S r. o' New von: os.seA or Deeeel s,stoe Sr. :es 0 So..", Sea- Si Aws NY 1221C To JEFFREY EPSTEIN t !TILE ST JAMES 6100 RED NOOK OuARTEPS SLATE 03 ST THOMAS vi ot3502 From Sex Offender Registry Unit NYS Division of CrImir?' Justice Serve:es RE Annual Address VesSoat on Sex Offender Registry Annual Address Verification Form Apni 9. 2014 Offender ID 33216 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 proyoder(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 • If you find any information that is incorrect or outdated. cross out incorrect or outdated information with a single line.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 now: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 Retstry at 518-457.3167 with any questions s firm OFFENDER INFORMATION LAST NAME FIRST SAME MIDDLE SSW LosTE % .EFCPEY E u... „,...•, , .-,... OTHER NAMES ERSTE N ,EFFREY ECWARD Enter any aliases. nick names or other names used in the following section EFTA_R1_00012193 EFTA01734336