Jeffrey_Epstein_Part_02_of_08_p0027.png

FD-794 (Rev, 2-7-00) up I} UCO (AF) FCI Case (DO) GcbeTr Group II se) a Qperalton (BC) Informanvow (E} Group (BD} InformantéCW Providing Drug info. {F) FC} ico iy eer Lookout 2. Date 2,3 b3 -2' 3. Request for: }) Advance ( Expense 4, Social Security No: — b6 -2 ©" Classification__3! & O (AC) Criminal Cage {CF) Asset (GA) sos (AD) Crminal OCDETF Case =: (DC) Gro a (GB) OPS * Dratt Request unit Lo _ ASSIGN WA Ge Wtstivcaticn | ise Asseviny smant File No. Symbol No. acn?Code Name. Period Covered to On Time Non-symbol Source Payment: - True Name: DOB: / / SSAN: Date of Waiver: f / 4+. Payment for reimbursable expense - forfeiture or drug related? Yes 4 No Supervisor Initials: (&SAC) AO / SAS Approval: upply Technician Approvat: Dratt Approval Officer: Procurement Authorization: ia A sO Beg nn PS Cec ee Os 26, Seitiement of Advance: Prior month Advance Balance: $ ThisAdvance: § Less: Receipts: $. Funds Returned and/or Gashon Hand $= e Riel as 28, Draft No: 28, Date: % Shaded areas for draft office use only Classification: ; v - } Classified By: 03956-360 White Orivinal - Submitted to Confidential Services Uni by Drafi Office Dec'assify on: