Extracted Text
Highlighting: “"Jeffrey"”
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Slate of New York
Division of Criminal Justice Services
•0 South Swan St
Albany, NY 12210
To: JEFFREY EPSTEIN April 9, 2015
LITTLE ST JAMES Offender ID: 33216
8100 RED HOOK QUARTERS, SUITE B3
ST THOMAS VI 00802
From: Sex Offender Registry Unit, NYS Division of Criminal Justice Services
RE: Annual Address Verification
Sex Offender Registry Annual Address Verification Form
The Sex Offender Registration Act (SORA) requires you to review, update, and sign this Annual Address
Verification Form and mail this form back to the Division of Criminal Justice Services within 10 days from receipt
of this form. You must do this whether or not you have reported updated information to parole, probation or a
law enforcement agency. If you attend, are enrolled at, reside at, or are employed at any institution of higher
education, you must provide that information on this form. You must also report your internet service provider(s),
all screen names, all e-mail addresses and all other information listed on the form. If you are a level 2 or 3 sex
offender, you must report the name and address of all employers.
INSTRUCTIONS:
• Review each line of information on this form carefully.
• If you find any information that is incorrect or outdated, cross out incorrect or outdated
information with a single line.
• Enter any corrections or any new/additional information in the blank boxes provided.
THIS FORM MUST BE SIGNED AND ALL PAGES RETURNED EVEN IF NONE OF THE INFORMATION
HAS CHANGED. FAILURE TO RETURN ALL PAGES OF THIS FORM WITHIN 10 DAYS OF RECEIPT IS A
FELONY AND MAY RESULT IN THE ISSUANCE OF A WARRANT FOR YOUR ARREST.
Please contact the Sex Offender Registry at 518-457-3167 with any questions about this form.
OFFENDER INFORMATION
LAST NAME FIRST NAME MIDDLE SSN
EPSTEIN Make
JEFFREY E ecetectons
C--- /we
OTHER NAMES
EPSTEIN,JEFFREY EDWARD
L
Enter any aliases, nick names or other names used in the following section.
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PHYSICAL ATTRIBUTES
BIRTHRATE HEIGHT WEIGHT HAIR EYES GLASSES
01 . h953 600 180 Gray Blue tam. cambons
4.— Mn
SCARS/MARKS/TATTOOS
Enter any other scars/marks/tattoos.
PR MARY ADDRESS
Primary address is the address where you live most of the time.
NUMBER/STREET/APT CITY
--14,=Leei JM4E6, eiRRTERS-SicliTiE-04— ST THOMAS
Mae inereceons
.
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STATE ZIP COUNTY COUNTRY
vl 00002 US Make carKSIOM
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Phone a el this acklress:16111)^168-7414S— I Enter phone l/ correcUsn here —s •
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Name of Coltege / University
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SECONDARY ADDRESS
Secondary Address is the address where you live some of the time.
NUMBFJUSTREET/APT CITY
9E71STST NEWYORK
Make caw:Ions
1 C.- here
STATE ZIP COUNTY COUNTRY
NY 100214102 New York US Make axreclans
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Phone N at Pm address: I Enler phone N correction here —a •
Name of College / UtwerSily.
NUMBENSTREETIAPT CITY
makemoutons
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1 1-_,
STATE ZIP COUNTY COUNTRY
FN Maks orremons
C.- ha°
Phone 8 ill this eddies. Enper phone IT catechon hero —, , 3
Name of College I University
NUMBER/STREET/APT CITY
358 EL BRILLO WAY PALM BEACH
Make ceerectons
3 <— two
STATE ZIP COUNTY COUNTRY
FL 33480 .1$ Make Cirecu0ns
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P11O1111i8lItes address Es Sr phone a correction hare --a' ,,..
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Name of College / Univers/1y
NUMBERISTREETIAPT CITY
49 ZORRO RANCH RD STANLEY
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STATE ZIP COUNTY COUNTRY
NM 87056 US Make catemons
Phone e at this address I Enter phone 8 corredan hen) —> -
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Name of College / UniverSoly
Enter any additional Secondary Address in the following section
NUMBER/STREET/APT CITY
.
1
STATE ZIP COUNTY COUNTRY
Enter phone a here —>
II the above address Is on the campus of a Cones, Or UniverSily.enter its name
NUMBER/STREET/APT CITY
2
STATE ZIP COUNTY COUNTRY
Enler phone a here a
If the above address is on ihe campus of a College or Unrvers4y.enter its name
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PO BOX ADDRESS
PO Box Address is allowed if mail cannot be delivered to the primary address. PO Box Address must be
approved by the Post Master and Law Enforcement.
Enter any PO BOX Information in the following section .
PO BOX CITY
i
STATE ZIP COUNTY COUNTRY
EMPLOYMENT INFORMATION
EMPLOYER'S NAME NUMBER/STREET/APT
-SOUTHESIN-TRUS-T-OOMP,4•24.- -SOUR4ERNTRUST-COMPAN6400--
-..C81USSR OLI P2ERS-SeirE-03—
Make torsalons
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CITY STATE ZIP COUNTY COUNTRY
ST THOMAS V1 00802 US . mike oximmons
C. hate
Name of Corege / University'
En er any additional employment information in the following section
EMPLOYER'S NAME NUMBER/STREET/APT
-
1
CITY STATE VP COUNTY COUNTRY
lithe above address it on the campus of a College or Universly,enter its name
EMPLOYER'S NAME NUMBER/STREET/APT
2
CITY STATE zur, COUNTY COUNTRY
If the above address 13 an Ihe Campus of a College or UnNersily enter its name
HIGHER EDUCATION INFORMATION
Higher education includes any 2 or 4 year colleges or any trade or vocational schools.
Enter any additional education information in the following section
SCHOOL NAME NUMBERISTREET/APT
1
CITY STATE ZIP COUNTY • COUNTRY
Dales or Attendance. Employment or Enrollment Check one
From Dale To Oats
0 ' Enrolled
• Employed
El Ntenohng
%RAHN.. NAM. NUMBER/STREET/API
2
CITY STATE ZIP COUNTY COUNTRY
Cites of Allandencro. Employmont ot Enrollment Chedc one
From Date To Dale
• Enrolled
0 Employed
• Anericlng
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VEHICLE INFORMATION
Information of any vehicle that you own or drive.
YEAR MAKE MODEL COLOR LIC PLATE STATE
2006 Bentley Amage Black V752DS - NY'- maw cur re< .E.knk
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2007 Hummer Hummer II Black CPK643 NM Mu:. <kr •s
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2002 Mercedes-Benz 500 Series Black C165SP FL Mat.. c roC.,.., I.
2010 Chevrolet Suburban Bled( TED218 VI MI/No <wroc.ors
NM Mots coiloC%Or I
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1968 N908JE - V1- Mew correcw.”
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1968 2583TC VI Yaks Urroccals
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2008 2907TC VI mikx rex-orioni
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2006 07307C VI lAisoi cart ockoe 3
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41061C VI ),.‘ '...a c .crw
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1999 2709113 VI Mt.!, caronvil
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2012 Cadillac Escalade Black UTX3155 - -4F1--- i:;., ca:ricbceis
2010 Chevrolet Suburban Black BDLH78 .T.L no c,r,oc,,N-.
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2008 Lend Rover Range Rover Black MLD718 NM Vskt reckcow
C. two
Dodge Caravan Black TEM492 FL Arnkkn <:rwc.1<wk
2013
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2013 Ford Expedition Black 522RZZ NM ro.,t9 4:aro:op- I
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YEAR MAKE MODEL COLOR UC PLATE , STATE
301Irt.- :' Vrtlet A.Onkirkenn F3Inci.._ No,LI5q KIM
;)0 ice. 1W, Iti4cin \Firth P„‘Or r TF T .T15 \II
a.)01 CSICik1100, c- :SrOlrlila NOCK_ GWG WMI NN
DRIVER'S LICENSE INFORMATION
DRIVER'S LICENSE NUMBER ISSUING STATE
- VI maxe carman
C0000
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0000026874 VI Malta earecoan
Enter any additional driver's license information in the following section
DRIVER'S LICENSE NUMBER ISSUING STATE
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INTFRNFT INFORMATION
SERVICE PROVIDER
SERVICE PROVIDER
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SCREEN NAME
SCREEN NAME
THEJEFFREYEPSTEINFOUNOATION Make cannon,
JEFFREYEPSTEIN Mike Canaan.
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JEFFREYEPSTEINORG Make «taxicab
THE JEFFREY EPSTEIN VI FOUNDATION NUM Careaoni
JEFFREYEPSTEINFOUNDATION Make correebona
JEFFREY EPSTEIN "like Canaan
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JEFFRETEPSTEIN1 MM. tarecUons
TVVITTERJEFFREY_EPSTEIN Melt* Cankbant
JEFFREYEPSTEINI2 MekA carecla
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EMAIL ADDRESS -3(c: V-41,1 nic nIt'Ll
E4AAIL ADDRESS
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MAILJEFFREtEP_STEINUSVI COM Maa «ontkom
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Enter any additional internet information in the following section
SERVICE PROVIDER SCREEN NAME E-MAIL ADDRESS
I CERTIFY THAT THE INFORMATION ON THIS FORM IS COMPLETE AND ACCURATE. I HAVE CROSSED
OUT ALL INFORMATION THAT IS INCORRECT OR OUTDATED. I HAVE ADDED ALL CORRECTIONS
AND ALL NEW INFORMATION. I UNDERSTAND THAT FAILING TO PROVIDE THIS INFORMATION OR
PROVIDING FALSE INFORMATION IS A FELONY.
1e i2 .;kern
Sex Offender's Signature Sex Offender's Date
Name(print)
THIS FORM MUST BE SIGNED AND ALL PAGES RETURNED EVEN IF NONE OF THE INFORMATION
HAS CHANGED. FAILURE TO RETURN ALL PAGES OF THIS FORM WITHIN 10 DAYS OF RECEIPT IS A
FELONY AND MAY RESULT IN THE ISSUANCE OF A WARRANT FOR YOUR ARREST.
Return to:
Division of Criminal Justice Services - SOR
80 South Swan St
Albany, NY 12210
Page 'C ofl
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ATTACHMENT TO SEXUAL OFFENDER REGISTRATION FORM
JEFFREY EPSTEIN
Automobiles,
. _ Boats, Aircraft, Telephone Numbers, Email Addresses, and Internet Related IrdormstIon
•
License • State
WM Mete Ftes,wed
1 2010 Chevrolet Sansban lIGNUCKEOSAR225550 TED 2T8 USVI Black 'LSJ
2.2002 Mercedes Bent 5500 V310 2A217037 C18 5SP Florida — Bradt Florida—
3:2010 Chevrolet Suburban riNUKKE3OAR251129 BOL H78 Frida Black Florida
4 2007 Hunimer H2 I 5GfiGN23U57H1002.9 CM 643 I New Mexico Mack Florida --
5 20138 Bentley Amage RL ISCWEDG28CX19439 vW i Florida 11sek iNew York
82012 Cadillac Escalade 11GYS4JEF4CR216978 NHL 381 New Met il TNew Mesico
7'2008 Range Rover _ — rUALS~128123 MLD 71$ F New Met 35W- New Medea
_8.2013 Dodge Caravan 2C.4ROGBØL~495 492 rervi Thlick LSJ
9 2013 Ford ExpeOlion EL 1FIAIK2A55DEF219W 5/2 RII New Memco 'tack New Mexi
10'2015 Chevrolet Suburban .1GNSKKKC5FR146558 NAL 190-- f New Mexico Mack New Marko
112015 GMC Yukon Denali IlGKS2JKJOFR553299 575 I USVI Black LSJ
12 .2015 Cadillac Escalade -TGYSIUKJ1FR584952 GWG 4871 I New York ,Black New York
Boat Registration Hui ID
BOATS , ~ Number ' WSW<
1 .1999 35' Rildecwilh Yamaha Engine Nana i2709-TC 99507
2 2011 Yamaha WC1800A-KB Infa i4108-TC US-YAMA28230111
3_2011 Yamaha Vl(T800A-KB Inia Nios-Tic YACAA3205C111
4 2006 31' Cape Hem 1PRO 0730-TC FA831056KM0
5.2008 36' Prom* little C 2907-TC WJF101881-61- IL8J
6 Miss Ave • 1968 7r LMC-6 (barge) wg N 12583-TC 74CM6763 1.8.1
7 2012 Bombadier Sea Doe n/a f4641-TC Troviareeniz 8J
Registration
Tail Number I Maoris - ter all lot:aeons
AIRCRAFT
1 1968 Boeing 727 N908JE .The Cyfl E. King airport in SI. Thomas
2.2001 Bell 430 N331JE Vitt Palm Beach International Upon and Boca Raton Airport
3 1988 Gulfstreaml34V N212JE ISenta Fe Municipal Airport & Albquerque International. New Mexico ,
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Jo F Kennedy Internationfil od, Newark international Airport &
Teterboro. NJ plus East 34th Streeiflesport 3401Streel & FOR Drive.
Wall Street Heliporl - Par 6 8 FOR Drive 8 VIP Heliport -1Nest 30111
Street & 12111 Ave
Long Island MeeArlburAkporl find Stewart International Airport
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61 I Staff line New Mexico
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1_71 Staff hoe I New Mexico
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CELLP
INTERNET RELATED INFORMATION - SEE NOTE BELOW
EMAIL ADDRESSES
ifeenfacallonarneconl
evacirs2n1Sme.corri
Jeeprojectlityapoo.com
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WEBSIT.0
www.jeffrev
__Mtfele_irateasieinktaLSIND
mytejeffrtte
TWITTER
jeffrey_epstein
jeffreyepsteln1
INSTAGRAM
jeeproject
OTHER INTERNET ACCOUNT INFORMATION
Company Type Settlement user Name
411 business directory Jeffrey Epstein VI Foundation LeffrAry@iellsceePSIelebre
Stoupons business directory Jeffrey Epstein VI Foundation jeffrey@jeffreyepstein.org
•aboutus.org Public profile JeffreyEfintein jeffreyepsteinorzegmal corn
AnYell business deed Jeffrey Epstein VI Foundation bilireralefireyepsielnors
article directory Jeffrey Epstein VI Foundation JeffreyEosiein ,
BesiOrTheWeb business directory Jeffrey Epstein VI Foundation tr
ItaraieffteyenClein.451
- .Blogspot Ownvitffreyiipsieinbiog.comTblog host The Jeffrey Epstein Foundation ieffreyepsieinor mail corn
Brand Yourself Ionline management Jeffrey Epstein
ChamberolCommerca.com business directory Jeffrey Epstein VI Foundation
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OlinStarch business directory Jeffrey Epstein VI Foundation ftlkeyaktrisyTheosteaufg
'Cricket business direciory Jeffrey Epstein VI Foundation Jeffteyaieffreyemitinorg
tixtbase _
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•
Delicious .public profile jeffreyipsteinl iefireyepsteinoraftmail.
DexKnows business &redo, Jeffrey Epstein VI Foundation jeffretajeffrey iNnsyg
Olgg sweet profile 'The Jeffrey Epstein Foundation mai.com
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Pholobucket public pr0file Jefhey_Epstein JeffroYePclernoGICANSccm
Mayes] public prole Jedreybpstein2 jeffreyeeeffreyepslein om
Pocket business directory Jeffrey Epstein VI Foundation Jakeygrateffreyepsteln.org
press releases The Jeffrey EpsteE Foundation eareYeeStein0rpaernall cora
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Superpages
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ouar ges.com social neva directory Jeffrey EpswirThThYundation leacleiMiceonabitnieLO3n1
Switchboard business directory Jeffrey Epstein 21TOundation terareNeltielfreyepsttqg •
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ADDITIONAL WEEISITESTCNFILOG SITES MAINTAINED BY THIRD PARTIES CONTENT RELATING TO
EHILANTIIROPIO SCIENCE OffEUSWESS RELATED ACTIVITIES QF JEFFREY evict+
wwwlenreyopsteino3.wordpressmen
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