EFTA00181822

# STATE OF FLORIDA
DEPARTMENT OF CORRECTIONS
WRITTEN MONTHLY REPORT

Officer’s Name: ___
For Month Ending: ___
Date/Time submitted:___

## Jeffrey Epstein

YOUR RESIDENCE ADDRESS: (include Name of Subdivision, Apartment Complex and Number, Mobile Home Park and Lot Number, if applicable):

358 El Brilloway Palm Beach, FL 33480

(Provide physical location – **NOT** Post Office Box)

TELEPHONE No

CELLULAR TELEPHONE N

PAGER No. ___

Vehicle Make/Model/Year/Tag #: ___

EMPLOYER: FSF

SUPERVISOR'S NAME:Darren Indyke

EMPLOYER'S ADDRESS:

250 S. Australian Ave Suite 104

West Palm Beach, FL 33401



EMPLOYER'S TELEPHONE N



CELLULAR TELEPHONE No.___



PAGER No. ___

EMPLOYER EMAIL: ___



YOUR TOTAL MONEY EARNED MONTHLY:

$ 10,000+ (Gross Amount)

Full time Part-time Hours Worked

Additional (2^{nd}}) employment information: ___

List full names, ages, and your relationship to all persons who resided at your residence during this month:

## , Age 24, Girlfriend

Have you been arrested or had any contact with law enforcement during the last month? police If yes, explain what happened on separate sheet of paper, attached to report came to house for false fire alarm

If not working, give reason and source of income: ___

If you have any questions or problems to discuss with your Officer, explain:___

If monetary obligation owed, amount paid this month: $___

Receipts are available through your probation officer. DO NOT SUBMIT CASH OR PERSONAL CHECKS! Make money order payable to the Department of Correction

Make money order payable to the Department of Corrections.

If monetary obligation owed and no payment made, give reason and date when payment will be made: ___

<table border="1"><tr><td colspan="2">Official Use Only:

Signature of Officer Receiving Report:</td></tr><tr><td colspan="2"></td></tr><tr><td>Date WMR Received:</td><td></td></tr><tr><td>Date WMR Due:</td><td></td></tr><tr><td>Comments:</td><td></td></tr></table>

I certify the above to be true and complete:

Your Signature:

Mailing Address: 356 El Brilloway

City: Palm Beach

State: FL Zip: 33480

E-Mail Address: ___

(if applicable)

EFTA00181823

<table border="1"><tr><td>e/Hora</td><td>Location/Localización</td><td>Activity/Actividad</td></tr><tr><td colspan="3">MIDNIGHT/MEDIA NOCHE</td></tr><tr><td>00 am</td><td></td><td></td></tr><tr><td>0</td><td></td><td></td></tr><tr><td>0</td><td></td><td></td></tr><tr><td>0</td><td></td><td></td></tr><tr><td>0</td><td></td><td></td></tr><tr><td colspan="3">MORNING/MANANA</td></tr><tr><td>00 am</td><td></td><td></td></tr><tr><td>00</td><td></td><td></td></tr><tr><td>0:00</td><td></td><td></td></tr><tr><td>0:00</td><td></td><td></td></tr><tr><td>0:00</td><td></td><td></td></tr><tr><td>1:00</td><td></td><td></td></tr><tr><td colspan="3">AFTERNOON/TARDE</td></tr><tr><td>12:00 pm</td><td></td><td></td></tr><tr><td>1:00</td><td></td><td></td></tr><tr><td>2:00</td><td></td><td></td></tr><tr><td>3:00</td><td></td><td></td></tr><tr><td>4:00</td><td></td><td></td></tr><tr><td>5:00</td><td></td><td></td></tr><tr><td colspan="3">EVENING/NOCHE</td></tr><tr><td>6:00 pm</td><td>Home</td><td></td></tr><tr><td>7:00</td><td></td><td></td></tr><tr><td>8:00</td><td></td><td></td></tr><tr><td>9:00</td><td></td><td></td></tr><tr><td>11:00</td><td></td><td></td></tr></table>

<table border="1"><tr><td>WEDNESDAY/MIERCOLES</td><td>7-22</td></tr><tr><td>Day/Dfa</td><td>Decha</td></tr></table>

<table border="1"><tr><td>Time/Hora</td><td colspan="2">Location/Localización</td><td>Activity/Actividad</td></tr><tr><td colspan="4">MIDNIGHT/MEDIA NOCHE</td></tr><tr><td>12:00 am</td><td></td><td></td><td></td></tr><tr><td>1:00</td><td></td><td></td><td></td></tr><tr><td>2:00</td><td></td><td></td><td></td></tr><tr><td>3:00</td><td></td><td></td><td></td></tr><tr><td>4:00</td><td></td><td></td><td></td></tr><tr><td>5:00</td><td></td><td></td><td></td></tr><tr><td colspan="4">MORNING/MANANA</td></tr><tr><td>6:00 am</td><td></td><td></td><td></td></tr><tr><td>7:00</td><td></td><td></td><td></td></tr><tr><td>8:00</td><td></td><td></td><td></td></tr><tr><td>9:00</td><td></td><td></td><td></td></tr><tr><td>10:00</td><td></td><td></td><td></td></tr><tr><td>11:00</td><td></td><td></td><td></td></tr><tr><td colspan="4">AFTERNOON/TARDE</td></tr><tr><td>12:00 pm</td><td></td><td></td><td></td></tr><tr><td>1:00</td><td></td><td></td><td></td></tr><tr><td>2:00</td><td></td><td></td><td></td></tr><tr><td>3:00</td><td></td><td></td><td></td></tr><tr><td>4:00</td><td></td><td></td><td></td></tr><tr><td>5:00</td><td></td><td></td><td></td></tr><tr><td colspan="4">EVENING/NOCHE</td></tr><tr><td>:00 pm</td><td></td><td></td><td></td></tr><tr><td>7:00</td><td></td><td></td><td></td></tr><tr><td>8:00</td><td></td><td></td><td></td></tr><tr><td>9:00</td><td></td><td></td><td></td></tr><tr><td>10:00</td><td></td><td></td><td></td></tr><tr><td>11:00</td><td></td><td></td><td></td></tr></table>

<table border="1"><tr><td>Time/Hora</td><td>Location/Localización</td><td>Activity/Actividad</td></tr><tr><td colspan="3">MIDNIGHT/MEDIA NOCHE</td></tr><tr><td>12:00 am</td><td></td><td></td></tr><tr><td>1:00</td><td></td><td></td></tr><tr><td>2:00</td><td></td><td></td></tr><tr><td>3:00</td><td></td><td></td></tr><tr><td>4:00</td><td></td><td></td></tr><tr><td>5:00</td><td></td><td></td></tr><tr><td colspan="3">MORNING/MANANA</td></tr><tr><td>6:00 am</td><td></td><td></td></tr><tr><td>7:00</td><td>Lee Hensur Probet</td><td></td></tr><tr><td>8:00</td><td>Probati</td><td></td></tr><tr><td>9:00</td><td>Home</td><td></td></tr><tr><td>10:00</td><td></td><td></td></tr><tr><td>11:00</td><td></td><td></td></tr><tr><td colspan="3">AFTERNOON/TARDE</td></tr><tr><td>12:00 pm</td><td></td><td></td></tr><tr><td>1:00</td><td></td><td></td></tr><tr><td>2:00</td><td></td><td></td></tr><tr><td>3:00</td><td></td><td></td></tr><tr><td>4:00</td><td></td><td></td></tr><tr><td>5:00</td><td></td><td></td></tr><tr><td colspan="3">EVENING/NOCHE</td></tr><tr><td>6:00 pm</td><td></td><td></td></tr><tr><td>7:00</td><td></td><td></td></tr><tr><td>8:00</td><td></td><td></td></tr><tr><td>9:00</td><td></td><td></td></tr><tr><td>10:00</td><td></td><td></td></tr><tr><td>11:00</td><td></td><td></td></tr></table>

7-23

<table border="1"><tr><td>Time/Hora</td><td>Location/Localización</td><td>Activity/Actividad</td></tr><tr><td colspan="3">MIDNIGHT/MEDIA NOCHE</td></tr><tr><td>12:00 am</td><td></td><td></td></tr><tr><td>1:00</td><td></td><td></td></tr><tr><td>2:00</td><td></td><td></td></tr><tr><td>3:00</td><td></td><td></td></tr><tr><td>4:00</td><td></td><td></td></tr><tr><td>5:00</td><td></td><td></td></tr><tr><td colspan="3">MORNING/MANANA</td></tr><tr><td>6:00 am</td><td></td><td></td></tr><tr><td>7:00</td><td></td><td></td></tr><tr><td>8:00</td><td></td><td></td></tr><tr><td>9:00</td><td></td><td></td></tr><tr><td>10:00</td><td></td><td></td></tr><tr><td>11:00</td><td></td><td></td></tr><tr><td colspan="3">AFTERNOON/TARDE</td></tr><tr><td>12:00 pm</td><td>12:30 Leave Home for Work</td><td></td></tr><tr><td>1:00</td><td></td><td></td></tr><tr><td>2:00</td><td></td><td></td></tr><tr><td>3:00 3:30 Home</td><td>301pm</td><td></td></tr><tr><td>4:00</td><td></td><td></td></tr><tr><td>5:00</td><td></td><td></td></tr><tr><td colspan="3">EVENING/NOCHE</td></tr><tr><td>6:00 pm</td><td></td><td></td></tr><tr><td>7:00</td><td></td><td></td></tr><tr><td>8:00</td><td></td><td></td></tr><tr><td>9:00</td><td></td><td></td></tr><tr><td>10:00</td><td></td><td></td></tr><tr><td>11:00</td><td></td><td></td></tr></table>