Financial record

EFTA00073350¶

For Internal Use Only¶

Biennial Statement¶

1379614¶

DOS ID: 1379614¶

ONLINE FILING:¶

• See reverse side for instructions. Please note Farm Corporations must file a paper form.

PAPER FILING:¶

• Farm corporations are exempt but must notify the Department by checking the Farm Corporation Exemption Box below, completing the signer information section and mailing this form to the Department of State at the address on the reverse side of this form. Forms may also be faxed to (518) 486-4680. No fee is required.

• All other corporations should provide or update information, if necessary, in Parts 1 through 3 below and complete the signer information section. Mail the form to the address on the reverse side of this form along with the filing fee. The fee is payable by check, VISA, MasterCard or American Express. Checks must be payable to the “Department of State”. Credit Card/Debit Card Authorization forms can be found on our website at www.dos.ny.gov. This form, along with the Credit Card/Debit Card Authorization form, can also be faxed to (518) 486-4680.

Farm Corporation Exemption¶

This is a farm corporation engaged in the production of crops, livestock and livestock products on the land used in agricultural production, as defined in Agriculture and Markets Law Section 301. Farm corporations are exempt from the Biennial Statement filing requirement.¶

Check if applicable¶

Part 1 - Chief Executive Officer’s Name and Business Address¶

JEFFREY EPSTEIN 6100 RED HOOK QTR STE B03 ST THOMAS VIRGIN ISL US 00802	Name
	Address
	City	State	Zip Code

Part 2 - Street Address of Principal Executive Office (A Post Office Box cannot be used)¶

NINE EAST 71ST STREET CORPORATION 301 EAST 65TH ST STE 10F NEW YORK NY 10005	Address Line 1 C/o Darren K. Indyke, PLLC
	Address Line 2 575 Lexington Ave., 4th FL
	City New York	State NY	Zip Code 10022

Part 3 - Service of Process Address (Address must be within the United States or its territories)¶

DARREN K INDYKE ESQ 301 EAST 66TH ST STE 10F NEW YORK NY 10005	Name Darren K. Indyke Esq.
	Address 575 Lexington Avenue, 4th F1
	City New York	State NY	Zip Code 10022

Signer Information¶

Name of Signer (Please Print)	Capacity of Signer (check one)
□ Officer	□
□ Director	□
□ Authorized Person	Signature

DOS-1179 (2011/12)¶