Ofthe (hilted Order to States, form w more perfea ectahQiiestice. hzcieredomectic proviaor the 7;w/fit/lit): ci9mmem de/ewe. pm/to te/he:mend trfare e wfd seav re the ikessikgs o/Lzherty oloYek,es (ma'. .",4 v ` ,do on irr andesteNia5 thu t, ermit4Wiiff tAt I /tea/Suva o/Ametiht SIGNATURE OF / SIGNATURE DU TITULAIRE / FIRMA DEL TITULAR OA CCI1(1O"1" A. • • NI11,...HITITh., W:s /Type I Tipp " Surname / Notr100tici , EPSTEIN Given Names / Prenoms / Nombres JEFFREY EDWARD Nationality / Nationality 1 Nacionalidad UNITED STATES OF AMERICA Date of birth / Date de naissance / Fecha de nacimiento Wa raa de:: Co Pits.%ppyl 40 I \ c1u \-a",zpoc<11,V" c1e PazapzAe. SA 5 66612.615 20 Jan 1953 Place of birth / Lieu de naissance / Lugar de nacimiento NEW YORK, U.S.A. Date of issue / Date de delivrance I Fecha de expedicion 08 Mar 2019 Date of expiration / Date d'expiration / Fecha de caducidad 07 Mar 2029 Endorsements / MentiOns Speciales / Anotaciones SEE PAGE 51 Sex I Sexe I Sexo M Authority I Autoute I Autotidad United States Department of Stat -jaw pp* AP. ; D<USA EPS TEI N<<J EF F REY<EDWARD<<“<<“<<“<<O :666726154USA5301207M2903079512548414<70690 EFTA01227880