EFTA00110599¶
FD-249 (Rev. 3-1-10)¶
STATE USAGE¶
LAST NAME: FIRST NAME, MIDDLE NAME, SUFFIX¶
Epstein, Jeffrey Edward¶
SIGNATURE OF PERSON FINGERPRINTED¶
SOCIAL SECURITY NO.¶
LEAVE BLANK¶
ALIASES/MAIDEN¶
LAST NAME, FIRST NAME, MIDDLE NAME, SUFFIX¶
76318-054 EPSTEIN¶
| FIL NO. | STATE IDENTIFICATION NO. | DATE OF BIRTH | MM DD YY | 01/20/1953 | SEX | M | RACE | HEIGHT | WEIGHT | EYES | HAIR | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | R.L. THUMB | 2.R. INDEX | 5.R. INCLE | | | 4.R. RING | | | | 5.R. LITLE | | | | R.L. THUMB | 7.L. INDEX | 8.L. INCLE | | | 9.L. RING | | | | 10.L. LITLE | | |¶
LEFT FOUR FINGERS TAKEN SANCTHANOUSLY¶
EFTA00110600¶