Registration No: 353899 Person Number: 73274 FDLE SEXUAL PREDATOR/OFFENDER REGISTRATION FORM Agency Name: Palm Beach County SO ***** Note: Your next ReRegistration month is July of 2011 ***** Registration For: January 2011 - SEXUAL OFFENDER Reason For Registration El Initial Registration 0 Scheduled ReRegistraban O Intonnattan Update O Early/ ate ReRegistration Registrant Information Name: JEFFREY E EPSTEIN *SSN: =MI DOB: 01120/1953 Race: White Sex: Male (First Middle Last. Suffix) 'Disclosure of your Social Secure), Number (SSN) is mandatory pursuant to Florida law. sertlons 77621.943.0435, 944.807, 085.481, FS.. end federal law. 42 USC 16901. et seq. Use of your SSN is for the purposes of identificatian.FDLE may share the information with the other agencies let the same purpose. FL DL or ID Card #: E123425530200 Height. 6' 00' Weight: 180 lbs Hair Grey Eyes: Blue Place of Birth: United States Of America (usa) Comely on Probation/Parole:ado O Yes Probation Type: O State O Federal O County Sins City Officer Name: Phone: ( ) Officer Name: Phone: ( ) Officer Name: Phone: ( ) County 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 stale 0 Temporarily leaving Florida to visit another state 0 Moving from another state to permanently establish a residence in Florida Visiting from another state and establishing a temporary address in Florida 1 .) 41 )cHa- — C." ho t)/ Other (please describe): will be at temp address tram Date of Departure: Date of Arrival Imereem. c thothi e.X Previous Permanent Address Current Permanent Address 6100 Red Hook Ouarter4Sle 83 (Address Lino I) (Address Line 1) Little St James Island* 4._ (Address Line 2) (Address Line 2) St Thomas VI 00802 (Coy) County: (SIMs) (a) End Date: (City) (Stale) (Zip) County: St Thomas Stan Date: 07/19/2