EFTA00102197

# THE CITY OF NEW YORK

VITAL RECORDS CERTIFICATE

# DEATH TRANSCRIPT

# DATE FILED THE CITY OF NEW YORK – DEPARTMENT OF HEALTH AND MENTAL HYGIENE

AUG-11-2019 07:36 PM CERTIFICATE OF DEATH Certificate No. 156-19-032838

# 1. DECEDENT'S LEGAL NAME JEFFREY EDWARD EPSTEIN

# Part II

## PART II

### 6. Injury Date (mm dd yyyy)

- **7a. Injury Date** (August 10, 2019)
- **7b. Time** (AM PM)
- **7c. Due to or as a consequence of**
- **7d. Due to or as a consequence of**

Other significant conditions contributing to death but not resulting in the underlying cause given in Part I. Include operation information.

## 7. How Injury Occured

### 7a. Transportation Injury Specify

- Driver/Operator
- Pedestrian
- Passenger
- Other Speed

### 8. Minor of Death

- Pending further study
- Natural
- Homicide
- Accident
- Suicide
- Undetermined

### 9. Autopsy

- Yes
- No Autopsy
- Paint to Law
- No Autopsy

### 10. On the basis of examination and/or investigation, in my opinion, death occurred due to the causes and manner as stated:

- Center Signature (KRISTIN ROMAN Medical Examiner) (Deputy Child) (Child) (Medical Examiner)

### 11. Usual Residence State US Virgin Islands

- County St Thomas
- City or Town St Thomas
- Little Saint James Island

### 12. Date of Birth (Month) (Day) (Year) (Years)

- January 20, 1943

### 13. Age at Work (Month) (Day) (Year) (Years)

- 1943

### 14. Social Security No.

- 3348

### 15. Dust Occupation (Type of work done during an out-of-work life)

- Consultant

### 16. Kind of business or industry

- Finance

### 17. Education (Check the box that best describes the highest degree or level of school completed at the time of death)

- Brooklyn, New York

### 18. Birthplace (City & State or Foreign Country)

- Brooklyn, New York

### 19. Event in U.S. Army Forest?

- First, Middle, Last

### 20. Mother's Name (First, Middle, Last)

- Seymour Epstein

### 21. Savings Squeeze to Partner's Name (If wife, name prior to first marriage)(First, Middle, Last)

- Paula Stolofsky

### 22. Informant's Name

- Mark Epstein

### 23. Method of Disposition

- Bursal

### 24. Place of Disposition (name of ceremony, cremation, other place)

- City Cemetery

### 25. Location of Disposition (City & State or Foreign Country)

- New York City Manhattan Hospital

### 26. Address (Street and Number)

- City & State ZIP Code

### 27. Date of Disposition

- August 11, 2019

### 28. Funeral Establishment

- New York-Presbyterian-Lower Manhattan Hospital

### 29. No Correction History.**

- EVT20190837726

The City of New York

| Gretchen Van Wye, Ph.D., City Registrar as of 9/1/18 |

| :--- | :--- |

This is a simple Markdown document with no headings or paragraphs. It contains a single line of text.

This is to certify that the foregoing to a true copy of a record on file in the Department of Health and Mental Hygiene. The Department of Health and Mental Hygiene does not certify to the truth of the statements made thereon, as no inquiry as to the facts has been provided by law.

Do not accept this transcript unless it bears the security features listed on the back. Reproduction or alteration of this transcript is prohibited by §3.19(b) of the New York City Health Code if the purpose is the evasion or violation of any provision of the Health Code or any other law.

DEPARTMENT OF HEALTH AND PUBLIC HYGIENE

NEW YORK
1891



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