EFTA01263124.pdf

YenronatriesavieilertAdeke aPonkte tatandizatioth: Oat° pfitj f eat. FEMALE %Sat.& Jut 8 thdtee ilia fitalstatea.• SINGLE eowthyipmenatioadier. FRANCE No. 27 564 548 ea.ST. THOMAS, VIRGIN ISLANDS St.litornet.Cennahavindoundeltat.- GHISLAINE NOELLE MAXWELL dun emanglifrdellmieeltftate& theta to-rea >i?k data/zed &ate altea refard Katataleattha, eft/wilaaaltitzeta, a/1°144d in, all athe witA 56,1i#frpoisionelsachnataintaztearduavand was, farina/to. , sadtpentott kwivSem de oath ealladience, ba cage/add le US INS OTZE IE ST. THOMAS USVI a tST. THOMAS, VIE IN IS/I,ANDS one NOV 2 7 200Z do/a/Snow" !* ipatenittedafracitiesbefthellnitedtftateslAnzerica IT IS PUNISHABLE BY U S LAW TO COPY. PRINT OR PHOTOGRAPH THIS CERTIFICATE. WITHOUT LAWFUL AUTHORITY. SDNY_GM_00000718 EFFA_00114802 EFTA01263124 t..S. Ikparinteen of.hunicc I trimly-anon and Naturalization Service uSILI No ilia woo Application for Naturalization Print dearly or type your answers using CAPITA I. letters. Failure to print clearly may delay your application. Use black or blue Ink. Part 1. Your Naine (The Person Applying for Naturalization) A Ymor ritrreta treat name. Ali9f4V E tea 1 1 Goal Name (first Name) i2i is la ine V Full Middle Name Of appltiable) 13. Your name fruity as it appears on your Permanent Resident Card. Family Name (Last Name) Maxwell Citron Name (Firer Name) Ghislaine Full Middk Name (If applicable) N. C. If you have ever used other names. provide them below. Family Name (Last Name) Given Name (First Name) Middle Name D. htme change (optional) Please read the Instructions before you decide whether to change your name. .11. Would you like to legally change your name? Yes Z No 2.11"Ycs." print the new name you would like to use. Do not use initials or abbreviations when writing your new name. Family Name (Los: Name) A Given Name (First Mime) Full Middle Namc Part 2. Information About Your Eligibility (cheek Only One) r Write your INS "A"- number here: FOR IN Via b. °NIA I I am.at least I8 years old AND A El I have been a Lawful Permanent Resident of the United States for at least 5 years. ty I have been a Lawful Permanent Resident of the United States for at least 3 years. AND I have been roamed to and living with the same C.S. citizen for the last 3 years. AND my spouse has been a U.S. citizen for the last 3 years. C. 0 I am applying on the basis of qualifying military service. D. K Other (Please explain) r rn co gz7. P) =men • • • to :le Dar Code 'a te (Imp rri - 4 Hv 44 .0c5...a tat ea •-i astet . . . . . . . . (7, et, -n fri CO 3.. APPROVED SAJ DISTRICT DIRECTOR AUG 29 2002 6672 itteyfaktA-k- Lir C v\s °fro> SDNY!•GMII 00000719 0l IN EFTA_00114803 EFTA01263125 Part .1. Information About You A. Social Stonily Number B. Dale of Birth allonth/DaWY ar) D. Country of Birth France Mut your INS "A. number haw: C. Dale You Became a Pennanent 'dent (Month/Day/Yea') 0 2 /0 5/1 9 9 — — E Country of Nationality France I firs. 'Ann ol your parents II S. citizens? (tf:vrt. A e hisuntrtions) O Yes 1:1 No G. What is your current marital status? El angk. Never Married Defamed Onivoreed D Widowed O MaMage Annulled or Other (Erpiain) II Arc you requesting a waiver of the English and/or U.S. History and Govenunent requirements based on a disability or impairment and attaching a Form N-648 with your application? I Arc you requesting an accommodation to the naturalization process because of o disabilityor impairment? (See Instruction, for some eventie's of accompowlatione.) If you answered "Yes", cheek the box below that applies: K I am deaf or hearing impaired and need a sign language interpreter who uses the following language. K I use a wheelchair. ElI am blind or sight unpaired. K I will need another type of accommodation. Please explain: Parf 4. Addresses and Telephone Numbers 1/ 115° Little St. James Island A. Home Address •- Street Number and Name NOT write a P.O. Box in tint space) City St. Thomas B. Core of Chiral/line Maxwell City County State U . S . V .1 . Mailing Address - Street Number and ZIP Code 00802 Country Apartment Nwnbe USA (If different from home address) 6100 Red Hook Quarter St. Thomas C. Daytime Phone Number (f am') Slate U.S.V.I. Evening Phone Number (If an 7 l ZIP Code Country A Smolt Number USA E-mail Address Of any) None 1.88Ne-10IMR800007201IN EFTA_00114804 EFTA01263126 Part 5. information for Criminal Record. Search Note: The categories below arc those required by the FBI. Sec Instructions for more information. A. Gender DAUB Efernale B. Height 5 Feet 8 Inches C. Weight , 126 .00:10,,43 D. Race ElWhite Asp or Pacific Islander D Black Amencan Indian or Alaskan Native E. Hair color Kr/ Blade Motown Li Blonde n Gray U White URed F. Eye color n Brown Blue ri Green n Hazel El Gray Li Sandy n Black K Pink I I Unknown Li Bald (No flair) El Maroon Other Part ti. Information About Your Residence aid Employment A. Where lave you lived during the last 5 years? Begin with where you live now and then list every place you lived for the last 5 years. If you need more space, use a separate sheet of paper. Street Number and Name. Apartment Number, City, State, Zip Code and Country Dates (Month/Year) From To Current Home Address - Sam as Barrie Part 4A 0 7 / 2 0 0 1 Present 0 1 / 2 0 0 1 0 6 2 0 0 1 0 2 / 1 9 9 6 0 1 2 0 / 0 1 I / / / B. What have you worked (or, if you were a student, what schools did you attend) during the last 5 years? Include military service. Begin with your careen or latest employer and then list every place you have worked or studied for tbc last S years. If you need more space. use a separate sheet of paper. Employer or School Name Employer or School Address , (Street City and State) Dates (Month/Year) Your Occupation From To 1...S.J ,. , LLC / 6100 Red Ilk, St. Thom. , Ur / D... LR63 il L 'Prese nt i manager NEB, LLC , y i 457 Madison Ave. , / NY, NY o 1 2 0 0 2. ji ttelLL Manager J. Epstein a . C./ v 457 Madison Ave., NY, NY 0 1 / 1 9 9 3 1 2 I 2 0 0 0 Manager I / _ _ /_ - I Farm N-400 (Rev. 05/3I/011N Page SDNY_GM_00000721 EFTA 00114805 EFTA01263127 Part 7. Time Outside tie Halted States (ladmithig Alia to Canada, Maks, oaths Caribbean islands) A. How many total days did you spend outside of the United States doing the past 5 years? 253 B. How many trips of 24 hours or mom have you taken outside of the United States during the past 5 years? 39 C. List below all the trips of 24 hours or more that you have taken outside of the United States since becoming a Lawful jt Permanent Resident. Begin with your most recent trip. [(you need more space, use a separate sheet of paper. Sec Iror days trips inAtst‘rnerit Date You Left the United States (ManthMay/Yeer) Date You Returned to the United States (Month/Day/year) Did Trip Last 6 Months or Mote? Countries to Which You Traveled Total Days Out of the United States 1 1 / 1 j/ 2 0 0 1 1 1 /21/2 0 0 1 France, Italy. United Kingdom a Oy el Vo. No olip _Di o o 1 1 o /01./2 o o 3. France, Italy, United Kingdom 10 a vcg v. µ, OL/1 9/2 0 0 1 0 8 /01/2 0 0 1 United Kingdom, France 12 ❑yea V mo 0 6/2 2/2 0 0 1 0 6/2 9J2 0 0 1 1,LENo France 7 ❑y en o sa2j2 0 0 1 0 sail/2 0 0 1❑ Canada 3 yet iNa 0 3 alp 0 0 1 0 3 /1 i2 0 0 1 France, United Kingdom 6 Myna/N o 1 2/0i/2 0 0 0 1 2 /0 9/2 0 0 0 Ely" V No France. United Kingdom 5 10/21/20 0 0 1 0/2 9./2 0 0 0 y et be NO United Kingdom 4 0 8 /3 0 0 0 0 9 /0 4 /2 0 0 0 United Kingdom 4 ❑y e, V me .2.../2 0 7 Li 5/2 0 0 0 0 7a 7/2 0 0 0 No Prance, United Kingdom 12 ❑Vei l, Part S. laformatios About Your Marital History A. How many times have you been married (including annulled marriages)? B. If you arc now married, give the following information about your spouse: 0 V I Iyou have NEVER been manned, go to Pan 9. I. Spouse's Family Name (Last Name) Given Name (First Name) Full Middle Name (/lappheable) 2. Date of Birth (Month/Day/Year) and Name 3. Date of Mamap (Month/Day/Year) 4. Spouse's Social Security Number / 5. Nome Address - Street Number Apartment Number City State ZIP Code 1 SDNY GM 00000722 runs N.4007Rev—OX3 I/01)N tap 4 EFTA_00 I 14806 EFTA01263128 Part R. Information About Your Marital Filson, taairitare.0 C. Is your spouse a U.S. citizen? likes O No D. If your spouse is a U.S. citizen. give the following information: I. When did your spouse become a U.S. citizen? If "Other." QAT the following information. O At Birth O Other l)alv 'our spouse became a U.S. citizen 3. Place your spouse became a U S. citizen (Pfeove..re blyirital(MA) I I City and State I-. II your spouse is NO1 a U.S. citizen. give the lollowing Information : I. Spouses Country of Citizenship 3. Spouses Immigration Sums 2. Spouses INS 'A". Number (4 applicable) El Lawful Permanent Resident El Other F. If you were married before, provide the following information about 3, marriage. use a separate sheet of paper to provide the information req I . Prim Spouses Family Name (LW Nunw) Give/nN e (First Name) Full Middle Name Illunplicstbk1 2. Prior Spouses Immigration Status 3/Date of Marriage (Monde/Day/Year) 4. Date Marriage Ended (Month/Day/Year) K U.S. Citizen K Lawful Permanent Resident K Other 5. How Moulage Ended K Divorce K Spouse Died K Other or spouse. If you have more than one previous in questions I.5 below. G. How many times has your inure spo e been married (including annulled marriages)? If your spouse has EVER been If your spouse has more than m I • 5 below. cd before, gin the following information about your spouse's prior marriage. vious marriage. use a separate sheet of paper to provide the information requested in questions I. Poor Spouses Family N (Last Name) Given Name (first Name) 2. Prim Spouses Iminij ion Status 1 3. Date of Marriage (Momh/Day/Year) 0 U.S. Citizen O Lawful Permanent Resident tEl Other 5. How Marriage Ended Full Middle Name NI applicable) 4. Date Marriage Ended (Month/Day/Year) I ODivorce 0 Spouse Died CI Other Form N.400 I Re.. OS/3 MN IN Page SDNY_GM_00000723 EFTA_00114807 EFTA01263129 Part 11 In formation Altntit 3.01ir Children Write your INS"A"- moldier hem L A. How many sons and daughters have you had? For more information on which sons and daughters you should include and how to complete this section. see the Instructions. [o I R. Provide the following infomtation about all of your sons and daughters. If you need more space. use a separate sheet of paper. r flat Ntiow of .on in Dauphin Date nrnitth I4lenth 11ovolectri INC "3". number III Auld ha% inul i runt°. at Huth (Song. C in. 4a/t• & Cumin( i I 1 A I / A __ / / / / / / I I a 1 — / I A_ / 1 _ A --- . — Part M. Additional Questktu PiCaSC ZUISINCI questions I through 14. If you answer "Yes" to any of these questions, include a written explanation with this form Your wnllen explanation should I I explain why your answer was -Yes; and (2) provide any additional infomiation that helps to explain your answer. A. General Questions I. Ilave you EVER claimed to be a U.S. citizen (in writing or any other way)? 2. Have you EVER registered to vote in any Federal. state, or local election in the United States? 3. Have you EVER voted in any Federal. state. or local election in the United States? 4. Since becoming a Lawful Permanent Resident. have you EVER failed to tile a required Federal. state, or local tax return? 5. Do you owe any Federal. state. or local taxes that arc overdue? 6. Do you have any title of nobility in any foreign country? 7. Have you ever been declared legally incompetent or been confined to a mental institution within the last 5 years? Ekes Dyes CI Yes Elva Elves oyes Ova Fomi IMItlyItculdata'age 6 EFTA_00114808 EFTA01263130 Part 10. Additional Questions (ennzinucet B. Affiliations L a 8. a. Have you EVER been a member of or associated with any organization. association, fund. foundation. party, club. society. or similar group in the United Slates or to any other place? K Yes No h. If you answered -Yes: list the name of each group below. If you need more space. wrack the names of the oilier groups) on a :rnoalat4. .disei of Papa. Name of Gmop Name of Group I 6 2. 7 1 8 4. 9 S. 10. 9. Have you EVER been a member of or in any way associated (either directly or indirectly) with: u. The Conunwtisl Party? 11. Any oilier totalitarian party? c. A tcnonst organization? 10. (lave you EVER advocated (either directly nr indirect6) the overthrow of any government by force or violence? I I. lime you EVER persecuted (either directly or indirectly) any person because of race. religion. national origin. membership in a particular social group, or political opinion? I?. Between March 23. 1933. and May 8. 1945. did you work for or associate in any way (either directly or indirectly) with: a. The Nari govenuneni of Germany? b. Any government in any area ( I) occupied by. (2) allied with, or (3) established with the help of the Nazi government of Germany? c. Any Gentian. Nazi. or S.S. military wilt. paramilitary unit, self•defense unit, vigilante unit. citizen unit, police ;mil. government agency or office. extermination camp, concentration camp. prisoner of war camp, prison. labor camp. or transit camp? C. Continuous Residence Since becoming a Lawful Permanent Resident of the United States: 13. Have you EVER called yourself a "nonresident on a Federal, state, or local tax return? 14. Hove you EVER failed to file a Federal. state. or local tax return because you considered yourself to be a "nonresident*? ❑Ya Dyes DYes Elves Eyes D Ycs Nit7 Oyes EN°, El Yea ❑Yes ZA0/ FO7711 N.400 IRev. 05/11/01 IN Pap 7 SDNY_GM_00000725 EFTA_00114809 EFTA01263131 l'arr lit 'AMU oo al Oittoions (Conamted) D. Good Moral Character 11 rile sour INS 'A-- number herr For the purposes of this application. you must answer "Yes" to the following questions. if applicable. even if your records were scaled or otherwise cleared or if anyone. including a judge. law enforcement officer. or attorney. told you that you no longer have a record. 13. Hasa you EVER coniniared a crime or intense fit which you were NO 1 arrested' tn. ( la', c you LVER bum micatcd. %owl. ur demurral by any law clifun.ciman officer tint:hiding INS and military officers) for any reason? 17. Have you EVER helm charged with cominitieng any crime or offense? tx. Have you E\'ER been convicted ol' a crime or offense? 19. Have you EVER been placed in an alternative sentencing or a rehabilitative program ( for example: diversion. deferred prosecution. withheld adjudication. deferred adjudication)? 20. Have you EVER received a suspended sentence. been placed on probation. or been paroled? 21. Have you EVER been in jail or prison? Eve. ❑Yes 0 ym Elva Eyes K yes If you answered -Yes" to any of questions I S through 21. complete the following table. If you need more space. use a separate sheet of paper to give the same information. Why were ymi arrested. cited. detained. or charged? Date arrested. cited. detained. or charged thfi ithiDavarar) Where were you arrested. cited. detained or charged? (City. State. Count)) Outcome or disposition of Ike arrest. citation. detention or charge (No ( larger flint charge.. &snset!. keit prob.:ma. ere.) \nswer questions?? through 33. If you answer "Yes" to any o these questions. attach ( your written explanation why your answer was "Yes." and (2) any additional information or documentation that helps explain your answer. 22. Have you EVER: a. been a habitual drunkard? b. been a prostitute, or procured anyone for prostitution? c. sold or smuggled controlled substances, illegal drugs or narcotics? d. been married 10 more than one person at the same nine? e. helped anyone enter or try to enter the United Slates illegally? gambled illegally or received income from illegal gambling? g. failed to suppon your dependents or to pay alimony? 23. Have you EVER given false or misleading information to any U.S. govemmem official while applying for any immigration benefit or to prevent deportation, exclusion. or removal? 24. I lave you EVER lied to any U.S. government o0icial to gain entry or admission into the United Stales? ElYes Eyes Oyes ElYcs a es k‘ Nov' ENV EN4/ ENV EINfr si Dyes E Oyes C:1 NI/ From N-4usoky 4emboodernes EFTA 00114810 EFTA01263132 Vail In, tilditi tttt 31 Qurstiont (Can fount? E. Removal. Exclusion, and Deportation Proceedings 25. Arc removal. exclusion. rescission or deportation proceedings pending against you? :6. Have you EVER been removed. excluded. or deported from the United Stales? ' 7 I frive -Fly EVER Sinn, °Mitred in he retrovrii erri.ydrel or drpnyled rrdir the r'90 'd 2". 1 hr.,. you EVER applied for .1111, kind of relief from I anoval. exclusion. ur deportation? INZ.E A—S Av n tt-PciarAclot- - .1.,j0 tint: [Sits 30. Iliac you EVER lei the United States to avoid being droned into the U.S. Armed Forces? K Ycs Nlititeri Service 29. Iliac you EVER served in the U.S. Armed Forces? 31. Rave you EVER applied for any kind of exemption front military service in the U.S. Armed Forces? 32. Have you EVER deserted from the U.S. Armed Forces? C. Selective Service Registration 33. Arc you a male who lived in the United States at any time between your ISM and 26th birthdays in any statist except as a lawful nonimmigrant? OYci Elves IJ Yes EYes 1:1 No It you answered "NO". go on to question 34. If you answered "YES". provide the information below. If you answered "YES". but you did NOT register with the Selective Service System and are still under 26 years of age. you must register before you apply for naturalization, so that you can complete the information below: Date Registered (Month/Day/Year) Selective Service Number II you answered "YES", but you did NOT register with the Selective Service and you are now 26 years old or older. attach a statement explaining why you did not register. H. Oath Requirements /See Parr 140r the rev ql the nods) Answer questions 34 through 39. If you answer -Non to any of these questions, attach ( I your written explanation why the answer was "No' and (Rally additional information or documentation that helps to explain your answer. 34. Do you support the Constitution and fonii of govenunent of the United States? 35. Do you understand the full Oath of Allegiance to the United States? 36. Arc you willing to take the full Oath of Allegiance to the United States? 37. If the law requires it. are you willing to bear antes on behalf of the United Stales? 3R. If the law requires it. arc you willing to perfomi noncombatant services in the U.S. Armed Forces? 39.11 the law requires it. are you willing to perform work of national importance under civilian direction? noon N.4%131414‘Glut IO1300098F9 EETA_00114811 EFTA01263133 I. a Past t2. Shinano. of Parson Vino Prepared This Appltaalon far tout (If oppliortal0 [ Pail It. Vile Signature write 'n' I ' a' • maser hat' — 1 I ccrniy. ander penalty of penny under the taws of du United States of AMCI1C1. that this appbc mon. and the evidence submitted with it arc all true and correct l authorize the release of any information which INS needs to deteramne my eligibility tor naturalization. Date tahonia/Dor/Year) /Z. 'Khali) of sici hay that I pswated Jus appliLaihni al the Saglatall of tie abort pawn.. The Jinn ers prig RICCI at: based of watch 1 how periunal lotowledgc andor went prat/Wed to nix by die above owned pet ion ut ...passe 14.• tlw ..rise I PIC' • iiiiii • criatattred on was town. no.-parer s Pinned Name One Mirmik/Devffeer) Palmists Address - Street Number and Name Prepares Cipatiirt Prcpam's Firm or Organisation Name (//appficabler City Preparct's Daytime Phone Number Sate ZIP Code Do Not Complete Parts 13 and 14 Until an INS Offices Instructs You To Du So IPart I.3. Signature at luttritt , I .wear (affirm' and certify under pc-awry of parfuly under the laws of the United States of AMC, ica that I know that the contents or this application for ItanIlliliati0n subscribed by me. stchataag corrections numbered I through and the evidence submitted by me numbered pages I through — arc mit and correct to the best of my knowledge and belief. Sonsc..ribcd to mud sworn 1O laffinncd) before rot DOROTHEA BERTRAND -DS 139 It Officals Printed Name or Stamp Con c S -nature or Applimt gcni—awas--._ ;U s /Aso. itf O...//kO- 11 -- // ‘it‘szitk Okettes Dare (Adonthenvaeor) r__ Pan 14.. Oath of Altivisap tryout applx anon i• approved you will be scheduled for a public oath ceremony at which time you will be required to take the following oath or Mice:tame uranediatcly pilot to becoming a natunfind citizen. By signing below, you acknowledge your willingness and ability to take this oath: I hereby dectaic. cm oath. that 1 absolutely and timely retail:act and abjure all allegiance and fidelity to any foreign pnnce. potentate. SIC or sovereignty- of whom or which which I have kerciofoic been a subject or citi ern. inn I will support and attend the Constitution and Lsats of the United States of America a3ainst all entail... foreign and domestic. ilun I will bear true faith and allegiance to the same. that l will bear dried on behalf of the United Slates when motored by the law; ion I will perform noncombatant Serviec nn the Armed Forces of the United States wham requucd b) the law: that I will perform wort of national unpottance under civilian direction when required by the 14‘.. and dun I take des obligation freely. without any mental rnervatioll or purpose of evasion, so help nit God. Pruned Natal. of Applicant c:jarkv sz1/4-% /‘__fstil a Co c_Stgruinut o p Imam G itoch_g_sat AtcymftntIlN Past Id P%-t..9.4._J-e-L/ • SONY_GM_00000728 EFTA 00114812 EFTA01263134 N U.S. Department of Justice Immigration and Naturalization Service 0M8 No. 1115-0053 Application to Register Permanent Residence or Adjust Status START HERE - Please Type or Print Part 1. Information about you. Famity Name Maxwell Address CtO The Villard Street Number and Name Cary New York Gwen Name Chia Laing t Middle India State New York bp Cade 113O2.2- / 87) <:- 1 Date of But (rmithIciaa Camay of Birth France A i (if any) None Security 9 Deb of LaW Arrival (month/clay/year) 9/19/95 '4114. a 70051451304 Current INS Slake H-18 Visa QI. 0 Expires on (nonei/daytyear) .1/4/95 • Part 2. Application Type. (check one) I am applying for adjustment to permanent resident status because: a. K an invngranl petition ening me an immediately available mungont visa number has been approved (attach a copy of the approval notiCe), or a relative, special immigrant juvenile. or special immigrant military visa pennon tied with this applicator will give me an mm/Matey available visa number if approval. b O My spouse or parent applied for adµstment of status a was granted lawful permanent residence o an immigrant visa category which allows derivative status for spouses and children. c. O I entered as a K-1 fonce(e) of a V.S. citizen whom I married within 90 days of entry, or I am me K-2 child of such a hanco(o) (attach a copy of the liance(e) petition approval notice and me marriage ceniscas). d. 0 I was granted asylum or derivative asylum status as the spouse or child of a person granted asylum and am eligible ler adjusunent. e. am a native or citizen of/Cuba admitted or paroled into the U.S. after January 1, 1959, and thereafterhaw been physically present in the U.S. for at least 1 yew. I. O I am the husband; wile, or minor unmained child of a Cuban described in (o) and am resdmg with that person, and was admitted or paroled into the U.S. alter January t, 1959. and thereafter have boon physically present in the I) S for at least I year. g O I have continuously resided in the U.S. since before January 1, 1972. h. M 0Mor-orpWn DV-96 Registration selected (see attached) am already a permanent resident and am applying to have the date I was granted permanent residence adjusted to the date I originally arrived in the U.S. as a nonimmigrant or parolee, or as of May 2, 1964. whichever Is later, and. (Crier/ one) I D I am a native or cation of Cuba and niool the description n (0), above. I. 3 I am the huSband, wile or minor unmarried chid of a Cuban, and meet the description in (f). above. Form 1-485 (09-09-92)N Continued on back. FOR NS USE ONLY Returned Reeeia L-!121 0CT 12 1995 Immitfreion and Naliseizaton Service New York, N.Y. ,..... , 3C:ilia% • -can *Ad Mime— - e.„„-" fotwaszatm.• 4.••:1 f.ev. Yoir. t:•\ • _RECEIVED INFORMATION Resubmitted Rdoc Sent --- . Robe Reed Ap cipin red c Section of Law O Sec 209(b). NA O Sec. 13. ACI 01 9/1157 SOC. 215. NA ■ Sec 219, min El Sec I Act of 'IRA% O Sec 2 Act of 1 ii2r66 O Other Country Chattiest:tie Eligibility Under Sec. 245 CI Approved yea Pontoon O Dependent of Poncroal Alien ■ Special Immigrant ret • A on.. , if". ' r, e-•• A / c,.. • - " 41, r 'Li/ ru,17:- q.4 CI 5 1996 is*, C — O _ TO Be completed 67 Attorney or Representative, it any D Fill in box if G-28 is attached to represent the anolicant vOLAG. Wale I-Cense a SDNY_GM_00000729 EFTA_0O1I48I3 EFTA01263135 Part 3. Processing Information. A. City/TownMiley° of birth Matson Laffitte Your mother's first name Current occupation Investment Liaison Elizabeth Your father's first name Give your name exactly how it appears on your Arrival /Departure Record (Form I-94) Maxwell, Ghislaine Robert Place of last entry into the U.S. (City/State) New York, New York •Were you inspected by a U.S. Immigration Officer? V yes 0 No In what status did you last enter? (Visitor. Student exchange alien, Crewmen, temporary worker. without inspection. etc.) H-1. Nonimmigrant Visa Number Consulate where Visa was issued London Date Visa was issued (mentivday/year) 1/15/93 'Sex: 0 Male 8 Female Marital Status: 0 Married Single 0 Divorced 0 Widowed Have you ever before applied for permanent resident status in ate U.S? $3 No 0 yea (give date and place of tons and final depesMOIR: 8. list your present husband/wile, all of wsur sons and daughters Of yOu havo none write "none". II additional space is hooded. use separate paper). Family Name NONE Given Name Middle Initial Date of Birth (month/day/year) Country of birth Relationship A # Applying with you? 0 yes 0 No Family Name Given Name !Addle Initial Date of Birth (month/day/year) Country of birth Relationship A # Applying with you? 0 yes CI No Family Name Given Name Middle Initial Date of Birth (month/day/year) Country of birth Relationship A# Applying with you? 0 yes O No I Family Name Given Name Middle Initial Date of Birth monthiday/year) ,Country of birth Relationship A # Applying with you? 0 Yos 0 No Family Name Given Name Middle Initial Date of Birth (month/day/year) Country of birth l i Relationship A # Applying with you? 0 Yes 0 No C. List your present and past membership In or affiliation with Lively pdiacal Ofgantiab00, association. fund. tounda0on. party, club. SOCsely. Or wituier group in the United States or in any other place since your 16th binhday. Include any foreign military sennce in this part. If none, write -none- . Include the name of organization, IscatiOn, dates of membership from and to. and the nature of the organization. II additional space is needed, use separate paper. NONE Fort-48(Rev. 09-09-92) N Continued On Next Page SONY_GM_00000730 EFTA_00I14.814. EFTA01263136 Part 3. Processing Information. (Continued) Please answor the (Nostra/is. ( If your answer is "Yin" on any ono of those questions. wean on a separate piece 01 paper. Answering "Yes" does not necessarily mean that you are not entitled to register la permanent residence or adjust status). 1. Have you ever. in or outside the U. S.: a knowingly committed any crime of moral turpitude or a drug-related offense for which you have not boon arrested? b. been arrested, Cited, Charged. matted, fined, or mrinSOned for breaking or violating any law or ordinance, excluding traffic violations? c. boon the beneficiary of a pardon, amnesty. rehabilitation decree, other act of clemency or similar action? d exercised diplomatic immunity to avoid prosecution for a criminal offense in tho V. S.? 2. Havu you received public assistance in the U.S. from any source, including the U.S. government a any state, county. city, or municipality (other than emergency medical treatment) or are you Ikoly to receive public assistance in the future? 3. Have you ever: a within the past 10 years been a prostitute or procured anyone fie prostitution, or intend to engage in such activities in the future? b. engaged in any unlawful commercialized vice, including. but not limited to. illegal gambling? c. knowingly encouraged, induced, assisted, abutted or aided any alien to try to enter the U.S. illegally? d. illicitly trafficked in any controlled substance. or knowingly assisted, abetted or colluded in tho Mot trathekrig of any controlled substance? 4. Have you over engaged in, conspired to engage in. or do you intend to engage in, or have you ever sOliated membership or funds for, or have you through any means ever assisted or provided any type of that has ever engaged or conspired to engage, in sabotage. kidnapping, political terrorist activity? I support to, any person or organization nation. hocking, or arty other form of O Yes IR] No O Yes El No O Yes El No O Yes W No 5. Do you intend to engage in the U.S. in a espionage? b. any activity a ourC0093 of which is Weston to. or the control or overthrow of. the Government of the United Slates, by force, violence or other unlawful moans? c. any actmty to violate or evade any law prohibiting the export from the Unnod Stales of goods. technology or sonsitivo O Yos ED No information? 6. Have you ever been a member Of, a in any way affiliated with, the Communist Party or any other totalitarian party? O Yes W No 7. Did you. during the period March 23. 1933 to May 8. 1945, in association with either the Nazi Government of Germany or any organization or government associated or allied with the Nazi Goverment of Germany. ever ordor, incite, assist or olhoivoso participate in the persecution of any person because of race, religion, nations origin or points' opinion? O Yes NO 8. Have you over engaged in gonocido. or otherwise ordered, meted, assisted or otherwise participated in the killing of any person because of race, religion, nationality, ethnic origin, or political opinion? O Yes El No 9. Have you over boon deported from the U.S.. or romovord from the U.S at government expense, excluded within the past year, a are you now in exclusion or deportation procoodings? O Yes LI No 10. Aro you under a final order ol civil penalty for violating section 274O of the Immigration Act for use of fraudulent documents. or have you, by fraud a willful noreprosonlation of 8 material fact, eversought to procure, or procured, a visa, other O Yes W No documentation, entry into the U.S., or any other mailgram ?Mehl? II. Have you over left the U.S. to avoid tieing drafted into tpti U.S. Armed Faces? 12. Have you ever boon a J nonrnmxgrant exchange moor who was subioct to Um 2 year foreign romdonce requirement and not yet complied with that requiremonl or obtained a waiver? 13. Aro you now withholding custody of a U.S. Citizen child outside the U.S from a person grantod custody of the child? Id. Do you plan to practice polygamy in the U.S.? ID Yes ®No O Yes aa No O Yes tz No O Yes tEl No Four; (-485 (Aar 09.09-92)N Continued on back SDNY_Glif_00000731 EFTA_00114815 EFTA01263137 Part 4. Signature. Read the information on penalties in the instructions before completing this section. You must file this While in the United States.) I CONY under penalty of penury's the of theyn_Led-Skales of America lug this application, and the evidence submitted with it, is al true and correct. authorize the release el inkspitla tram y reCOrdS w the fairmegfeat4Naturahration Service needs to determine eligibility fix the benefit i am Seeking S Print Your Name Ghislaine Maxwell . A -1 ALA./ft Date Daytime Phone NUM1MI P Lyta -73- a you do not completely fill out this (arm. or fail to submit rep ire documents listed found eligible for the requested document and this application may be denied. Part 5. Signature of person preparing form if other than above. (Sign Below) I declare that I prepared this application at the request of the above person and it is based on all information of which I have knowledge. Signature Print Your Name Date Day time Phone Number Firm Name and Address Factual aReplay 09 09 92) N SDNY_GM_00000732 FPI.LOM EFTA_00114816 EFTA01263138 U.S. Department of Justice Immigration and Naturalization Service OMB •1115.0005 AppliCation fdr Travel Document START HERE - Please Type or Print Part 1. Information about you. Family Name Maxwell Address • GO Given Name Ghlslaine Iabal Middle N Street Number and Name Apt • a A City New York Slate or Province NY Country USA Postai Code 10021 Date of Binh (MontivDayNoar) Country of Beth France A Social Security # Part 2. Application Type (check one). O i am a pwrnanent resident or conditional resident of the United States and I am applying tor a Reentry Permit now hold U S. refugee or asnee status and I am applying for a Refugee Travel Document c. O I am a permanent resident as a direct fowl! of fol0000 or &gybe status, and am applying for a Refugee Travel Document, 0. (3 lam applyng for an Advance Parole to allow me to return to tne V.S. after temporary foreign travel. e O lam outside the U.S. and am applying for an Advance Parole I. O lam applying or an Advance Parole for another person who is outside the U S Give the following in forman about Mat person N/A Family Name Given Name Initial MONO Dale of Birth (MontniDay/Year) Country of Borth Foreign Address - C./O Street Number and Name Apt • City State or Province Country ZIP:Postai Code Part 3. Processing Information. Date of Intended departure (MonnDay/Year) 10/31/95 Expected length of kip; 1 week to 10 days Are you, or any person included in this application, now in exclusion or deportation ceoceedings? 13 No O Yee, at (give office name) if applying for an Advance Parole Document, skip to Part 7. '-' Have you ever before been issued a Reentry Paint or Refugee Travel Document? O No O Yes (gnie the folkiwing for the last document issued to you) Date Issued Disposition (attached, lost. etc.) N/A Form 1.131 (Rev. 12/10'91) N Continued on back. FOR INS USE ONLY Returned Receipt In t,n ( -1 Resubmitted Reim- Sont Reim Reed O Applicant Intervevfed on • ••••' (V --- - .- ... • . . . - . . -O ( -1 c.- : O 1 -e ':) Document Issued,- • - •• 1:1 Reentry Per itCrin 1 ) (:) Relugee Travel1)0*nel! O Single Advance Parole O Multiple Advance Parole validity to It Reentry Permit or Refugee Travel Document O Mail to Address m Pant El Mad to American Consulate O Mad to INS overseas office AT Remarks: O Document Hand Dowered On By Action Mock —Delt1 '1, 4 tssee A kS typki ke avinlic 0 i N c ickic(p To Be Completed by Attorney or Representative, it any K Fill in box if G-28 is attached to represent the applicant VOLAGsf ATTY State 1:3O10933M_00000733 EFTA_00114817 EFTA01263139 Part 3. Processing Information. (continued) Whore do you want this travel document sent? (chock ono) N/A a. O Address in Part 2, above b. O American Consulate at (give City and Country. below) c. O INS overseas once at (gore City and COuntry, below) City It you chocked b. or c., above. gnu your overseas address: Country Part 4. Information about the Proposed Travel. N/A Purpose of lop fl you need more room, continue on a separate sheet of paper. List the countnaa you inland lo visit Part 5. Complete only if applying for a Reentry Permit. N/A Since becoming a Permanent Resident (or during the past Iwo years, whichever is loss) how meth total time have you spent outside the United States? Since you becalm a Permanent Resident, have you ever Ned a federal income tax return as a nonresident, or failed to lit a federal return because you considered yourself to be a nonresident? (if yes, give details on a separate sheet of paper). O loss than 6 months O 2 to 3 years O 6 months to I year O 3 to 4 years O 1 to 2 years K more than 4 years O Yes No Part 6. Complete only if applying for a Refugee Travel Document. N/A Country from which you are a refugee or asylee: If you answer yes to any of the thawing questions, explain on a separate sheet d paper. Do you plan to travel to the abovemarned country? Since you wore accorded RefugeolAsylee status, nave you over returned to the abovanamod country; applied for atVor obtained a national passport passport renewal, et entry permit into this Country; or applied for anlor received any bends from such country (lei example, health insurance benefits)? O Yes O No O Yes O No Since bang accorded RetugoeMsylee stasis, have you, by any legal procedure or voluntary act, tie acquired the nationality of the above-named country. acquied a new nationality. or been granted refugee Or aSyb30 status in any other country? O Yes K No Part 7. Complete only If applying for an Advance Parole. On a separate sheet of paper, please explain how you Qualify for an Advance Parole and what circumstances warrant issuance of Advance Parole. Include copies or any documents you wish considered. (See instructions.) For how may Inge do you intend to use this document? O 1 WO II outside the U S . at right give the U.S. Consulate or INS office you wish nabbed if this application is approved. t) More than 1 trip Part 8. Signature. Read the information on penalties in the instructions before completing this section. You must file this application while in the United Slates if filing for a reentry permit or refugee travel dOCument. I certty under penalty of porter the laws of the United Slates dAmerica that this petition, and the evidence submitted with it, is all true and correct. I authorize the release d from my records which the immigration and Naturalization Service needs to determine eligibility for the benefit I am seeking. Signature Dale Im T a 10/6/95 Please Note: It Mete* fist out this form, or fail to submit required documents listed in the MStructi0ns. you may not be found eligible for the requested document and this application will have to be denied Part 9. Signature of person preparing form if other than above. (sign below) I declare Matti:neared this application at the request of the above person and it is based on informal/On Of which I have knowledge. Signalon Pont VOW Name Dale Pint' Names Daytime Telephone and Address stpai car6A1-164/32741 EFTA_00114818 EFTA01263140 Part 3. Processing Information. (continued) Whore do you wad Lt this travel document sent? :k one) N/A • a . O A d d r e s s Part 2. above b. O American Consulate at (give City and Country, below) c. O INS overseas office at (give City and Country, below) it Ciy II you chocked b. or c., above. give your overseas address Country Part 4. Information about the Proposed Travel. N/A Purpose of Yip If you need mote room. continue on a separate sheet of paper. List the counties you intend to visit Part 5. Complete only if applying for a Reentry Permit. N/A Since becoming a Permanent Resident (or during the past live years. whichever rs less) how much total tine have you spent outside the United States? Since youXecame a Permanent Resident, have you ever hied a fedora) income tax 'mum as a nonresident. Or failed to file a federal return because you considered yourself to be a nonresident? (if yes, give details on a separate sheet of paper). O less than 6 months O 6 months to 1 year O 1 to 2 years K 2 to 3 years 13 3 to 4 years O mere than 4 years K Yes O NO Part E. Complete only if applying for a Refugee Travel Document. N / A County from which you are a refugee or asyloe II you answer yes to any of the lollowing questions. explain on a separate sheet or paper. Do you plan to travel to the above-named country? Since you were accorded Relugee/Asylee status. have you ever returned to the above named country-y, applied for allor obtained a national passport Passport renewal, or entry pernkt into this country-y, or applied for arVor received any benefit hem such country (lo example, health insurance benefits)? Since bang accorded Rofugeo/Asylee status, have you, by any legal procedure or voluntary aCt re-acquired the nationality of the abovo•named Cooney. acquired a new nationahty, or been granted refugee or asyleo status in any other country? • Yes O No O Yes O No K Yes O No Part 7. Complete only If applying for an Advance Parole. On a separate sheet of paper, please explain how you qualify for an Advance Parole and what circumstances warrant issuance of Advance Parole. include copies or any documents you wish considered. (See instructions) For how may trips do you intend to use this document? O 1 trip lb More than I trip If outside the U.S.. at right give the U.S. Consulate or MS office you wish notified if Mis applic aeon is approved. Part 8. Si nature. Read the information on penalties in ere before completing this section. You must Ne this application g while in the United States if filing for a reentry permit or refugee travel document. I certify under penalty of perjury under the laws of the United Slates of America that this potion, and the evidence submitted with it, is ail We and Correct. I authorize the release of from my records which the Immigration and NaturalizatiOn Sennett needs to detentione eligibility la the benefit I am Soaking. Signature Date 10/6/95 -T. I Please Note: If pielely NI out this form. Of fail to submit required documents tested in The instructions, you may not be found eligible for the reouested document and this application will have to be denied. Part 9. Signature of person preparing form If other than above. (sign below) I declare that I prepared this appliCaliOn at the request of the above person and 4 is based on all information Of which I have knowledge Signature Pent Your Name Date Firm Name Daytime Telephone • and Address L * U.S. 6P0:1994-301-161/97741 SONY_GM_00000735 EFTA_00114819 EFTA01263141 • (.4-thisiAc A NI Otaztu. SDNY_GM_00000736 EFTA_00114820 EFTA01263142 U.S. Department of Justice Immigration and Naturalization Service OMB #1115-0005 Application for Travel Document START HERE - Please Type or Print Part 1. Information about you. Farniy Name Maxwell Address CIO Given Ndf10 Ghistaine Medle Maid N Street Nun • t and Name Apt. # SA City New York State or Province NY Country USA ZIP/Postal Code 10021 Date of But (MontIVDayNear) Country of Birth France Soaal Scanty 0 A Part 2. Application Type (check one). a. O I am a permanent resident or conditional resident of the United Stales and I am applying for a Reentry Permit. b. O I ncnv hold U.S. refugee or asylee status and I am applying for a Refugee Travel Document c. O I am a permanent resident as a direct result of refugee or asylee status. and am applying for a Refugee Travel Document. d. 10 lam applying for an Advance Parole to allow me to return to the U S after temporary foreign travel. e- O lam outside the U.S. arid am applying for an Advance Pardo. I. O lam applyirg for an Advance Parole for another person who is outside the U.S. One the following information about that person. Family Name Date of Birth (MonthClaytYear) Given Name Country of Birth Middle Initial Foreign Address • DO Street Number and Name Apt. City State or Provnte Country ZIP/Potosi Code Part 3. Processing Information Dale of Intended depend° (MontIVDayivear) Expected kn. (ft If1/17/9S 1 week-i tog days Are you, or any person included in this application. now in excluedµa clapottakon proceedings? 0 No O Yes al (give dace name) If applying for an Advance Parole Document, skip to Part 7. Z9, Have you ever before been issued a Reentry Perrin a Refugee Travel Document? O No O Yes (give the following for the last &amen; issued to you) N/A Dale Issued thspositen (attached. lost. etc.) Form 1-131 (Rev. 12/10191) N Conitpued on back. FOR INS USE ONLY Returned Receipt RECEIvED FLOUR CASHIER OCT 1 7 1995 I mmigsapun and Naturalization Servla how York, N.Y. Resubmitted Roloc Sent 3rid Retoc Roc'd O Aoricant Interviewed on Document Issued ID Reentry Permit O Refugee Travel Document O Snag Advance Parole Irf-Mulhple Advance Parole Validity to (1....< n 7, I C ig If Reentry Permit or Refugee Travel Document ID Mail to Address in Pan 2 O Marl to American Consulate O Marl to INS overseas office AT Remarks: (3 Document Hand Deivered On By Action Block 1*--) di i7 ( ../ To Bs Completed by Attorney or Representative, if any O FA in box it 0.28 is attached to represent the applicant VOLAG# ATTY Stale 1:3034ifeelM_00000737 EFFA_00114821 EFTA01263143 Part 3. Processing Information. (continued) Whore do you want this travel document sent? (check one) N/A a. O Address in Part 2, above b. O American Consulate al (give City and Country, below) c. O INS overseas office at (give City and Country, below) City If you chocked b. or c., above. give your overseas address- Country Part 4. Information about the Proposed Travel. N/A Purpose of trip. if you need more room, continue on a separate sheer of paper. List the countries you intend to visit. Part 5. Complete only if applying for a Reentry Permit. N/A Site becoming a Permanent Rosident (or during the past live years. whichever is loss) how much total urns have you spent outside the United States? O O toss than 6 months 6 months tot year 1 to 2 years K (:( 2 to 3 years 3 to 4 years more than 4 years Site became a Permanent Resident, have over bled federal O Yes O No you you a income lax return as a nontesidenL or failed to lite a federal return because you considered yourself to be a nonresident? (it yes, give details on a separate sheet of paper). Part 6. Complete only if applying for a Refugee Travel Document. N/A Country from whet) you we a refugee or asylee: II you answer yes to any ol the I0Iowmg quesbons, explain on a separate sheet 04 paper. Do you plan ti travel to the above-named country? O Yes Site you were accorded Refugeo/Asylee status, nava yOu over: returned to Urn abovionamod country; applied for ant, obtained a national passport, passport renewal, Or entry permit oto this country; or applied for an/or received any benefit from such country (tor example, health insurance benefits)? Since being accorded RelugeeiAsylee status, have you, by any legal procedure or voluntary act, re-acquired the nationality of the above-named country, acquired a new nationality, a been granted refugee or asylee status in any other country? O N0 O Yes O No 0 Yes O No Part 7. Complete only if applying for an Advance Parole. On a separate sheet of paper, please explain how you qualify for an Advance Parole and what circumstances warrant issuance of Advance Parole. Include copies of any documents you rash consfdered. (See instruCtrons) For how may trips do you intend le use this document? trip 63 Moro than 1 trip If outside the U.S.. at right give the U.S. Consulate or INS office you wish notified if this application is approved. Part 8. Signature. Read the information on penalties in the instructions before completing this section. You must tile this application while in the United States if hang for a reentry permit or refugee travel document I certify under penalty of perpury under the laws of the gilded States of America that this petition, and the evidence submitted with it, is all true and correct. I authorize the re 1 information from my records which the Immegrabon and Naturalization Serval needs to determine eligibility for the benefit 1 am SeClung Signature Dale 10/16/95 Daytime Telephone • (212 )750-9895 Please N for the requested docu of completely NI out this form, or fail to submit required documents listed in the instructions. you may not be found eligible ent and this application will have to be denied Part 9. Signature of person preparing form if other than above. (sign below) I declare that I prepared this application at to request of the above person and it is based on all triliarnatiOn d Wadi I have enowieage. Signature Print You Name Date Firm Name and Address Daytime Telephone • stdieson Mat -164192741 • EFTA_O0114822 EFTA01263144