Registration No: 353899 Person Number: 73274 FDLE SEXUAL PREDATOR/OFFENDER REGISTRATION FORM Agency Name: Palm Beach County SO nee Note: Your next ReRegistration month is July of 2011 ***** Registration For: January 2011 - SEXUAL OFFENDER Reason For Registration O Initial Registration 0 Scheduled ReRegistration O Intimation Update K Early.Late ReRegistration Registrant Information White Race: Name: JEFFREY E EPSTEIN Sex: Male (First Middle Last. Suffix) •SSN: 'Disclosure of your Social Security Number (SSN) is mandatory pursuant to Fonda law. sections 775.21. 943.0435. 944.607. 955.481. F.S.. and federal law. 42 USC 16901. et seg. Use of your SSN 5 for the purposes of Identification, FDLE may share the information wyth the other agencies for the same purpose. FL DL or ID Card #: £123425530200 Height: 6' CO " Weight 180 lbs Hair: Place of Birth: United States Of America (usa) Currently on Probation/Parole: ❑x No O Yes Probation Type: K State K Federal Officer Name: Grey Eyes: Blue Phone: ( ) State Officer Name: Phone: ( ) City Officer Name: Phone: ( ) County Out of State Travel Information (Complete if permanent, temporary, or transient address Is out of state) O Permanently leaving Florida to establish a residence in another state O Temporarily leaving Florida to visit another stale O Moving from another state to permanently establish a residence in Florida O Visiting from another state and establishing a temporary address in Florida O Other (please describe): Date of Departure: Date of Arrival: 1/17/2011 will be at temp address from 01/17/2011 . 01/20/2011 Previous Permanent Address Current Permanent Address 6100 Red Hook Quarters Ste 83 (Address Line 1) (Address Una 1) Little St James Islands (Address Line 2) (Address Line 2) St Thomas VI 00802 (City) County: (State) (Zip) End Date: (O,Y) (State) (Zip) Count,: St Thomas Stan Date: 07/1 9/201 0 O I do NOT have a permanent addres