EFTA01263124.pdf

No. 27 564 548
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US INS OTZE IE ST. THOMAS USVI
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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 uSILI No ilia woo
I trimly-anon and Naturalization Service 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.
r
Part 1. Your Naine (The Person Applying for Naturalization) Write your INS "A"- number here: I
A Ymor ritrreta treat name.
Ali9f4V FOR IN Via b. °NIA
E tea 11 Dar Code 'a te (Imp
r rn
co
Goal Name (first Name) Full Middle Name Of appltiable)
V rri - 4
i2i is la ine Hv 44
.0c5..a. tat ea
g•-iz 7. astet
13. Your name fruity as it appears on your Permanent Resident Card.
=men
Family Name (Last Name)
P• ) to :le • •
Maxwell
Citron Name (Firer Name) Full Middk Name (Ifa pplicable) ( e 7 t, ,
Ghislaine N. -n
fri
CO
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 3..
2.11"Ycs." print the new name you would like to use. Do not use initials or
. . . . . . . .
abbreviations when writing your new name.
APPROVED
Family Name (Los: Name)
SAJ DISTRICT DIRECTOR
A
Given Name (First Mime) Full Middle Namc
AUG 29 2002
Part 2. Information About Your Eligibility (cheek Only One) 6672
I am.at least I8 years old AND
El
A 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. q Other (Please explain)
itteyfaktA-k- Lir C
SDNY!•GMII 00000719 0l IN
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EFTA_00114803
EFTA01263125

Part .1. Information About You Mut your INS "A. number haw:
A. Social Stonily Number B. Dale of Birth allonth/DaWY ar) C. Dale You Became a Pennanent 'dent (Month/Day/Yea')
0 2 /0 5/1 9 9
— —
D. Country of Birth E Country of Nationality
France France
O
I firs. 'Ann ol your parents II S. citizens? (tf:vrt. A e hisuntrtions) Yes 1:1 No
D
G. What is your current marital status? El angk. Never Married Defamed Onivoreed 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,f or some eventie's ofa ccompowlatione.)
If you answered "Yes", cheek the box below that applies:
q I am deaf or hearing impaired and need a sign language interpreter who uses the following language.
q I use a wheelchair.
El
I am blind or sight unpaired.
q I will need another type of accommodation. Please explain:
Parf 4. Addresses and Telephone Numbers
A. Home Address •- Street Number and Name NOT write a P.O. Box in tint space) Apartment Nwnbe
Little St. James Island
1/ 115°
City County State ZIP Code Country
St. Thomas U . S . V .1 . 00802 USA
B. Core of Mailing Address - Street Number and (If different from home address) A Smolt Number
Chiral/line Maxwell 6100 Red Hook Quarter
City Slate ZIP Code Country
St. Thomas U.S.V.I. USA
C. Daytime Phone Number (f am') Evening Phone Number ( Ilf a n 7 E-mail Address Of any)
None
1.88Ne-10IMR800007201IN
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Part 5. information for Criminal Record. Search
Note: The categories below arc those required by the FBI. Sec Instructions for more information.
A. Gender B. Height C. Weight
DAUB Efernale 126 ,
5 Feet 8 Inches .00:10,,43
D. Race
El D I I
White Asp or Pacific Islander Black Amencan Indian or Alaskan Native Unknown
E. Hair color n
Kr/ Li Li
Blade Motown Blonde Gray U White URed Li Sandy Bald (No flair)
F. Eye color ri n
n n
Brown Blue Green Hazel El Gray Black q Pink 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.
Dates (Month/Year)
Street Number and Name. Apartment Number, City, State, Zip Code and Country
From To
Current Home Address - BSaarmrie as 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 Employer or School Address Dates (Month/Year) Your
School Name , (Street City and State) From To Occupation
/ il L 'Pres i e nt
1...S.J ,. , LLC / 6100 Red Ilk, St. Thom. , Ur D...LR63 manager
NEB, LLC , y i 457 Madison Ave. , NY, NY o 1 2 0 0 2. ji ttelLL Manager
/
J. Epstein a C./. 457 Madison Ave., NY, NY 0 1 /1 9 9 3 1 2 I 2 0 0 0 Manager
v
I /
_ _ /_ - I
Farm N-400 (Rev. 05/3I/011N Page
SDNY_GM_00000721
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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
days
B. How many trips of 24 hours or mom have you taken outside of the United States during the past 5 years? 39 trips
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 inAtst‘rnerit
Date You Left the Date You Returned to Did Trip Last Total Days
United States the United States 6 Months or Out of the
(ManthMay/Yeer) (Month/Day/year) Mote? Countries to Which You Traveled United States
1 1 / 1 j/ 2 0 0 1 1 1 /21/2 0 0 1 Oy el Vo. No France, Italy. United Kingdom a
olip _Di o o 1 1 o /01./2 o o 3. a vcg v. µ, France, Italy, United Kingdom 10
OL/1 9/2 0 0 1 0 8 /01/2 0 0 1 ❑yea V mo United Kingdom, France 12
0 6/2 2/2 0 0 1 0 6/2 9J2 0 0 1 ❑y enL1,ENo France 7
sa2j2 sail/2 0 0 1❑ yet iNa
o 0 0 1 0 Canada 3
0 3 alp 0 0 1 0 3 /1 i2 0 0 1 Myna/N o France, United Kingdom 6
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 .2.../2 0 0 0 0 9 /0 4 /2 0 0 0 ❑y e, V me United Kingdom 4
0 7 Li 5/2 0 0 0 0 7a 7/2 0 0 0 ❑Vei l, No Prance, United Kingdom 12
Part S. laformatios About Your Marital History
A. How many times have you been married (including annulled marriages)? 0 I Iyou have NEVER been manned, go to Pan 9.
V
B. If you arc now married, give the following information about your spouse:
I. Spouse's Family Name (Last Name) Given Name (First Name) Full Middle Name (/lappheable) 1
2. Date of Birth (Month/Day/Year) 3. Date of Mamap (Month/Day/Year) 4. Spouse's Social Security Number
/
5. Nome Address - Street Number and Name Apartment Number
City State ZIP Code
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:
O
I. When did your spouse become a U.S. citizen? At Birth O Other
If "Other." QAT the following information.
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 2. Spouses INS 'A". Number (4 applicable)
3. Spouses Immigration Sums
El
Lawful Permanent Resident El Other
F. If you were married before, provide the following information about 3, or spouse. If you have more than one previous
marriage. use a separate sheet of paper to provide the information req in questions I.5 below.
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)
q U.S. Citizen
q Lawful Permanent Resident 5. How Moulage Ended
q Other q Divorce q Spouse Died q Other
G. How many times has your inure spo e been married (including annulled marriages)?
If your spouse has EVER been cd before, gin the following information about your spouse's prior marriage.
If your spouse has more than m vious marriage. use a separate sheet of paper to provide the information requested in questions
I • 5 below.
I. Poor Spouses Family N (Last Name) Given Name (first Name) Full Middle Name NIa pplicable)
2. Prim Spouses Iminij 1i on Status 3. Date of Marriage (Momh/Day/Year) 4. Date Marriage Ended (Month/Day/Year)
0 I
U.S. Citizen
O
Lawful Permanent Resident 5. How Marriage Ended
tEl O Died CI
Other Divorce 0 Spouse Other
Form N.400 I Re.. OS/3 MN IN Page
SDNY_GM_00000723
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Write your INS "A"- moldier hem L
Part 11 In formation Altntit 3.01ir Children
[o I
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.
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 Date nrnitth INC "3". number i runt°. at Huth
.on in Dauphin I4lenth 11ovolectri III Auld ha% inul (Song. C in. 4a/t• & Cumin(
i
I 1 A
I / A
__ / /
/ /
/ /
I I a
— / I A_
1
/ 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
Ek
I. Ilave you EVER claimed to be a U.S. citizen (in writing or any other way)? es
D
2. Have you EVER registered to vote in any Federal. state, or local election in the United States? yes
CI
3. Have you EVER voted in any Federal. state. or local election in the United States? Yes
4. Since becoming a Lawful Permanent Resident. have you EVER failed to tile a required Federal.
state, or local tax return? Elva
Elves
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?
oyes
7. Have you ever been declared legally incompetent or been confined to a mental institution
within the last 5 years?
Ova
Fomi IMItlyItculdata'age 6
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L
a
Part 10. Additional Questions (ennzinucet
B. Affiliations
8. a. Have you EVER been a member of or associated with any organization. association, fund. q Yes No
foundation. party, club. society. or similar group in the United Slates or to any other place?
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? ❑Ya
11. Any oilier totalitarian party? Dyes
c. A tcnonst organization? DYes
10. (lave you EVER advocated (either directly nr indirect6) the overthrow of any government
by force or violence? Elves
I I. lime you EVER persecuted (either directly or indirectly) any person because of race.
E
religion. national origin. membership in a particular social group, or political opinion? yes
I?. Between March 23. 1933. and May 8. 1945. did you work for or associate in any way (either
directly or indirectly) with:
D
a. The Nari govenuneni of Germany? Ycs Nit7
b. Any government in any area ( I) occupied by. (2) allied with, or (3) established with the
EN°,
help of the Nazi government of Germany? Oyes
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:
El
13. Have you EVER called yourself a "nonresident on a Federal, state, or local tax return? Yea
14. Hove you EVER failed to file a Federal. state. or local tax return because you considered
ZA0/
yourself to be a "nonresident*? ❑Yes
FO7711 N.400 IRev. 05/11/01I N Pap 7
SDNY_GM_00000725
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l'arr lit 'AMUo o al Oittoions (Conamted) 11 rile sour INS 'A-- number herr
D. Good Moral Character
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? Eve.
17. Have you EVER helm charged with cominitieng any crime or offense? ❑Yes
0 ym
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
Elva
( for example: diversion. deferred prosecution. withheld adjudication. deferred adjudication)?
20. Have you EVER received a suspended sentence. been placed on probation. or been paroled? Eyes
21. Have you EVER been in jail or prison? q 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. Date arrested. cited. Where were you arrested. Outcome or disposition of Ike
detained. or charged? detained. or charged cited. detained or charged? arrest. citation. detention or charge
thfi ithiDavarar) (City. State. Count)) (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:
k‘
a. been a habitual drunkard? ElYes
Nov'
b. been a prostitute, or procured anyone for prostitution? Eyes
ENV
c. sold or smuggled controlled substances, illegal drugs or narcotics? Oyes
EN4/
d. been married 10 more than one person at the same nine?
ENV
e. helped anyone enter or try to enter the United Slates illegally?
EINfr
gambled illegally or received income from illegal gambling? ElYcs
a
g. failed to suppon your dependents or to pay alimony? si
es
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? Dyes E
24. I lave you EVER lied to any U.S. government o0icial to gain entry or admission into the
United Stales? Oyes C:1 NI/
From N-4usoky4emboodernes
EFTA 00114810
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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". 1h r.,. you EVER applied for .1111, kind of relief from I anoval. exclusion. ur deportation? OYci
INZ.E A—S
n tt-PciarAclot-
Nlititeri Service
-
Av
.1.,j0 tint:
29. Iliac you EVER served in the U.S. Armed Forces? [Sits
30. Iliac you EVER lei the United States to avoid being droned into the U.S. Armed Forces? q Ycs
31. Rave you EVER applied for any kind of exemption front military service in the U.S. Armed Forces? Elves
32. Have you EVER deserted from the U.S. Armed Forces? IJ Yes
C. Selective Service Registration
33. Arc you a male who lived in the United States at any time between your ISM and 26th birthdays
EYes
in any statist except as a lawful nonimmigrant? 1:1N o
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?
39.11t he law requires it. are you willing to perform work of national importance under civilian
direction?
noon N.4%131414‘Glut IO1300098F9
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I.
a
write 'n' I ' a' • maser hat' — 1
[ Pail It. Vile Signature
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.
Past t2. Shinano. of Parson Vino Prepared This Appltaalon far tout (If oppliortal0
'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 Prepares Cipatiirt
One Mirmik/Devffeer) Prcpam's Firm or Organisation Name (//appficabler Preparct's Daytime Phone Number
Palmists Address - Street Number and Name City Sate ZIP Code
Do Not Complete Parts 13 and 14 Until an INS Offices Instructs You To Du So
I
Part I.3. Signature at luttritt ,
I .wear (affirm' and certify under pc-awry of parfuly under the laws of the United States of AMC,i ca 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.
DOROTHEA BERTRAND
-DS 139 It
Sonsc..ribcd to mud sworn 1O laffinncd) before rot
Officals Printed Name or Stamp Dare (Adonthenvaeor)
Con c S -nature or Applimt
O‘keitttes ‘ szitk
gcni—awas--._ ;Us /Aso. itf O...//kO- r__
11 -- //
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 Co c_Stgruinut o p Imam
c:jarkv sz14/-%
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/‘__fstila itoch_g_sat
AtcymftntIlN Past Id
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SONY_GM_00000728
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N
U.S. Department of Justice
0M8 No. 1115-0053
Immigration and Naturalization Service Application to Register Permanent Residence or Adjust Status
START HERE - Please Type or Print
FOR NS USEO NLY
Part 1. Information about you. Returned Reeeia
Famity Gwen Middle
Name Name India
Maxwell Chia Laing _RECEIVED L-!121
Address CtO
INFORMATION
The Villard t Resubmitted
Street Number 0CT 12 1995
and Name
Cary Immitfreion and
Naliseizaton Service
New York New York, N.Y.
State bp Cade Rdoc Sent --- .
New York 113O2.2- / 87) <:- 1 ,..... ,
Date of But Camay 3C:ilia%
of Birth
(rmithIciaa France
A i (if any)
Security 9
None Robe Reed
Deb of LaW Arrival
(month/clay/year) 9/19/95 '4114. a 70051451304 Mim • e — -c a - n e * . A „ d „ -"
fotwaszatm.• 4.••:1
H-18 QI. .1/4/95
Current INS Expires on f.ev. Yoir. t:•\ •
Slake (nonei/daytyear)
Visa 0
• Part 2. Application Type. (check one) cipinA p
red
c
I am applying for adjustment to permanent resident status because:
a. q an invngranl petition ening me an immediately available mungont visa number has Section of Law
been approved (attach a copy of the approval notiCe), or a relative, special O Sec 209(b). NA
O Sec. 13. ACI 01 9/1157
immigrant juvenile. or special immigrant military visa pennon tied with this applicator SOC. 215. NA
will give me an mm/Matey available visa number if approval. ■ Sec 219, min
El Sec I Act of 'IRA%
b O My spouse or parent applied for adµstment of status a was granted lawful O Sec 2 Act of 1 ii2r66
O Other
permanent residence o an immigrant visa category which allows derivative status
for spouses and children. Country Chattiest:tie
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). Eligibility Under Sec. 245
d. 0 I was granted asylum or derivative asylum status as the spouse or child of a person CI Approved yea Pontoon
granted asylum and am eligible ler adjusunent. O Dependent of Poncroal Alien
■ Special Immigrant
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. ret
•
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 A on.. , if". ' r, e-•• A / c,..
January t, 1959. and thereafter have boon physically present in the I) S for at least • - " 41, r 'Li/ ru,17:-
I year.
g O I have continuously resided in the U.S. since before January 1, 1972. q.4 CI 5 1996
h. M 0Mor-orpWn DV-96 Registration selected (see attached) is*,
— _
O
C
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) TO Be completed 67
Attorney or Representative, it any
I D I am a native or cation of Cuba and niool the description n (0), above.
D Fill in box if G-28 is attached to represent
I. 3 I am the huSband, wile or minor unmarried chid of a Cuban, and meet the the anolicant
description in (f). above. vOLAG.
Wale I-Cense a
Form 1-485 (09-09-92)N Continued on back. SDNY_GM_00000729
EFTA_0O1I48I3
EFTA01263135

Part 3. Processing Information.
A. City/TownMiley° of birth Current occupation
Matson Laffitte Investment Liaison
Your mother's first name
Your father's first name
Elizabeth
Robert
Give your name exactly how it appears on your Arrival /Departure Record (Form I-94)
Maxwell, Ghislaine
Place of last entry into the U.S. (City/State) In what status did you last enter? (Visitor. Student exchange
New York, New York alien, Crewmen, temporary worker. without inspection. etc.)
•Were you inspected by a U.S. Immigration Officer? V yes 0 No H-1.
Nonimmigrant Visa Number Consulate where Visa was issued
London
D (m a e te n t V iv i d sa a y w /y a e s a i r s ) s ued 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 Given Middle
Date of Birth
Name NONE Name Initial (month/day/year)
Country of birth Relationship A Applying with you?
#
0 yes 0 No
Family Given !Addle
Date of Birth
Name Name Initial (month/day/year)
Country of birth Relationship A Applying with you?
#
0 yes CI No
Family Given Middle Date of Birth
Name Name Initial (month/day/year)
Country of birth Relationship Applying with you?
A# 0 yes O No
I Family Given Middle Date of Birth
Name Name Initial monthiday/year)
,Country of birth Relationship A Applying with you?
#
0 Yos 0 No
Family Given Middle Date of Birth
Name Name Initial (month/day/year)
Country of birth Relationship li 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.? O Yes IR] No
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? O Yes El No
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? O Yes El No
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 I support to, any person or organization
that has ever engaged or conspired to engage, in sabotage. kidnapping, political nation. hocking, or arty other form of
terrorist activity? 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? ID Yes ®No
12. Have you ever boon a J nonrnmxgrant exchange moor who was subioct to Um 2 year foreign romdonce requirement and not
O Yes aa No
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? O Yes tz No
tEl
Id. Do you plan to practice polygamy in the U.S.? O Yes No
Continued on back
Four; (-485 (Aar 09.09-92)N
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 Date Daytime Phone NUM1M . -1 I A ALA./ft P Lyta
-73-
Ghislaine Maxwell
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
SDNY_GM_00000732
Factual aReplay 09 09 92) N FPI.LOM
EFTA_00114816
EFTA01263138

U.S. Department of Justice OMB •1115.0005
Immigration and Naturalization Service AppliCation fdr Travel Document
START HERE - Please Type or Print FOR INS USE ONLY
Returned Receipt
Part 1. Information about you.
Family Given Middle
Name Maxwell Name Ghlslaine Iabal N
Address • GO
Resubmitted
Street Number Apt
and Name • a A
City Slate or
New York Province NY
Country Postai Reim- Sont
USA Code 10021
Date of Binh Country
(MontivDayNoar) of Beth France
Social A
Security #
Reim Reed
Part 2. Application Type (check one). In
t,n
O i am a pwrnanent resident or conditional resident of the United States and I am applying
(-1
tor a Reentry Permit
now hold U S. refugee or asnee status and I am applying for a Refugee Travel O Applicant . • - • . •• . • . ' - ( - V - -
Document Intervevfed • . ..
c. O I am a permanent resident as a direct fowl! of fol0000 or &gybe status, and am applying on - . . - : O ( O -1 1 c.-
for a Refugee Travel Document, -e ':)
0. (3 lam applyng for an Advance Parole to allow me to return to tne V.S. after temporary Document Issued,- • - ••
foreign travel. 1:1 Reentry Per itCrin 1)
e O lam outside the U.S. and am applying for an Advance Parole (:) Relugee Travel1)0*nel!
O Single Advance Parole
I. O lam applying or an Advance Parole for another person who is outside the U S Give O Multiple Advance Parole
the following inf orman about Mat person N/A validity to
Family Given MONO It Reentry Permit or Refugee Travel
Name Name Initial
Document
Dale of Birth Country O Mail to Address m Pant
(MontniDay/Year) of Borth
El Mad to American Consulate
Foreign Address - C./O O Mad to INS overseas office
AT
Street Number Apt Remarks:
and Name •
O Document Hand Dowered
City State or
Province On By
Action Mock
Country ZIP:Postai
Code
4
Part 3. Processing Information. —Delt1 '1,
Date of Intended departure (MonnDay/Year) Expected length of kip;
10/31/95 1 week to 10 days tssee A
kS typki ke
Are you, or any person included in this application, now in exclusion or deportation ceoceedings?
13 No O Yee, at (give office name) avinlic 0
i N c ickic(p
if applying for an Advance Parole Document, skip to Part 7. '-'
Have you ever before been issued a Reentry Paint or Refugee Travel Document? To Be Completed by
O No O Yes (gnie the folkiwing for the last document issued to you) Attorney or Representative, it any
Date Issued Disposition (attached, lost. etc.) q Fill in box if G-28 is attached to represent
N/A the applicant
VOLAGsf
Form 1.131 (Rev. 12/10'91) N Continued on back. 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 Country
It you chocked b. or c., above. gnu your overseas address:
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
O loss than 6 months O 2 to 3 years
Since becoming a Permanent Resident (or during the past Iwo years, whichever is loss) how O 6 months to I year O 3 to 4 years
meth total time have you spent outside the United States? O 1 to 2 years q more than 4 years
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 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? O Yes O No
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
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 q 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 t) More than 1 trip
II outside the U S . at right give the U.S. Consulate or INS office you wish nabbed if this application is approved.
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
Part 2. above
a. O Address
b. O American Consulate at (give City and Country, below)
c. O INS overseas office at (give City and Country, below)
it
Ciy Country
II you chocked b. or c., above. give your overseas address
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
O less than 6 months q 2 to 3 years
Since becoming a Permanent Resident (or during the past live years. whichever rs less) how O 6 months to 1 year 13 3 to 4 years
much total tine have you spent outside the United States? O 1 to 2 years O mere than 4 years
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). q 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? • Yes O No
Since you were accorded Relugee/Asylee status. have you ever returned to the above named
countryy-, applied for allor obtained a national passport Passport renewal, or entry pernkt into
this countryy-, or applied for arVor received any benefit hem such country (lo example, health
insurance benefits)? O Yes O No
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? q 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. Sig n ature. R
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h
a
ile
d
i
t
n
h e
th
i
e
n f
U
or
n
m
ite
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t a
o
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p
i
e
f
n
fi
a
li
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ti
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fo
in
r a
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eentry permit
b
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o
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.
i on. You must Ne this application
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 I -T.
10/6/95
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 OMB #1115-0005
Immigration and Naturalization Service Application for Travel Document
START HERE - Please Type or Print
FOR INS USE ONLY
Part 1. Information about you. Returned Receipt
Farniy Given Medle
Name Maxwell Ndf10 Ghistaine Maid N
Address CIO
Resubmitted
Street Nun • t Apt.
and Name # SA
City State or
New York Province NY
Country ZIP/Postal Roloc Sent
USA Code 10021 RECEIvED
Date of But Country 3rid FLOUR CASHIER
(MontIVDayNear) of Birth France
Soaal A OCT 1 7 1995
Scanty 0
Retoc Roc'd
I mmigsapun and
Part 2. Application Type (check one).
Naturalization Servla
how York, N.Y.
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 O Aoricant
Document Interviewed
on
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 Document Issued
foreign travel. ID Reentry Permit
e- O lam outside the U.S. arid am applying for an Advance Pardo. O Refugee Travel Document
O Snag Advance Parole
I. O lam applyirg for an Advance Parole for another person who is outside the U.S. One Irf-Mulhple Advance Parole
the following information about that person. Validity to (1....< n 7, I C i g
Family Given Middle If Reentry Permit or Refugee Travel
Name Name Initial Document
Date of Birth Country ID Mail to Address in Pan 2
(MonthClaytYear) of Birth
O Marl to American Consulate
Foreign Address • DO O Marl to INS overseas office
AT
Street Number Apt. Remarks:
and Name
(3 Document Hand Deivered
City State or
Provnte On By
Action Block
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) 1*--) di i7 ( ../
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? To Bs Completed by
O No O Yes (give the following for the last &amen; issued to you) Attorney or Representative, if any
N/A Dale Issued thspositen (attached. lost. etc.) O FA in box it 0.28 is attached to represent
the applicant
VOLAG#
Form 1-131 (Rev. 12/10191) N Conitpued on back. 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 Country
If you chocked b. or c., above. give your overseas address-
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
toss than 6 months q 2 to 3 years
Site becoming a Permanent Rosident (or during the past live years. whichever is loss) how O 6 months tot year 3 to 4 years
much total urns have you spent outside the United States? O 1 to 2 years (:( more than 4 years
Site you became a Permanent Resident, have you over bled a federal 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). O Yes O No
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 O N0
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)? O Yes O No
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? 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)
63
For how may trips do you intend le use this document? trip 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 Daytime Telephone •
10/16/95
(212 )750-9895
Please N of completely NI out this form, or fail to submit required documents listed in the instructions. you may not be found eligible
for the requested docu 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 Daytime Telephone •
and Address
stdiesonM at -164192741
•
EFTA_O0114822
EFTA01263144