Email to FBI on completing a U-visa form for a victim in the Maxwell case

Subject: ADG Immigration form¶

Date: Fri, 10 Sep 2021 23:35:13 +0000¶

Importance: Normal¶

Attachments: ADG_immigration_form192707.pdf¶

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Attached is the Form I-918B, which needs to be completed and signed by the law enforcement agency. I have completed the parts I need to complete, but please make sure that the FBI completes the following:¶

1. Part 2. Agency Information:¶

a. (questions 1-3) Please complete the full name and title of the FBI agent signing the Form.¶

b. (questions 4.2.-5.h.) include the name of the Head of the FBI and the address for the FBI Office¶

c. (question 9.) include the court case number for defendant Ghislaine Maxwell¶

2. Part 3. Criminal Acts:¶

a. (question 1.-3) I listed sexual exploitation and trafficking as the criminal activity for parts 2.a.-2.d. please list the dates the criminal activity occurred as alleged in the Indictment and the section of the USC code she is charged with¶

b. (question 4.b.) list the city and state where the violations occurred¶

c. (question 6.) Please describe the criminal activity being investigated according to the charges and allegations in the indictment¶

d. (question 7) describe the injury to Ms. De Georgiou¶

3. Part 6. Certification¶

a. Have the FBI agent sign, date and include his telephone and fax number¶

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Supplement B, U Nonimmigrant Status Certification¶

Department of Homeland Security¶

U.S. Citizenship and Immigration Services¶

USCIS Form I-918 OMB No. 1615-01 Expires 04/30/202¶

Remarks¶

For USCIS Use Only¶

▶ START HERE - Type or print in black or blue ink.¶

Part 1. Victim Information¶

1. Alien Registration Number (A-Number) (if any)

► A-¶

[ ] [ ] [ ] [ ] [ ] [ ] [ ]¶

2.a. Family Name¶

(Last Name)¶

2.b. Given Nam¶

(First Name)¶

2. c. Middle Name

Other Names Used (Include maiden names, nicknames, and aliases, if applicable.)¶

If you need extra space to provide additional names, use the space provided in Part 7. Additional Information.¶

3.a. Family Name¶

(Last Name)¶

3.b. Given Name¶

(First Name)¶

3. c. Middle Nan

4. Date of Birth (mm/dd/yyyy)

5. Gender □ Male ☑ Female

Part 2. Agency Information¶

1. Name of Certifying Agency

Federal Bureau of Investigations¶

Name of Certifying Official¶

2.a. Family Name¶

(Last Name)¶

2.b. Given Name¶

(First Name)¶

2. c. Middle Name

3. Title and Division/Office of Certifying Official

Name of Head of Certifying Agency¶

4.a. Family Name¶

(Last Name)¶

4.b. Given Name¶

(First Name)¶

4. c. Middle Name

Agency Address¶

5. a. Street Number and Name

6. b. $ \Box $ Apt.

□ Ste. □ Flr.¶

5. c. City or Town

6. d. State

7. f. ZIP Code

8. f. Province

9. g. Postal Code

10. h. Country

Other Agency Information¶

6. Agency Type

X Federal¶

□ State □ Local¶

7. Case Status

X On-going¶

☐ Completed¶

□ Other¶

8. Certifying Agency Category

□ Judge X Law Enforcement □ Prosecutor¶

□ Other¶

9. Case Number

10. FBI Number or SID Number (if applicable)

Page 1¶

Form I-918 Supplement B 04/24/2019¶

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Part 3. Criminal Acts¶

If you need extra space to complete this section, use the space provided in Part 7. Additional Information.¶

1. The petitioner is a victim of criminal activity involving a violation of one of the following Federal, state, or local criminal offenses (or any similar activity). (Select all applicable boxes)

□ Abduction¶

□ Abusive Sexual Contact¶

□ Manslaughter¶

□ Murder¶

□ Attempt to Commit Any of the Named Crimes¶

☐ Being Held Hostage¶

□ Obstruction of Justice¶

□ Peonage¶

□ Blackmail¶

□ Perjury¶

□ Conspiracy to Commit Any of the Named Crimes¶

□ Prostitution¶

□ Rape¶

□ Domestic Violence¶

□ Sexual Assault¶

□ Extortion¶

| | |¶

| :--- | :--- |¶

| [X] | Sexual Exploitation |¶

False Imprisonment¶

□ Slave Trade¶

☐ Felonious Assault¶

□ Female Genital Mutilation¶

□ Solicitation to Commit Any of the Named Crimes¶

□ Fraud in Foreign Labor Contracting¶

□ Stalking¶

□ Incest¶

□ Torture¶

[X] Trafficking¶

□ Involuntary Servitude¶

□ Kidnapping¶

□ Unlawful Criminal Restraint¶

□ Witness Tampering¶

Provide the dates on which the criminal activity occurred.¶

2. a. Date (mm/dd/yyyy)

3. b. Date (mm/dd/yyyy)

4. c. Date (mm/dd/yyyy)

5. d. Date (mm/dd/yyyy)

6. List the statutory citations for the criminal activity being investigated or prosecuted, or that was investigated or prosecuted.

7. a. Did the criminal activity occur in the United States (including Indian country and military installations) or territories or possessions of the United States?

□ Yes □ No¶

4. b. If you answered “Yes,” where did the criminal activity occur?

5. a. Did the criminal activity violate a Federal extraterritorial jurisdiction statute? Yes No

6. b. If you answered “Yes,” provide the statutory citation providing the authority for extraterritorial jurisdiction.

7. Briefly describe the criminal activity being investigated and/or prosecuted and the involvement of the petitioner named in Part 1. Attach copies of all relevant reports a findings.

8. Provide a description of any known or documented injury to the victim. Attach copies of all relevant reports and findings.

Form I-918 Supplement B 04/24/2019¶

Page 2 of 5¶

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Part 4. Helpfulness Of The Victim¶

For the following questions, if the victim is under 16 years of age, incompetent or incapacitated, then a parent, guardian, or next friend may act on behalf of the victim.¶

1. Does the victim possess information concerning the criminal activity listed in Part 3.? Yes No

2. Has the victim been helpful, is the victim being helpful, or is the victim likely to be helpful in the investigation or prosecution of the criminal activity detailed above?

X Yes □ No¶

3. Since the initiation of cooperation, has the victim refused or failed to provide assistance reasonably requested in the investigation or prosecution of the criminal activity detailed above? Yes No

If you answer “Yes” to Item Numbers 1.-3., provide an explanation in the space below. If you need extra space to complete this section, use the space provided in Part 7. Additional Information.¶

4. Other. Include any additional information you would like to provide.

Form I-918 Supplement B 04/24/2019¶

Page 3 of 5¶

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Part 5. Family Members Culpable In Criminal Activity¶

1. Are any of the victim’s family members culpable or believed to be culpable in the criminal activity of which the petitioner is a victim? Yes No

If you answered “Yes,” list the family members and their criminal involvement. (If you need extra space to complete this section, use the space provided in Part 7. Additional Information.)¶

2.a. Family Name¶

(Last Name)¶

2. b. Given Name (First Name)

3. c. Middle Name

4. d. Relationship

5. e. Involvement

3.a. Family Name¶

(Last Name)¶

3.b. Given Name¶

(First Name)¶

3. c. Middle Name

4. d. Relationship

5. e. Involvement

4.a. Family Name¶

(Last Name)¶

4.b. Given Name¶

(First Name)¶

4. c. Middle Name

5. d. Relationship

6. e. Involvement

Part 6. Certification¶

I am the head of the agency listed in Part 2. or I am the person in the agency who was specifically designated by the head of the agency to issue a U Nonimmigrant Status Certification on behalf of the agency. Based upon investigation of the facts, I certify, under penalty of perjury, that the individual identified in Part 1. is or was a victim of one or more of the crimes listed in Part 3. I certify that the above information is complete, true and correct to the best of my knowledge, and that I have made and will make no promises regarding the above victim’s ability to obtain a visa from U.S. Citizenship and Immigration Service (USCIS), based upon this certification. I further certify that if the victim unreasonably refuses to assist in the investigation or prosecution of the qualifying criminal activity of which he or she is a victim, I will notify USCIS.¶

1. Signature of Certifying Official (sign in ink)

2. Date of Signature (mm/dd/yyyy)

3. Daytime Telephone Number

4. Fax Number

Form I-918 Supplement B 04/24/2019¶

Page 4 of 5¶

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Part 7. Additional Information¶

If you need extra space to complete any item within this supplement, use the space below or attach a separate sheet of paper; type or print the agency’s name, petitioner’s name, and the Alien Registration Number (A-Number) (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. If you need more space than what is provided, you may also make copies of this page to complete and file with this supplement.¶

1. Agency Name

Federal Bureau of Investigations¶

Petitioner’s Name¶

2.a.	Family Name(Last Name)
2.b.	Given Name(First Name)

2. c. Middle Name

3. A-Number (if any)

▶ A-[ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ]¶

4. a. Page Number 4.b. Part Number 4.c. Item Number

5. d.

6. a. Page Number 5.b. Part Number 5.c. Item Number

7. d.

8. a. Page Number 6.b. Part Number 6.c. Item Number

9. d.

Form I-918 Supplement B 04/24/2019¶

Page 5 of 5¶

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