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 OIntonnattan 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 OFederal 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 (Street Address) New York NY 10021.4102 (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) 3. Employer. r 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: SlesSISIMIS (c2 ton ietO kirk V' (Address tine a. t .& t" — 3 (Address Une 2) Home 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) a NOT used as a residence 0 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 .rISM oak 5. Adjudication Information Dale Adjudicated Curie Location or Adjudication/Conviction Victim Information 1. ' —(Sta —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 by As law a Sexual to abide Predator by (F.S. 775.21) or Sexual Offender (F.S. 943.0435; 944.607; or 985.481) I understand that I am required the following: Permanent residence" means a place where the person abides, lodges, or resides for 5 or more consecutive days. "Temporary business. or personal residence" means a place where the person abides, lodges, or resides. including but not limited to, vacation, travel destinations calendar year and which in or out of this state, for a period of 5 or more days in the aggregate during any state, a place where is not the person's permanent address or, for a person whose permanent residence is not in this the person is employed, practices a vocation, or is enrolled as a student for any period of time in this state. "Transient the aggregate residence" during a means a place or county where a person lives, remains, or is located for a period of 5 or more days in is not limited calendar year and which is not the person's permanent or temporary address. The term includes, but 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 within MUST 48 report hours ingerson of to the local Sheriffs Office within 48 hours of establishing or maintaining a residence in this state, and Family Services release from custody and/or supervision of Department of Corrections (DOC), Department of Children conviction (DCFS), or Department of Juvenile Justice (DJJ), or in the county of conviction within 48 hours of other if not under custody and/or supervision of DOC to register my temporary, transient, or permanent address and information specified in statute. {F.S. 943.0435(2)(a); 775.21(6)(e)1). 2. race, At initial sex, registration, height, weight, I MUST provide the following information to the department: name, date of birth, social security number, electronic mail address hair and eye color, photograph, home telephone number and any cellular telephone number, any F.S., address of and any instant message name required to be provided pursuant to paragraph s.943.0435(4)(d) transient legal residence, address of any current temporary residence, if no permanent or temporary residence, any occupation residence and place within of the state, dates of any current or known future temporary residence within the state or out of state, or crimes committed. employment, date and place of each conviction, fingerprints, and a brief description of the crime {F.S. 943.0435(2)(b): 775.21(6)(a)1}. 3. license Within 48 office hours of after the initial report required as stated in requirement #2 above, I MUST report in person to the drivers as a sexual the Department of Highway Safety and Motor Vehicles (DHSMV) and provide proof of initial registration of offender or predator to secure or renew a valid Florida driver's license or identification card displaying one designation the following was designations: previously -775.21, F.S." or "943.0435, F.S.", unless a driver's license or identification card with such the department secured or updated. The sexual offender shall submit to the taking of a photograph for use by in maintaining current records of sexual offenders. {F.S. 943.0435(3); 775.21(6)(f)). 4. Each temporary, time my or driver's license or identification card is subject to renewal, or within 48 hours after any change in my permanent, driver's transient residence or change in name made by marriage or other legal process, I MUST report in.pArffisie to a card displays license office to update my driver's license or identification card and ensure that the driver's license or identification the designations as identified in requirement #3. {F.S. 943.0435(4)(a); 775.21(6)g1). 5. address If I am enrolled, and county employed of each or carrying on a vocation at an institution of higher education in Florida, I MUST provide the name, in enrollment or employment institution including each campus, enrollment or employment status. including each change offender on supervision with status, i.e. commencement or termination, [parson at the Sheriff's Office; OR, for a sexual officer, within 48 the Florida (DOC) or (DJJ), this information must be reported to the sexual offender's probation hours after any change in status. {F.S. 943.0435(2)(b)2; 775.21(6)(a)b}. 6. I or MUST by providing report any electronic mail address or instant message name, prior to using such, during registration/reregistration {F.S.943.0435(4)(d); all updates through the online system maintained by the Florida Department of Law Enforcement. 775.21(6)(g)4}. 7. If residence, I vacate a permanent, temporary, or transient residence, and do not have another permanent, temporary, or transient 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 in_person I report that I have vacated a permanent, temporary, or transient residence and then remain at that residence, I MUSTreport second degree. to the Sheriffs Office where I reported vacating my residence. Failure to report this information is a felony of the {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 943.0435(6);775.21(8)}. understand that my address will be verified by county, state or local law enforcement agencies. {F.S. 10. If ofFlorida, I intend on establishing a permanent. temporary, or transient residence in another state or jurisdiction other than the State date that I I MUST report in person to the Sheriffs Office of the county of my current residence within 48 hours before the intend to leave this state to establish residence in another state or jurisdiction. {F.S. 943.0435(7): 775.21(6)(i)}. 11. If of I Florida intend and to establish a permanent, temporary, or transient residence in another state or jurisdiction other than the State my later decide to remain in this state, I MUST report in person to the Sheriffs Office to which I reported felony intention of leaving the state within 48 hours after the intended departure date. Failure to report this information is a in the second degree. {F.S. 943.0435(8); 775.21(6)(j)}. 12. I month) MUST or report in person either twice a year (during the month of my birth and during the 6th month following my birth designation, four times a year (once during the month of my birth and every 3rd month thereafter), depending upon my offense/ 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: Sexual All Offenders Sexual Predators, Sexual Offenders convicted for offenses specified in F.S 943.0435(14), and Juvenile Sexual Offenders are required to register per F.S 943.043591)(a)1.d are required to reregister four times a year. All other 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 Oct April, July. Oct & Jan Nov May. Aug, Nov & Feb Dec June, Sept, Dec & Mar 13. If address I live in within another 48 hours state, but work or attend school in Florida, I MUST register my work or school address as a temporary 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 correspondence. from FDLE within three weeks of the date of the (F.S. 943.0435(14)(c)4; 775.21(10)(a)). 15. If a I requirement am employed, carry on a vocation, am a student, or become a resident of another state, I am on notice that I may have 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 REQUIREMENTS. I HAVE READ OR HAVE BEEN READ THE REQUIREMENTS ON THIS FORM, AND THAT I UNDERSTAND THESE Under penalty of perjury I declare the above is true and correct. January YOU ARE AND REQUIRED TO REREGISTER EACH YEAR AT THE SHERIFF'S OFFICE IN THE MONTHS OF July. Registrant: Signature Required Printed Name: JEFFREY E EPSTEIN Page 6 of 6 Witnessed by Reporting Officer: CA (34 JDate: 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