Registration No: 436693 Person Number: 73274 FDLE SEXUAL PREDATOR/OFFENDER REGISTRATION FORM Agency Name: Palm Beach County SO Note: Your next ReRegistration month is July of 2012 Registration For: January 2012 • SEXUAL OFFENDER Reason For Registration 0 Iota: Registration 0 Scheduled ReRegairaton O Inforwabon Update O Eany/Laa ReFlegisUaeon Registrant Information Name: JEFFREY E EPSTEIN "SSN: 000: 01120/1953 Race: White (First Moe,. Last. Suffix) Sex Male 'Disclosure of your Social Security Number (SSN) is mandatory pursuant to Florida law. sections 77521.943 0435. 944 607. 985.481, F S . and federal law. 42 USO 16901. et seq. Use at your SSN a for the purposes of kleoUlkation. FDLE may share the inionnation with the other agencies for the same purpose. FL DI. or ID Card Jr. Hair: Grey Eyes: Blue Height• 6'00 ' Weight. 1130 lbs Place of pith: United States Of America (usa) Cunently on Probation/Parole: 0 No O yes Probation Type: O State O Federal 0 County Officer Name: Phone. ( ) State Officer Name Phone: ( ) City Od.* Officer Name: Phone:( 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 state O Temporarily leaving Florida to visit another stale O Moving from another stale to permanently establish a residence in Florida O Visiting from another slate and establishing a temporary address in Florida ▪ Other (please describe) Date or Deparlure Date of Arnwiti iI boi a_ I Mr. EPSTEIN vdt be staying at his Temporary address 358 El Breo Way Pevn Beach FL 33410 until OSa ata Previous Permanent Address Curreyt Permanent Address 6100 Red Hook Quarter/Ste B9 (Address Line 1) (Address Line 1) Little St James Islandsfr" (Address Line 2) (Address Line 2) SI Thomas VI 00802 (City) County (Vale) (70) Erd Date: (AY) (Slate) (20) County St Thomas Stan Oat 07/19/2010 O