first name, middle initial)
, . ... . . ..
4'
t ri v :MI:ailair Taapayer ID Woman+. Social Sectoly Nemtel or Taxftbies ID Numbs
filitliatUAldriCAlaitlitr BS • •
Addissi :Address'
Not applicable .0080i..1—•
• Crty,:State
https://www.justice.gov/epstein/files/DataSet%2010/EFTA01392655.pdf