Federal Bureau of Investigation¶
Victim Services Division¶
Epstein Briefing RSVP¶
October 15, 2019 - Miami, FL || October 23, 2019 - New York, NY¶
Please fill out the following form and return to the VictimServices@fbi.gov emailbox by October 4, 2019.¶
Address 2: Click here to enter address 2¶
Zip:¶
Country of Birth: United States¶
If you have spoken with a FBI Victim Specialist, please provide their name:¶
will also attend with victim and victim’s mother.¶
☑ Yes, I will attend¶
□ No, I cannot attend¶
If yes, which location will you attend?¶
□ 10/23/2019 New York, NY¶
You are authorized to bring one support person. Will you be bringing a support person with you to the briefing?¶
□ No, I will not bring a support person¶
Will you need travel arrangements?¶
□ No, I will not need travel arrangements¶
If yes, which mode of transportation do you prefer?¶
| Air | Rail – Brightline from West Palm to Miami and will need transportation to the field office |
| Bus | Mileage reimbursement (if you are utilizing your own vehicle) |
Only economy, roundtrip fares and one checked luggage bag per person will be authorized. You will be responsible for any incidental charges incurred such as in-flight snacks, Pay-Per-View, Wi-Fi, etc.¶
Airport of origin:¶
Click here to enter departure airport name¶
Do you require lodging?¶
Only two nights of lodging will be authorized and only hotel room cost and tax will be authorized. You will be required to provide a credit card for incidental charges upon check in. You will be responsible for any incidental charges incurred such as snacks, mini bar, Pay-Per-View, phone charges, etc.¶
No, I will not require lodging¶
✦ Yes, I will require lodging¶
Do you require airport transportation?¶
□ Yes, I will require transportation to/from the airport¶
No, I will not require transportation to/from the airport¶
EFTA00152995¶
Support person information¶
Support Person’s Name:¶
Relationship: Mother of¶
Email Address:¶
Phone Number:¶
Address 1:¶
Social Security Number: Click here to enter SSN¶
City: Lakewood State:¶
Address 2: Click here to enter address 2¶
Citizenship: US Citizen¶
Zip:¶
Country of Birth: United States¶
Will your support person need travel arrangements?¶
☑ Yes, my support person will need travel arrangements ☐ No, my support person will not need travel arrangements¶
If yes, which mode of transportation do they prefer?¶
□ Air¶
Rail – Brightline from West Palm to Miami and will need transportation to the field office¶
□ Bus¶
□ Mileage reimbursement (if they are utilizing their own vehicle)¶
Only economy, roundtrip fares and one checked luggage bag per person will be authorized. You will be responsible for any incidental charges incurred such as in-flight snacks, Pay-Per-View, Wi-Fi, etc.¶
Date of Birth (required by airlines): Click here to enter date of birth¶
Preferred time of travel: Click here to enter preferred time of travel¶
Airport of origin:¶
Click here to enter departure airport name¶
If bringing a support person, will your support person require separate lodging?¶
Only two nights of lodging will be authorized and only hotel room cost and tax will be authorized. You will be required to provide a credit card for incidental charges upon check in. You will be responsible for any incidental charges incurred such as snacks, mini bar, Pay-Per-View, phone charges, etc.¶
No, my support person will not require separate lodging¶
If bringing a support person, will your support person require airport transportation?¶
□ Yes, my support person will require transportation to/from the airport¶
No, my support person will not require transportation to/from the airport¶
Acknowledgement and Signature¶
By checking and signing below, I acknowledge I have read and understand that only lodging, lodging taxes, mileage, and commercial transportation expenses (airfare, bus, train, and hotel transportation only) will be authorized as outlined above. I understand that the following will not be included/provided in the authorized expenses: meals, rental vehicle, entertainment, or other incidental charges.¶
□ Yes, I acknowledge the above statement Click here to enter your full name¶
Click here to enter signature date¶
2¶
EFTA00152996¶