/7/2019 yr UNCLASSIFIED 10 of 26 Page: 21 of 153 - 2020-01577 MI Record Images (i3).pdf D H( EFTA00140947 2020.01577 .1 UNCLASSIFIED Record Images 1.--)°'Lk 3 MA-- V\ (0c6,1 >ovsp 17„.1_ 17o74 e.-H/ 2020-01577 ITEM 3 UNCLASSIFIED Page: 22 ol 153 . 2020.01577.1 Record Images (i3).pctl 11 5726 SDNY_000178.52 EFTA00140948 2020-01577 01 UNCLASSIFIED Record Images ;34,4- 1:3 • I 1 Q--s „/-1-- (.-4,4-qt Ll_f_,2fe! UNCLASSIFIED Page: 23 ol 153 - 2020.01577 01 Record Images 03).pdl 12o-_ SL,' 0001/653 EFTA00140949 2020.01577 41 UNCLASSIFIED Record Images Bur of Prisons :leaitn Services Nr %,.Ical Duty Status Reg ff: 76318-054 Inmate Name: EPSTEIN. JEFFREY EDWARD Housing Status confined to the living quaffert 9.. 'pt _meals pill line treatments Exp Date. on complete bed rest bathroom privileges only Exp. Date: X cell cell on fir- 0no. single cell X lower bunk _airborne infection isolation Exp. Date: : 9r, or 019 other. Exp. Date: Physical Lir .tatio.. Restriction all snnn. we..4*..: 9: upper body lower body .rchovascular exercise. running _jogging walking softball football _basketball handball stationary e ent other rxi. Dn. E :o Oate Ixp Date' Exp Date. May have the following equipment in his I her possession: Equipment Star' fl'e End Date Re:urn Date C-Pap 07-1L2L, PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE SERIAL s. P1131281381ED Work Restriction / Limitation: Cleared for Food Service. Yes X No Restnctions Comments: N/A MD Health Services Staff Yr 07/3012019 Date Inmate Name EPSTEIN JF-Ft.ZY EDWARD Reg # 76318-054 Quarters 204 ALL EXPIRATION DATES At EAT 21:00 Generated 07/30/2019 14 27 by Beaudourn. Rotron MD rill.',. MORS • NM Page 1 of 1 20 2 0-0 1 5 7 7 ITEM 3 UNCLASSIFIED 13 of 26 Page: 24 of 153 - 202P01577 41 Record Images (i3).pdf SDNY_00017854 EFTA00140950 2020-01577 #1 UNCLASSIFIED Record Images Bur of Prisons :leaitn Services NI ”*.ical Duty Status Reg #. 76318-054 Inmate Name. EPSTEIN. JEFFREY EDWARD Housing Status confined to the living quarter t lot _meals pill line treatments Exp. Date: on complete bed rest. bathroom privileges only Exp. Date: X cell: cell on fir _single cell X lower bunk _airborne infection isolation Exp. Date: 9.. er .019 other: Exp. Date: Physical Lir .tatIo/ 'Restriction all snqn. D'rx: 19 _upper body _lower body E -a. Date: ..rdioyascular exercise. _running _jogging walking softball 3.xp. Date football basketball handball stationary e ent other. Exp. Date. May have the following equipment in his her possession: Equipment Star fl 'e C-Pap 0. 2k, 3 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE SERIAL #: P11312813B1E0 End Date Return Date Work Restriction f Limitation: Cleared for Food Service Yes X No Restrictions Comments: N/A Health Services Staff 07/30/2019 Date Inmate Name. EPSTEIN JF-Ft .2Y EDWARD Reg #: 76318-054 Quarters Z04 ALL EXPIRATION DATES At EAT 24:00 Generated 07/30:2019 1x.27 by &auctorial Robert MO risonS NYIA Pap t of 1 UNCLASSIFIED 14 of 26 Page: 25 of 153 - 2020.01577 41 Record Images 03).pdl SDNY_000178S5 EFTA00140951 UNCLASSIFIED Record Images DEPARTMENT OF JUST! FEDERAL BUREAU OF PRE MCC, NEW YORK October 2018, Commissary Prig All Sales Are Final NO REFUNDS OR EXCHANC "9 SOUTH" PRINT FULL NAME (LAST, FIRST) Fe/4c,, REG. NUMBERn 743 it- oc“ UNIT s Stamps - (Limit to 510.00 total) Book (Limit D $9.80 Envelope & Stamp $0.62 Single $1.00 Stamp $1.00 Religious Items (Limit 1 Each) (Chaplain Approval) l Muslim Prayer Rug 512.96 Muslim Kufi (White or Black) $5.99 Prayer Oil 1 $4.80 Vitamins (Limit 'Each) Daily Vitamin Ii. 4.10 Calcium Vitamin $2.70 Vitamin C 53.25 Soap Items (Limit 2 Each) , Tone Soap $1.00 ( Dove (Pork Free)® e, 4S $1.90 Sundry Items 1 for 1 Exchange \ I Battery (Double AA) I for I SI.50 I Battery (Triple AAA) I for I $1.50 Envelopes (Legal) t NC Head Set ' c90 59.95 Playing Cards $1.60 \\ ( Radio JRFM35 85,, Writing Pad 1.0/k Mailing Envelopes (50 Box) Medical Items (Limit 1 Each) I Aspirin or Tylenol or Advil® ' Antifinicl„Ce:essam® i n in 0 ' Ha _ r Hy oCort. ® \ILO Da 1.75 Lactaid .---. V 6.60 t Metam it ® $5.I 5 I Mylanta $3.85 Pepto-bism $4.05 Per f Cha 0 1 Coc 0 i Q-T 0 Sho• Greeting Cards Blank Cards $0.90 Happy Birthday Cards $0.90 Happy Fathers Day Card S0.90 Happy Mothers Day Card $0.50 I Miss You Cards $0.90 Love Cards $0 .90 Season Greeting Cards $0.90 Thanksgiving Cards SI.30 Thinking of You Cards $0.90 ••• General Information . The spending limit is 5100 00 BrWeekly. Once a receipt is signed all sales are final Validations takes place monthly. Ducounted rams will be sold until stock u depleted. Items sold under cammusar, ItIlIglion are marked by an 'T . Kosher items are marked with a "K" Any questions concerning the wiling price and the delivery of Commissary items should be addressed to the Commissary Foreman via 'p our. Questions regarding inmate accounts should be directed to the Thal Fund Prices are subject to change Inmates are prohibited under any circumstances to trans.kr any property to another inmate. Damaged Radios. 11P3 players. headphones and watches I(should be s an...2nufircturer as directed by the arr nryinstructions ecr AW ate , Warden Date 15 o126 UNCLASSIFIED Page: 2601153' 2020.01577 #1 Record Images 03).pd1 SDNY_00017856 EFTA00140952 2020.1316/214/86dEttiages ITI RI rice NC 'er ;ha :oc oh :rectally Cards lank C "771717nTrrer7er7e laPPY 232C-31577 ITEM 3 laPPY APPY r miss ore Cards 0 0 0 $0.90 $0.90 $0.90 S0.50 $0.90 so.00 UNCLASSIFIED o126 Page: 27 of 153 2020.01577 #1 Record Images (i3).pdl SON1100017857 EFTA00140953 2020-01577 #1 UNCLASSIFIED Record Images DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS MCC, NEW YORK October 2013. Commissary Price List All Sales Are Final NO REFUNDS OR EXCHANGES "9 SOUTH" PRINT FULL NAME (LAST, FIRST) REG. NUMBER# UNIT TIER/CELL DATE AND SIGN Meld, 1-CreAF,4 7421t-°c4¶ G-- 1.,Vb t\* Stamps - (Limit to $10.00 total) Book (Limit I) $9.80 Envelope & Stamp S0.62 Single S1.00 Stamp $1.00 Religious Items (Limit I Each) (Chaplain Approval) I Muslim Prayer Rug $12.96 Muslim Kurt (White or Black) S5.99 Prayer Oil $4.80 Vitamins (Limit 'Each) Daily Vitamin 4.10 Calcium Vitamin $2.70 t Vitamin C 53.25 Soap Items (Limit 2 Each) I Tone Soap S1.00 ( Dove (Pork Free)® SI.90 Sundry Items 1 for I Exchange ) Battery (Double AA) I for I 51.50 I Battery (Triple AAA) 1 for I S1.50 Envelopes (Legal) . $0.90 t NC Head Set ••• 1 59.95 Playing Cards 51.60 ( Radio JRFN135 85,, \ Writing Pad 1..;t.Mailing Envelopes (50 Box) Medical Items (Limit 1 Each) 1Aspirin or Tylenol or Advil® 1Anti fur4czam. SI . en sin OD 5 Ha r Hy o Cort. tritei& 1.75 Lactaid * 6.60 l Metam it ® 55.15 I Mylanta 53.85 Pepto-bism $4.05 Personal Health / Hygiene limit I Each) I Chapstick $1.60 I. Cocoa Butter Lotion S6.00 t Q-Tips . $1.10 Shower Shoes (Size) $19.95 Greeting Cards Blank Cards $0.90 Happy Birthday Cards $0.90 Happy Father's Day Card $0.90 Happy Mother's Day Card $0.50 Miss You Cards S0.90 Love Cards 50.90 Season Greeting Cards $0.90 Thanksgiving Cards S1.30 Thinking of You Cards $0.90 ••• General Information • The spending limit u 5100.00 Br•Weekly. Once a receipt is Jived all sales are final. Validations takes place monthly Discounted items will be sold until stock "depleted. hems sold under commissary mime:ton are marked by an "IS . Kosher teems are marked with a "K' Any questions concerning the selling price and the delivery of Commissary nem should be addressed w the Commissary Foreman WO out Questions regarding inmate accounts should de directed to the .*rust Fund Prices are subject to change Inmates are prohibited under any circumstances to transfer any property to another inmate. Damaged Radiar. kin players. headphones and watches should be :Comm. as directed by the arr/nry inonmamar. 4 611111 —Warden //676 / ate /1/4 /./P Date UNCLASSIFIED Page: 28 o1153 • 2020.01577 #1 Record Images (i3).pdt SLAv F.A.0 11'.513 EFTA00140954 2020-01577 al UNCLASSIFIED Record Images BP-5293.C5 2 INMATE RIGHTS AT DISCIPLINE HEARING orp.y. rE9.4DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Institution: As an inmate charged with a violation of Bureau of Prisons rules or regulations referred to the Discipline Hearing Officer (DHO) for disposition, you have the following rights: 1. The right to have a written copy of the charge(s) against you at least 24 hours prior to appearing before the Discipline Hearing Officer; 2. The right to have a full-time member of the staff who is reasonably available to represent you before the Discipline Hearing Officer; 3. The right to call witnesses (or present written statements of unavailable witnesses) and to present documentary evidence in your behalf, provided institutional safety would not be jeopardized; 4. The right to present a statement or to remain silent. Your silence may be used to draw an adverse inference against you. However, your silence alone may not be used to support a finding that you committed a prohibited act; 5. The right to be present throughout the discipline hearing except during a period of deliberation or when institutional safety would be jeopardized. If you elect not to appear before the DHO, you may still have witnesses and a staff representative appear on your behalf; 6. The right to be advised of the DHO's decision, the facts supporting that decision, except where institutional safety would be jeopardized, and the DHO's disposition in writing; and, 7. The right to appeal the decision of the DHO by means of the Administrative Remedy Procedure to the Regional Director within 20 calendar days of notice of the DHO's decision and disposition. I hereby acknowledge that I have been advised of the above rights afforded me at a hearing before the Discipline Hearing Officer. I have further been advised that if I have previously received either a presumptive or effective parole date from the Parole Commission, a finding by the DHO that I committed the prohibited act(s) may result in a rescission or retardation by the Parole Commission of the presumptive or effective parole date. Inmate's Name: EPSTEIN. JEFFREY E WARD Reg. No.: 76318-054 Inmate Signature: x Notice of right by: Date: -1\ nivon rn inmAre(nate/time): -1\23C1‘ 41 5.11 Pµ Staff Prin(!l eyame/Signature (This form may be replicated via NP) irl'i'l'HI'I'PHITP1T I I 2020-01577 ITEM 3 Replaces BP-S293(52) of JAN 88. "iit2C-MCV)- , ..S - UNCLASSIFIED 18 of 26 Page: 29 ol 153 - 2020-01577 #1 Record Images (i3).pdl SDNY_00017859 EFTA00140955 2020.01577 e1 UNCLASSIFIED Record Images EPSTEIN, JEFFREY Register No. 76318-054 ilimputrultprrmriTiripyr C10 C I 577 ITEM 5 UNCLASSIFIED Page:30 of 153 - 2020-01577 #1 Record Images (i3).pdf 19 of 26 SDNY_00017860 EFTA00140956 2020-01577 #1 UNCLASSIFIED Record Images 4 INCIDENT REPORT !Aro . U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Part I— Incident Reportnedent MCC New York Repon itenber aisc ea, nrrnm”. tlems: Epstein . Jeffery 3 Register Number 76318-0544 Date of-Diadem 07/23/2019 57 new. 1:27amB Place of rodent SHU M-Tier Cell 124 7. Assganeflt Unassigned 5. ZA sea4aottaaon 10 Prohibited Ad Code (*). 228 11. DesulPhon of indent (Date: 07/23/2019 time. 1:27AM Stan miasma aware of incident): On Jury 23.2019 at apper 1 27arn girlie waking in the Speaal Housing Unit Myself and S/0 Siva hoard noise from the M tier cell 124 Upon arrival Ions Epsten.Jerfery1763I8-054 cell mate (UM Tartaghonee78514-054Neas al the door stag UM Epstein. 6318-054 had attempted to hang Amiss,' I kept a visual whole 5)0 Sara grabbed the door keys and called for am-slang ARer SM ring IM iartag 78514-054 and removing him frorn me oat.' entered then pieced UM Epstein on his side and removed a orange homemade rope keen his neck IPA was breathing al this lime Bul unresponsive Actaeon staff and Ops LI Anderson arrived PM was then removed from SHU NanWSipn 13. Dag And Tent 07212019 3 30am 14. incident Re (Type Na to al15. Date Mock ve 1- 7 or S.440 ..."t -Peng —Committee Action 17. Canning of Inmate to Cammabla Repealing Move inoidont 18 A ll 4 the finding of the commalee that you 3 Committed the Prohibited All as Charged. Del not Commit a Prohibited Act Committed Prohibited Act Code (s)-8. Cl The Committees relemng the Cnarge(s) to the DHO for turner C an The Committee relmsel the mmate of as finding and of the right 10 an appeal within 20 calendar days 19. Committee Decision is Based an SPOWIM Evidence as Follows: 20 Committee action and/or recommendation If referred to 0110 (Contingent upon OHO rating inmate committed prohibited all) 21 Dale and Time of Action (The UDC Chairmanss signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings) chairman Owed NamtvSignatuie) Member I Typed Name) 'Member (Typed Name) IN NUt, I IONS. Al items outside of heavy rug are for staff use only Begin entries with the number 1 and wont up, tonnes not completed will be voided by staff Distribute OnginaliCentral File Record. COPY•1.0H0 COPY-2.Inmate after UDC Acton COPY 3-Inmate within 24 hours of Pan I Preparation PDC Prescribed br Pkr0 Replaces BP-40288 of AUG II "IT I!! 2020-01577 :TEX 3 UNCLASSIFIED 20 of 26 Page: 31 of 153 2020.01577 #1 Record Images (i3).ccd SDNY_00017861 EFTA00140957 202001577 91 UNCLASSIFIED Record Images BP42S4 052 NOTICE OF DISCIPLINE HEARING BEFORE THE (DHO) laAY U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS MCC NY Iratution DATE: TO, EPSTEIN. JEFFREY EDWARD Rog No: 76318-054 ALLEGED VKKATION(S): Tattooing or Self-Mutilation DATE OF OFFENSE: 07/73/2019 You are term referred to the DHO fix the above charge()) The hearingwe be held on: -re-A-Code No.: 22807/30/2019 . al (A. M 1st ) at the follow.ng location You are 0AMk0 to have a full-time staff member represent you at me hearing Please .d ate Pekerwhether you desire to have a staff representative. and it so. he or her name. I ( d0) (do not) si web t0 have a staff representative if so. the staff representatives name is • You will OISO have the right to call witnesses at the hearing and to present documentary 'Wends in your Shalt provided casing your witnesses wd not isopatclize institutional safety Names of witnesses you wish to call should to hated belOw. Welly Male to what each proposed witness would be able t0 testry t (do) (do nor) wish to have *Creases NAME ,Can TIM* NAME. Con Tetley Ix \MAE' . Can Testify to. The Disopene Hearing Officer sell call those w4n0SSeS (Staff or on ww) who are reasonable available, and who are oeternwieci by the DHOW have information relevant to the charge(s) Repetitive witnesses and repetitive character references need not be calla Unavailable witnesses may be asked to scant written statements additional space is deeded. use the reverse aide 01 the form Date sign, and return du m to the DHO. DATE 1N% CS Notece 01 hearing before DHO giveninmate 1 NV' €.; 1fprilsy aterTime SIGNATURE Staff Primed HeilL54)(titUre Replaces SP.294(52) of JAN se UNCLASSIFIED 21 of 26 Page: 32 of 153 - 2020-01577 #1 Record Images (i3).pel SDNY_0001 7862 EFTA00140958 2020-01577 #1 UNCLASSIFIED Page: 33 of 153. 2020.01577 #1 Record Images (13).pdf UNCLASSIFIED Record Images 22 of 26 SON1100017863 EFTA00140959 2020-01577 (11 UNCLASSIFIED Record Images or-mama 1:S. DEPARTMENT OF Jr:Silt E Visitinn Application Metropolitan Corteenenai Cane ISO Park Row New York, Y.Y. IOW RE: Date: Inreste Name and Regsaszton ?weber Dar. Is. reddening that you be included among my approved visitors. In order to establish your suitability asa +Vet«. it may be necessary for inning/on officials to feed an Inalry tote appropriate law enforcement or crime informarka mazy to »certain whether or not niacin; you on my ?in would peewit a nuort ment problem ror ae lanininon. or ban other maple +averse ettec6 The information obtalegd wilt be used CO determine your acceptability asa visitor. The Bureau of Prisons' authority to request bang:round laformatiou on proposed viaiton is contained in Title 181 .S.0 4041. In order for you to be considered for the privilege with me. it will be neeemary for you to fill out the questionmare and release form below and return it to the !Mowing address: Metropolitan Correctional Canter 150 Park Row, New York, H.Y. 10007 Attn: Counselor ?nit 7 South lou are not required to supply the information requested. Flowerer. if yon do sot furabb the Informative. the pratsting of vour request will be suspended, a nu you MD receive mo further cousideradon. If NOG tartlet, only part of the informadon requireel. the procuring of your request may be significantly delayed. If the information withheld is found to be menial to the processing of your rtcruct. you will be informed. and your repstat will receive no further consideration unless you apply the missing information. Although no penalties arc sod:barbed if Yon Do not supply the 'ptomaine, requetted. Mare to supply snob laformadoes could rank ko year not being combined for admittance asa visitor. The criminal mien for =Wig false sea amens b a Sae of ea more than $250.000 or imprisoacerar for not more than five years or both (See ititS.C.101). Sincerely. IInmate Signature: *Forms Returned To The Inmate WILL NOT BE ACCEPTED* 1. Legal Name 2. Date of birth 4. Telephone Number (:ncluding Area Code) S. RaceandSexofeisitor 3. Address (Including Sip Code) 6. Are you • z s Citizen? Yes yo da If yes. provide Social Security No: Ms. If no, provide Alien Registration No: 6c. Provide Passport No: 6d. Provide a copy of Drivers Liman at Seaport 7. Relationship to above :'tamed Erato P. Do you desire to visit hla/her? Yes So 9. Did you knots this person prior to his/her current incarceration? Yes No 10. It the answer to 99 19 yes. indicate the length of time you have known this person and where the rotational:;; il. Save you ever been arrested and/or Convicted of a crime? If so, state the number. date, place, and nature of the arrest/s and/or conviction/at :2. Are you currently on probation, parole, or say other typo of supervision? If so, state the name of your supervisir.: probation/parole officer and the address and telephone no. Where he/she can be Contacted: 13. Do you correspond or visit with other inmates? If so, indicate the individual (al and their location(*) t 14. Driver's License so. and State of Issuance: ADISIORImazOK to RIINZASE liteltablATICat I hereby authorize relax to the Warden ofi rie Metropolitan (orrecdoral Center Y.Y. any record of criminal offenses for which I have been arrested ander coovieted. and any information related to those tomatoes. ••FORMS RETURNED TO THE INMATt WILL NOT BE ACCEPTED** Applicant's Signature for Authorization to Release !colonnade:4(5:w rid NMI >Wirt) :if gulkant is under 18 years of age, signanire of parent or guardian indicates =Pent of mhza »obit inmate) If additional space h required. you way use tco back of Pus forn This ken may be replicated via WP) To be filed in Inmate Casa Fik FOI Section 2 FOI EXEMPT/SENSITIVE BUT UNCLASSIFIED 23 Dl 26 UNCLASSIFIED Page: 34 01 153 202D01577 #1 Record Images 03).edl SDNY_00017864 EFTA00140960 202001577 #1 UNCLASSIFIED Recordlmages Or•OVAYNVA MAR2002 Visiting Application Metropolitm Corr=iceul Center 1 Poi( Roo New york, N.Y. 10037 RE: U.S. DEPARTMENT OF „IL STILL FEDERAL ILLREAL. OF PRISON'S Date: Lnithle Name and /iv:trance' number Der: i am reyuadoB Coat you be included amoot m. approved Ntitors In order m establish your suitability as s tidtor. it may be otcesary for insumdoa omash to send so Iogoiry m an appropriate law enforcement or crime information agency to ascesttla whether or cot pbdeegg yon oe my tin would preens a .Saa(mtnt reek.. for the instituter...or have other poeUele &Orme effects The InforinetIOD obtained will be toed to detenniet your acceptability as a *ewer. Tee Bureau of Prisons' authority to request background ',forma*, on proposed visitors is contained in Tide 18 U.S.0 ONL InOrderforyouMbeamnderedfordmprivilegavddvme,hwillbcomeaaryforyontofillonttbequationnaireandreleawfonybdowsndremmittothe RAkodots4dnaa Metropolitan Correctional Center 150 Park Row, Now York, N.T. 10007 Attn: Counselor Eklund, Unit 7 South You arc not required m supph the Information regneted However. if you do not furnish the information. the processng of7oar request will be suspended, sod yosvartveleeno(mthereossidemdmilfyouturnisboMypsmoftbelaRovadoorequirtd,dmpommuMizofyourrovelmay be sipifendy de syed if dre iufortnsdoo withbeld is found to be essential to the processing o(ywr request you will be informed. and soar request will recent eo further consideration udea/oo supply the missing informatioa. Alehoagh oo penalties arc antbeinzedifyou do notsappay the information redoestedfulore to supply such ltiftormatiOnaitildraeltia Vert/0ther:8 considered for admittasee as s Wltor. The criminal penalty for maidnr false statements is a tint of not more t an 5250.000 or imprisoomtat for not more than rise years or both (See 181,S.C. LOB- ststresro:y. :nnate signature; *Porous Returned To The Inmate WILL NOT BE ACCEPTED' I. Legal Nam 2. Date of Birth . Address ;:r.C:tilAas Zi; Code) 4. telephone Zemke (Including Area Code) S. Race and Sex of Visitor 6. Are you • C.S. Citizen? Yes No 6a. If yes, provide 6b. If no, provide 6c. Provide (4. Provide Social Alien Passport No: Security No: Registration Pro a copy of Drivers Limnos or Passport 7. Relationship to above-named innate S. Do you desire to visit him/her? Yes No 9. Did you know this person prior to his/her current incarceration? Yes No 10. If the answer to 69 is yes, indicate the length of time you have known this person and where the telahLonship developed.: 11. Rave you ever been arrested and/or convicted of a crime? If so, state the number, date, place, oral nature of the arrest/s and/Or conviction/s: 12. Are you currently on probation, parole, or any other type of supervision? If so, state the name of your supervising probation/parole officer and the addition and telephone no. where laIsh• can be contacted, 13. Do you correspond or visit with other inmates? If so, indicate the individual(*) and their location(s): :4. Driver's License No. and State of Issuance: ADTEntrZATION TO RICLEASE 72,7CattaTICel I hereby authorize release to the Warden of: The Metropolitan Corradonal Ceder NA' env record of criminal offenses for w hich I ban beta arrested 'odor convicted, and any information related to those coneledons. "FORMS RETURNED TO THE IIkf MATK WILL NOT BE ACCEPTED" Applkaars Strum re for Authorization to Release Information(Sip and Print Name) Spplitant is miler 18 years of ate, sit:Inure of pato: or guardian thdiestes consent of once tO urnite) If santional spice is required you may use the back or cps form (This kim may be retaliated eta WP) To be filed in Inmate Central File, FOI Section 2 FOI EXEMPT/SENSITIVE BUT UNCLASSIFIED rI,(III(IfI(II 1r'I',l 2020-01577 ITEM 3 UNCLASSIFIED 24 al 26 Page: 35 of 153 - 2020-01577 11 Record Images (13).pdf SDNY_0001 7865 EFTA00140961 2020-01577#1 UNCLASSIFIED Record Images TRULINCS Contact Request Form THENT OF JUSTICE /11 FEDERAL BUREAU OF PRISONS RBOISTBR MODER: DATE: UNIT: Man MAWR: CONTACT 1 All fields are required. Action: 0 Add O Delete O Edit Contact's First Name: diaxiaus 10 ehmetetersi Contact's Lest Name: (maxims 19 characters/ Phone 1: ( ) Phone 2: ( ) Relationship: Attorney Business Children Clergy Friend Other Relation Parent Sibling Spouse Language of Contact: O English O Spanish Postal Address Country: Zip Code: City: State: Re: Address Line 1: Address Line 2: Address Line 3•: For international labels only CONTACT 2 (Optional) All fields are required if second contact is requested. Action: O Add O Delete O Edit Contact's First Memo: IMaximun 10 Char0Cter$1 Contact's Last Hama: Maxima 19 chansctetill Phone 1: ( ) Phone 2: ( Relationship: Attorney Business Children Clergy Friend Other Relation Parent Sibling Spouse Language of Contact: O English 0 Spanish Postal Address Country: Lip Code: City: State: Re: Address Line 1: Address Line 2: Address Line 3•: I 2020-01577 ITEM 3 UNCLASSIFIED 25 ol 26 Page: 36 of 153 - 2020.01577 #1 Record Images (13).pcli SDNY_00017866 EFTA00140962 2020-01577 al UNCLASSIFIED Record Images ormmumhc MAR .1002 Visitina Application !An:opal= Cur. ectionst Cente- 1 50 Prk Row New YOth.. N.Y. 10007 RE: Date: US. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISON'S Inmate Nene and Repstresice MUMJSC: Dear: Inert-queuing that you be included among my approved visitors. In order to establish your suitability as a visitor. It may be necessary for institution officials to send an Inquiry to an appropriate last enforcement or crime information agency to ascertain whether or not peeing you mi my tin would present a ma angemen t rothcm to. tic lostioadorm or ham other possible /Oven( Meets. The LOIOrtalliOn Obtalnal v411 be used to determine your teceptabilles ass visitor. The Bureau of Prisons authority to request background information on proposed visitor, is contained is Tide IS 4041 In order for you to he considered for the privilege with me. it will be necessary for you to fill out the questionnaire and release form below and return it to the following address: Metropolitan Correctional Center 150 Park Row, New York, N.Y. 10007 Attn: Counselor Eklund, Unit 7 South You are not required to supply the Information requested. However. if you do not furnish the information. the processing of your request will be *upended, and you will receive no further consideration. U you furnish only part of the information required, the processing of your request may be significantly delayed. If the information withheld is found to bt essential to the practising of your request. you wig be informed. and your request will receive no further consideration unless you supply the missing information. Although no penalties are authorized if you do not supply the information requested. failure to =pen such Information could result in your not am considered for admittance as • visitor. The criminal penalty for ma Hag (Rise stattmeas u eta of sot more than 5250.000 or imprisonment for oot more than fin years or both (See IS l'S.0 101). SIncerely. :r.r..nte St.:nature! *Forma Returned To The Inmate WILL NOT HE ACCEPTZD• I. :Acta: Nare 2. Gate ot girth 4. Telephone Number :Including Area Code) S. Race and Sex of Visitor 3. Address CircludItc 11; :ode 6. Are you a C.S. Citizen? yes No 6a. If yes, provide Social Security No: 60. If no, provide Alien Registration No: dc. Provide Passport No: 6d. Print a copy of Drivers UMW." or PeesPort Relationship to above-mad inmate S. Do you desire to visit his/her? Yes No 9. Did you know this person prior to his/her current incarceration? Yes NO 10. If the saver to 69 is yes, indicate the length of time you have known this person and where the relationship developed.: :1. Nave you ever been arrested and/or convicted of a crime? If so, state the number. date, place, and nature of the arrest/s and/or conviction/a: 12. Are you currently on probation, parole, or any other type of. supervision? if so, state the name of your supervising probation/parole officer and the address and telephone no. where he/she Can be contacted: 13. Do you correspond or visit with other inmates? If so, SPA:Siesta the individualts) and their location(s): 14. Driver's License No. and State of Issuance: Artregel arras TO =SP= 1,701.10l. ICU I hereby authorize release to the Warden of: The Metr000litan Correctional Center. N.Y any record of criminal offense for which I have beet arrested anciar coasted. and any information rested to those convict:as. ••FORNIS RETURNED TO THE INMATE WILL NOT BE ACCEPTED** Applicant's Signature for Authociadoe to Release Information(Sia and Print Name) lid Want is tzsder IS years of zits:pm of paten: or radial Micas cement of Mx as %nit inmate) If additiceal speoc is requoed you may use the beck of tux kem (This kern may be replicated via WP) To be 69:d in innate Central Pik, FOI Section FOI EXEMPT/SENSITIVE BUT UNCLASSIFIED UNCLASSIFIED 26 al 26 Page: 37 el 153 • 2020.01577 r,5 Record Images (i3).pdi SDNY_00017867 EFTA00140963 202001577 #1 UNCLASSIFIED Record Images Top Top Item 6: ESDA lift from Item 3 Front, Lift #1 2020-01577 16 Paper beginning "AutHoR..DONALD... - Paper beginning "JHONNY CONTReRAS..: UNCLASSIFIED I of 4 Page: 38 of 153 - 2020-01577 #1 Record Images 06) pcd SDNY_00017868 EFTA00140964 2020.01577 #1 UNCLASSIFIED Record Images Paper beginning "AutHoR..DONALD..." 61f a Paper beginning 1HONNY CONTReRAS..." Item 6: ESDA lift from Item 3 Back, Lift #2 Top 207U-01577 io UNCLASSIFIED 2 old Page: 39 ol 153 - 2020.01577 #1 Record Images 06)•Pdi SDNY_00017869 EFTA00140965 202001577 41 Item 6: ESDA lift from Item 3 Page bearing "...AIR..." Back, Lift #1 Page: 40 of 153 - 2020.01577 41 Record Images (i6).pdl UNCLASSIFIED 2020-01577 i6 Record Images UNCLASSIFIED 3 ol 4 SDNY_00017870 EFTA00140966 EFTA00140967 202001577 UNCLASSIFIED Enclosures Red boxes denote indented writing of unknown value Item 6: ESDA lift from Item 3 Page bearing "...AIR..." Back, Lift #1 2020-01577 lb Blue box denotes possible indented writinn hnt which lark< Innihilitv UNCLASSIFIED Page: 42 of 153 - 2020.01577 Enclosures:pal 1 012 SDNY_00017872 EFTA00140968 2020.01577 UNCLASSIFIED Enclosures Paper beginning "AutHoR..DONALD..." unaccounted Paper beginning "JHONNY CONTReRAS..." UNCLASSIFIED 2 01 2 Page: 43 of 153 2020.01577 Encbsures.pd1 SDNY 00017873 EFTA00140969 2020.01577 42 UNCLASSIFIED Record Images )Ct IA ',fl dvyreieifAe9 NYC A/ /oeo • INMATE NAME AND PROPERLY O UNAUTHO NO APPROVAL a UNAMORIZA SSerYWPOSIC 14613$ CF PM 31. 0 SE a GrirR NUMB/RAM RBOUIREDTO IOBITtf FialtrWeriNON/E n 0 "?`tiinn. NO 763 LC03ER AT THIS ADZ.FIEL.-S. 66 B5756-970600 iil g 5 75-e IP 111111 2020.01577 -F81--- UNCLASSIFIED 1 ol 4 Page: 44 ol 153 - 2020-01577 42 Record Images (14-15).pd1 SDNV_00017874 EFTA00140970 2020.01577 52 UNCLASSIFIED Record Images • • • • 0 • • • • • • • • • • • 0 • • • • • • 04 • • • • • • O • • • • • • • • • • • • • • • • • • * * • • • • • • • • • • • • • • • • • • t. • • • • • • .• • • to • • • • • • • • 7$ • • • • • • • • • • • • a • • • • • • • • • • • • • • • • • • I • • • • • • • • • • • • C) • • • • • • • • • • •• • • • AlA • • • • • • • • • • • • • • • • e • • ` • • • • • • • • . • • • • • • • .4, • • • • • • • • • • 10 • • • • • • • • I • • 4 • • • II • •• • • 14• • • • 0 • • •• • , 1/4_ • • • •• • • • • • • Q. • • ." • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 2020-01577 64 UNCLASSIFIED 2 ol 4 Page: 45 01 153 - 2020-01577 42 Record Images (i445)