FORM NOT COMPLETE - TURN PAGE OVER TO CONTINUE

SECTION L - Offer YICTM | | | Adult | | X ] Minor | | | Ansilited by Reason of In-AS No URNS AMINOR VICIPI (BestApr) ESB) County Court No Rogistered an a Bex Offender in another State: [ ] NO [ X ] VES YES, which state: NEW YORK LEVEL SECTION M - PLEASE READ CAREFULLY BEFORE SIGNING As a Sexual Offender (Title 14 V.I.C. § 1721-1721) you are tuquired by low to abiles by Within these (3) business days of expension to ac refusion to the usil negister in the Virgin Islands a not cured in each pristicien in which you reach juristics and in each jurintisim annual project including sell engi compensating and v al. and in each jurisdiction where sou any a stud vent there is a change in your nam nel identifiers, you are required its spear in pensor al the Degatment of Justice Hot later than thee (I) working day a film a the event that you move outside of the United States Virgin Nilands, you. your rea ou are traveling outside of the Viegin is Slands your and fo required to appear in person at the Department of Justice from, dates of travel, places of anival and departure, itinerary details, addr. to your departure and provide your havel desire ending on the type of sex offense for which you have bee claimed, you are legisted to access in carson all the Decartmen 144 [ [ every three [3] months [ ] [ every six (6) months | [ ] every your on the hose o required to appear in person at the Departme and to take a current photograph, when recessary, for a per [ ] 15 years [ ] 25 years [ ] for ills. ply with these tion four failures in resealedies a Virgin Islands Code, Title 14, Section 1730, punishable by a fine not less than $3,000 nor more than $5,000, or sprisonment. for not leas than fires months nor more than two years, or both; and b. Federal Law, 18 U.S.C. Section 2250, punishable by up to 10 years of imprisonmant. Be Raminded that under Title 1 of the Adam Walsh Act endited the “Sexual Offender Rogi tion and Notlikeation Art 1/5/5/9/ toviduals convi Bed of a sex offerse are register and liees ther registration cument in each jurisdich resides, is an employee and is a student FAILURE TO DO SO MAY SUBJECT YOU TO CRIMINAL PROSECUTION YOUR NEXT REGISTRATION DATE: 03/05/2020 Registrant

VIRGIN ISLANS DEPARTMENT OF JUSTICE OFFICE OF THE ATTORNEY GENERAL IRGIN ISLANDS SEXUAL OFFENDER REGISTRY

Notification of Daty to Report Travel

Name of rocipiene Jeffrey Epstein

On this 15th day of Mar . 2019 . I have been advised, and I understand,

Travel to US Jurisdictions

I . That pursuant to Chapter 86, Section 1724 (b) (1) in the event of a change in tentperary lolging, I an required to inform the Virgin Islands Department of Institution, in person, of any changes to my temperary ledging information and shall notify the juriselicism, in in which I will be temporarily staying. 7_ Inquali

ing, but not limited to vacation, business to a place where I abide, lodge, or reside, U.S. Virgin Islands, U.S. Virgin Islands. A Intials

International Travel

1 1. That pursuant to Chapter 86, Section 1724 (b) (4) 1 am required to appear in person at the Virgin Islands Department of Jusice at least twenty one (21) calends days prior 1s any intended travel outside of the United States and provide persiness travel

If information in the 21-day rotice requirement is requirement is requested, I must submit information in support of the request for approval at the discretion of the Department ed Autice. frights Initials

Required Information for Travel

That when I appear in pensen to inform the Department of Justice of my intent to travel, I must provide the following information:

• i. Destination
• ii. Dates of travel
• iii. Places of arrival and departure
• iv. Itinerary details.
• v. Addross ce, in lieu, telephone contact informs
• vi. Purpose of travel
• vii. Any other required information

MOOT SON 18