--- title: "DOJ Epstein Files, Data Set 9 (EFTA00185519)" source: "DOJ Epstein Files, Data Set 9" sourceUrl: "https://huggingface.co/datasets/ishumilin/epstein-files-ocr-complete" date: "2026-01-01" category: "DOJ Data Set" eftaNumber: "EFTA00185519" ocrPages: 0 ocrChars: 45746 ocrElapsed: 0.0 parseTier: "external" engine: "ishumilin OCR pipeline (engine undisclosed; CC0 mirror)" externalSource: "ishumilin-ocr-complete" externalLicense: "CC0-1.0" externalCredit: "ishumilin/epstein-files-ocr-complete (Hugging Face)" externalUrl: "https://huggingface.co/datasets/ishumilin/epstein-files-ocr-complete" --- EFTA00185519 # United States District Court SOUTHERN DISTRICT OF FLORIDA ```markdown TO: CAPITAL ONE Subpoena Compliance 15000 Capital One Drive Richmond, VA 23238 Fax ``` SUBPOENA TO TESTIFY BEFORE GRAND JURY FGJ 05-02(WPB)-Fri./No. OLY-03 ```markdown SUBPOENA FOR: □ PERSON ``` ```markdown X DOCUMENTS OR OBJECT[S] ``` YOU ARE HEREBY COMMANDED to appear and testify before the Grand Jury of the United States District Court at the place, date and time specified below.
PLACE: Palm Beach County Courthouse Juvenile Courts Building 205 N. Dixie Highway West Palm Beach, Florida 33401 (Temporary location for the United States District Courthouse, West Palm Beach)ROOM: Room 4-A
DATE AND TIME: August 18, 2006 9:00am
YOU ARE ALSO COMMANDED to bring with you the following document(s) or object(s): All applications, signature cards, credit or background investigations conducted, and correspondence related to Jeffrey Epstein, , Janusz Banasiak, Alfredo Rodriguez, and/or Mastercard Account Number For the period of January 1, 2004 to the present, all monthly billing statements, individual charge invoices, repayment records disclosing the dates, amounts, and method of repayment, and checks used to make repayments (front and back) for Mastercard Account Number. Please coordinate your compliance of this subpoena and confirm the date and time of your appearance with Special Agent Federal Bureau of Investigation, Telephone: ```markdown □ Please see additional information on reverse ``` This subpoena shall remain in effect until you are granted leave to depart by the court or by an officer acting on behalf of the court.
CLERKDATE:August 2, 2006
(BY) DEPUTY CLERK
This subpoena is issued upon application of the United States of AmericaName, Address and Phone Number of Assistant U.S. AttorneyAssistant U.S. Attorney500 So. Australian Avenue, Suite 400West Palm Beach, FL 33401-6235Tel:x3047Fax:
UNITED STATES DISTRICT COURT SOUTHEERN DISTRICT OF FLORIDA *If not applicable, enter "none." To be used in lieu of AO110 FORM ORD-227 EFTA00185520 JAN.86 # RETURN OF SERVICE¹ RECEIVED BY SERVER DATE 08/03/06 PLACE West Palm Beach, FL SERVED DATE 08/09/06 PLACE Richmond, VA (Vim Fax) SERVED ON (NAME) Capital One SERVED TITLE FBI Special Agent STATEMENT OF SERVICE FEES TRAVEL SERVICES TOTAL DECLARATION OF SERVICE² I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on 08/09/06 DATE Signature of Server 505 S. Flagler . West Palm Beach, FL Address of Server ADDITIONAL INFORMATION 1.As to who may serve a subpoena and the manner of its service see Rule 17(d). Federal Rules of Criminal Procedure, or Rule 45(c), Federal Rules of Civil Procedure. 2."Fees and mileage need not be tendered to the witness upon service of a subpoena issued on behalf of the United States or an officer or agency thereof (Rule 45(c), Federal Rules of Civil Procedure; Rule 17(d), Federal Rules of Criminal Procedure) or on behalf of certain indigent parties and criminal defendants who are unable to pay such costs (28 USC 1825, Rule 17(b) Federal Rules of Criminal Procedure)" EFTA00185521 # United States District Court SOUTHERN DISTRICT OF FLORIDA ```markdown TO: CAPITAL ONE Subpoena Compliance 15000 Capital One Drive Richmond, VA 23238 Fax ``` SUBPOENA TO TESTIFY BEFORE GRAND JURY FGJ 05-02(WPB)-Fri./No. OLY-03 SUBPOENA FOR: □ PERSON ```markdown X DOCUMENTS OR OBJECT[S] ``` YOU ARE HEREBY COMMANDED to appear and testify before the Grand Jury of the United States District Court at the place, date and time specified below.
PLACE: Palm Beach County Courthouse Juvenile Courts Building 205 N. Dixie Highway West Palm Beach, Florida 33401 (Temporary location for the United States District Courthouse, West Palm Beach)ROOM: Room 4-A
DATE AND TIME: August 18, 2006 9:00am
YOU ARE ALSO COMMANDED to bring with you the following document(s) or object(s): All applications, signature cards, credit or background investigations conducted, and correspondence related to Jeffrey Epstein, , Janusz Banasiak, , Alfredo Rodriguez, and/or Mastercard Account Number . For the period of January 1, 2004 to the present, all monthly billing statements, individual charge invoices, repayment records disclosing the dates, amounts, and method of repayment, and checks used to make repayments (front and back) for Mastercard Account Number Please coordinate your compliance of this subpoena and confirm the date and time of your appearance with Special Agent Federal Bureau of Investigation, Telephone: . ```markdown Please see additional information on reverse ``` This subpoena shall remain in effect until you are granted leave to depart by the court or by an officer acting on behalf of the court.
CLERKDATE:August 2, 2006
(BY) DEPUTY CLERK
This subpoena is issued upon application of the United States of AmericaName, Address and Phone Number of Assistant U.S. AttorneyAssistant U.S. Attorney500 So. Australian Avenue, Suite 400West Palm Beach, FL 33401-6235Tel:x3047Fax:
UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA *If not applicable, enter "none." To be used in lieu of AO110 FORM ORD-227 EFTA00185522 JAN.86 # RETURN OF SERVICE | RECEIVED BY SERVER | DATE | PLACE | | :--- | :--- | :--- | | SERVED | DATE 08/09/06 | PLACE Richmond, VA (VIA Fax) | SERVED ON (NAME) Capital One SERVED BY TITLE FBI Special Agent STATEMENT OF SERVICE FEES TRAVEL | SERVICES | TOTAL DECLARATION OF SERVICE² I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on 08/09/06 DATE Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who may serve a subpoena and the manner of its service see Rule 17(d). Federal Rules of Criminal Procedure, or Rule 45(c), Federal Rules of Civil Procedure. 2. "Fees and mileage need not be tendered to the witness upon service of a subpoena issued on behalf of the United States or an officer or agency thereof (Rule 45(c), Federal Rules of Civil Procedure; Rule 17(d), Federal Rules of Criminal Procedure) or on behalf of certain indigent parties and criminal defendants who are unable to pay such costs (28 USC 1825, Rule 17(b) Federal Rules of Criminal Procedure)" EFTA00185523 U.S. Department of Justice Washington, D.C. 10530 Request for Financial Information (Authorization, Purchase Order, Receiving Report)
1 Purchase Order Number/DCN#:11011-19622 Date Order Prepared:08/02/20063 Case Number:(Optional)FGJ 05-02(WPB)NO.051-03(OLY-03)
Section A - Authorization and Purchase Order
4 Names and Address of Financial Institution:Attn.:Subpoena ComplianceCapital One,15000 Capital One Drive,Richmond,VA23238-Fax
5 Deliver To:Special Agent:Federal Bureau of Investigation,505 South Flagler Drive,Suite 500,Florida33401,Tel:6 Return Date08/18/2006
7 Remarks:FOR REIMBURSEMENT PLEASE RETURN THIS FORM,THE RECORD OFSERVICES,AND A COPY OF THE SUBPOENA.
8 Name Of Requester:AUSA9 Telephone Number:10 Date of request:08/02/2006
Section B - Financial Institution Invoice No Payment Shall Be Made Unless Expenses Are Itemized Below Or On Your Form To Be Attached.
11 Service/Financial Records Provided:QuantityUnit PriceAmount
CostPer
Please note that reimbursement cannot be made for the records pertaining to corporations or large partnerships of six or more. IMPORTANT: The DCIA Mandates the use of EFT/DD. In order to receive payment complete the attached EFT enrollment Form.0.25Copy
11.00Hour Clerical Tech
17.00Hour Manager or Supervisor
Form OBD211 This form was electronically produced by Elite Federal Forms, Inc. APR 84 Page 1 of 3 EFTA00185524 ## GENERAL This is a multi-purpose form designed to serve as an Authorization, Purchase Order, Itemized Invoice, receiving Report and Payment voucher in conjunction with "requests for financial information," pursuant to the Right to Financial Privacy Act of 1978, P.L. 95-630, Title XL, 12 U.S.C. 3415. ## NOTE: Payments under this purchase order will be due on the 30th calendar day after the date of actual receipt of a proper invoice in the office designated to receive the invoice. The Prompt Payment Act, Public Law 97-177, 96 Stat. 85 (31 U.S.C. 180), is applicable to payments under this purchase order and requires the payment to contractors of interest or overdue payments and improperly taken discounts. Determination of interest due will be made in accordance with the provision of the Prompt Payment Act and the Office of Management and Budge Circular A-125. ## PREPARATION INSTRUCTIONS ITEM 1 - A Purchase Order Number will be preprinted on each form. This number will be used for reference purposes on any correspondence relating to this specific request for financial information. ITEM 2 - Self explanatory. ITEM 3 - This block may be used to identify the specific case for which the financial information is required. This block may be left blank. SECTION A - AUTHORIZATION AND PURCHASE ORDER (To be completed by the requesting official). ITEM 4 - Enter the name and mailing address of the financial institution being requested to furnish financial information. ITEM 5 - Enter the and address to which the financial information is to be sent by the financial institution. This will normally be the name and the address of the requesting official. ITEM 6 - Enter the date the financial information is required. ITEM 7 - Include, if appropriate, any pertinent information related to the purchase order not provided for elsewhere on the form. ITEM 8, 9 and 10 - Self-explanatory. SECTION B - FINANCIAL INSTITUTION INVOICE (To be completed by the financial institution). ITEM 11 - Self-explanatory. Completion of this block constitutes an itemized bill or invoice for reimbursement for the costs incurred in providing the information requested. The DCIA Mandates the use of EFT/DD. In order to receive payment complete the attached EFT enrollment Form. ITEM 12 and 13 - Self-explanatory. SECTION C - RECEIVING REPORT (To be completed by the requesting official, when the requested financial information has been delivered). ITEM 14 and 15 - Self-explanatory. ITEM 16 - This block should be used to reflect any differences between the amount claimed by the financial institution and the correct amount to be reimbursed. Differences may result from computation errors, or failure of the financial institution to deliver information requested. ITEM 17 - Enter the amount certified to be proper for payment. ITEM 18 - Check the box which identifies the appropriate procedure authorized by the Act, which necessitates the request for financial information. ITEM 19 and 20 - These blocks must be signed and dated by an official of the organization whose funds will be charged. His or her signature constitutes a statement that the records to which the invoice refers were required for official business and were provided by the financial institution in accordance with the ordering instrument. ITEM 21 - The Schedule and Voucher Number will be entered by the office which actually schedules the approved amount for payment by the Treasury Department. ITEM 22 - Enter, if appropriate, any data not provided for elsewhere on the receiving report, such as, reasons for any claim amounts disallowed. ```markdown FORM OBD-211 APR. 84 Page 2 of 3 ``` EFTA00185525 VENDOR ELECTRONIC FUNDS TRANSFER (EFT) ENROLLMENT FORM Please comply to this information if you have not done so already ## PAYEE/COMPANY INFORMATION:
Vendor Company Name:
Address:
Taxpayer ID Number
Contact Person Name
Telephone Number
E-mail Address(If you would like to be notified via e-mail)
FINANCIAL INSTITUTION INFORMATION:
Bank Name
Bank Address
Bank Phone Number
Nine Digit ABA Routing Transit Number
Type of Account(Checking or Saving)
Depositor Account Number
Signature of Vendor's Authorizing Official
Name & Title of Authorizing Official
Please Return or Fax to: U.S. Attorney's Office Southern District of Florida 99 NE 4 street, Suite 200 Miami, FL. 33132 Attention: ## Fax Number: The Debt Collection Improvement Act of 1996 requires that payments made by the Federal government, including vendor payments, must be made by electronic funds transfer (EFT). A benefit of receiving payments by EFT is that your funds are directly deposited to your account at a financial institution and are available to you on the date of payment. If you have questions regarding the delivery of the remittance information, please contact the financial institution where your account is held. If you have any questions on the completion of this form, please contact ```markdown FORM OBD-211 APR. 84 Page 3 of 3 ``` EFTA00185526 U.S. Department of Justice Washington, D.C. 20530 Request for Financial Information (Authorization, Purchase Order, Receiving Report)
1 Purchase Order Number/DCN#:11011-19622 Date Order Prepared:08/02/20063 Case Number:(Optional)FGJ 05-02(WPB)NO.051-03(OLY-03)
Section A - Authorization and Purchase Order
4 Names and Address of Financial Institution:Attn.: Subpoena ComplianceCapital One,15000 Capital One Drive,Richmond,VA 23238-Fax
5 Deliver To:Special AgentFederal Bureau of Investigation,505 South Flagler Drive,Suite 500,Florida 33401,Tel:6 Return Date08/18/2006
7 Remarks:FOR REIMBURSEMENT PLEASE RETURN THIS FORM,THE RECORD OFSERVICES,AND A COPY OF THE SUBPOENA.
8 Name of Requestor:(Type or Print)AUSA9 Telephone Number:10 Date of request:08/02/2006
Section B - Financial Institution Invoice No Payment Shall Be Made Unless Expenses Are Itemized Below Or On Your Form To Be Attached.
11 Service/Financial Records Provided:QuantityUnit PriceAmount
CostPer
Please note that reimbursement cannot be made for the records pertaining to corporations or large partnerships of six or more. IMPORTANT: The DCIA Mandates the use of EFT/DD. In order to receive payment complete the attached EFT enrollment Form.0.25Copy
11.00Hour Clerical Tech
17.00Hour Manager or Supervisor
Form OBD211 This form was electronically produced by Elite Federal Forms, Inc. APR 84 EFTA00185527 ## GENERAL This is a multi-purpose form designed to serve as an Authorization, Purchase Order, Itemized Invoice, receiving Report and Payment voucher in conjunction with "requests for financial information," pursuant to the Right to Financial Privacy Act of 1978, P.L. 95-630, Title XL, 12 U.S.C. 3415. ## NOTE: Payments under this purchase order will be due on the 30th calendar day after the date of actual receipt of a proper invoice in the office designated to receive the invoice. The Prompt Payment Act, Public Law 97-177, 96 Stat. 85 (31 U.S.C. 180), is applicable to payments under this purchase order and requires the payment to contractors of interest or overdue payments and improperly taken discounts. Determination of interest due will be made in accordance with the provision of the Prompt Payment Act and the Office of Management and Budge Circular A-125. ## PREPARATION INSTRUCTIONS ITEM 1 - A Purchase Order Number will be preprinted on each form. This number will be used for reference purposes on any correspondence relating to this specific request for financial information. ITEM 2 - Self explanatory. ITEM 3 - This block may be used to identify the specific case for which the financial information is required. This block may be left blank. SECTION A - AUTHORIZATION AND PURCHASE ORDER (To be completed by the requesting official). ITEM 4 - Enter the name and mailing address of the financial institution being requested to furnish financial information. ITEM 5 - Enter the and address to which the financial information is to be sent by the financial institution. This will normally be the name and the address of the requesting official. ITEM 6 - Enter the date the financial information is required. ITEM 7 - Include, if appropriate, any pertinent information related to the purchase order not provided for elsewhere on the form ITEM 8, 9 and 10 - Self-explanatory. SECTION B - FINANCIAL INSTITUTION INVOICE (To be completed by the financial institution). ITEM 11 - Self-explanatory. Completion of this block constitutes an itemized bill or invoice for reimbursement for the costs incurred in providing the information requested. The DCIA Mandates the use of EFT/DD. In order to receive payment complete the attached EFT enrollment Form. ITEM 12 and 13 - Self-explanatory. SECTION C - RECEIVING REPORT (To be completed by the requesting official, when the requested financial information has been delivered). ITEM 14 and 15 - Self-explanatory. ITEM 16 - This block should be used to reflect any differences between the amount claimed by the financial institution and the correct amount to be reimbursed. Differences may result from computation errors, or failure of the financial institution to deliver information requested. ITEM 17 - Enter the amount certified to be proper for payment. ITEM 18 - Check the box which identifies the appropriate procedure authorized by the Act, which necessitates the request for financial information. ITEM 19 and 20 - These blocks must be signed and dated by an official of the organization whose funds will be charged. His or her signature constitutes a statement that the records to which the invoice refers were required for official business and were provided by the financial institution in accordance with the ordering instrument. ITEM 21 - The Schedule and Voucher Number will be entered by the office which actually schedules the approved amount for payment by the Treasury Department. ITEM 22 - Enter, if appropriate, any data not provided for elsewhere on the receiving report, such as, reasons for any claim amounts disallowed. ```markdown FORM OBD-211 APR. 84 Page 2 of 3 ``` EFTA00185528 # VENDOR ELECTRONIC FUNDS TRANSFER (EFT) ENROLLMENT FORM ## Please comply to this information if you have not done so already ## PAYEE/COMPANY INFORMATION:
Vendor Company Name:
Address:
Taxpayer ID Number
Contact Person Name
Telephone Number
E-mail Address(If you would like to be notified via e-mail)
FINANCIAL INSTITUTION INFORMATION:
Bank Name
Bank Address
Bank Phone Number
Nine Digit ABA Routing Transit Number
Type of Account(Checking or Saving)
Depositor Account Number
Signature of Vendor's Authorizing Official
Name & Title of Authorizing Official
Please Return or Fax to: U.S. Attorney's Office Southern District of Florida 99 NE 4 street, Suite 200 Miami, FL. 33132 Attention: ## Fax Number: The Debt Collection Improvement Act of 1996 requires that payments made by the Federal government, including vendor payments, must be made by electronic funds transfer (EFT). A benefit of receiving payments by EFT is that your funds are directly deposited to your account at a financial institution and are available to you on the date of payment. If you have questions regarding the delivery of the remittance information, please contact the financial institution where your account is held. If you have any questions on the completion of this form, please contact ```markdown FORM OBD-211 APR. 84 Page 3 of 3 ``` EFTA00185529 HUG 09 2006 11:39 FK FRHUD USKU 08/08/2006 WED 11:29 FN FD-448 (Rev. 6-2-97) ```markdown P.01 ``` # FBI FACSIMILE # COVER SHEET ## PRECEDENCE ## CLASSIFICATION ```markdown □ Immediate ``` ```markdown Priority ``` ```markdown □ Top Secret ``` Routine ```markdown Secret ``` Time Transmitted: ___ □ Confidential Unclassified ```markdown Sensitive ``` Sender's Initials: ___ Number of Pages: 6 (including cover sheet) Date: 08/08/2006 From: FBI Subject: Subpoena Request Special Handling Instructions: ___ Originator's Name: SA ___ Telephone: ___ Originator's Facsimile Number: ___ Approved: ___ Brief Description of Communication Faxed: ___ ## WARNING Information attached to the cover sheet is U.S. Government Property. If you are not the intended recipient of this information, disclosure, reproduction, distribution, or use of this information is prohibited (18.USC, § 641). Please notify the originator or the local FBI Office immediately to arrange for proper disposition. EFTA00185530 # ```markdown CapitalOne ``` ```markdown PO Box 85032 Richmond, VA 23285-5032 ``` August 10, 2006 Federal Bureau of Investigation Attn: Special Agent 505 South Flagler Drive, Suite 500 West Palm Beach, FL 33401 Re: SF number: 21705 Case number: FGJ 05-02 (WPB)-Fri./ No.OLY-03 Dear Special Agent We received your request for customer records on August 9, 2006. We object to this request on the grounds that the request is overbroad and unspecific to which entity your request is in regards to. There are two bankcard entities which may have customer financial records that exist within the scope of your request. If you wish to obtain information from these entities you will need to reissue a subpoena specifically identifying the entity. The entities that manage customer financial records must be identified as: ## Capital One Bank/FSB Please resubmit your request to the below address for review and response: ```markdown Capital One Bank/FSB PO Box 85032 Richmond, VA 23285-5032 Fax: [blank] ``` Thank you for your attention to this matter. If you have any further questions, please contact our office at . Sincerely, Subpoena Coordinator Capital One Services, Inc. Enclosure ©2006 Capital One Services, Inc. Capital One is a federally registered service mark. All rights reserved. EFTA00185531 AUG 09 2006 11:39 FR FRAUD DSRU 08/09/2006 WED 11:29 PAL P.02 # United States District Court SOUTHERN DISTRICT OF FLORIDA TO: CAPITAL ONE Subpoena Compliance 15000 Capital One Drive Richmond, VA 23238 Fax SUBPOENA TO TESTIFY BEFORE GRAND JURY FGJ 05-02(WPB)-Pri./No. OLY-03 SUBPOENA FOR: □ PERSON X DOCUMENTS OR OBJECT[S] YOU ARE HERE BY COMMANDED to appear and testify before the Grand Jury of the United States District Court at the place, date and time specified below.
PLACE: Palm Beach County Courthouse Juvenile Courts Building 205 N. Dixie Highway West Palm Beach, Florida 33401 (Temporary location for the United States District Courthouse, West Palm Beach)ROOM: Room 4-A
DATE AND TIME: August 18, 2006 9:00am
YOU ARE ALSO COMMANDED to bring with you the following document(s) or object(s): All applications, signature cards, credit or background investigations conducted, and correspondence related to Jeffrey Epstein, Janusz Banaslak, Alfredo Rodriguez, and/or Mastercard Account Number For the period of January 1, 2004 to the present, all monthly billing statements, individual charge invoices, repayment records disclosing the dates, amounts, and method of repayment, and checks used to make repayments (front and back) for Mastercard Account Number Please coordinate your compliance of this subpoena and confirm the date and time of your appearance with Special Agent Federal Bureau of Investigation, Telephone: ```markdown □ Please see additional information on reverse ``` This subpoena shall remain in effect until you are granted leave to depart by the court or by an officer acting on behalf of the court.
CLERKDATE:
(BY) DEPUTY CLERKAugust 2, 2006
This subpoena is issued upon application of the United States of AmericaName, Address and Phone Number of Assistant U.S. Attorney Assistant U.S. Attorney500 So. Australian Avenue, Suite 400West Palm Beach, FL 33401-6235Tel:Pax:
*If not applicable, enter "none." To be used in lieu of AO110 EFTA00185532 AUG 09 2006 11:39 U8/U9/Z006 NEN 11.00 TO # RETURN OF SERVICE¹ | RECEIVED BY SERVER | DATE | PLACE | | :--- | :--- | :--- | | SERVED | DATE | PLACE | SERVED ON (NAME) SERVED BY | TITLE | # STATEMENT OF SERVICE FEES | TRAVEL | SERVICES | TOTAL | # DECLARATION OF SERVICE² I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct. Executed on ___ Date ___ Signature of Server Address of Server ADDITIONAL INFORMATION 1.As to who may serve a subpoena and the manner of its service see Rule 17(d). Federal Rules of Criminal Procedure, or Rule 45(c), Federal Rules of Civil Procedure. 2. "Fees and mileage need not be tendered to the witness upon service of a subpoena issued on behalf of the United States or an officer or agency thereof (Rule 45(c), Federal Rules of Civil Procedure; Rule 17(d), Federal Rules of Criminal Procedure) or on behalf of certain indigent parties and criminal defendants who are unable to pay such costs (28 USC 1825, Rule 17(b) Federal Rules of Criminal Procedure)" EFTA00185533 AUG 09 2006 11:39 FR FRAUD DSRU 08/09/2006 WED 11:30 FAX P.04 ## U.S. Department of Justice Washington, DC 20501 ### Request for Financial Information (Authorization, Purchase Order, Receiving Report) File from shall only be used when requesting financial records of individuals and partnerships of fow or brow individuals. 1. **Purchase Order Number:** 1962-1011 - **Date Order Prepared:** 08/02/2006 - **Case Number:** FGJ 05-02(WEB) NO.051-03 (OLY-03) ## Section A - Authorization and Purchase Order 4. **Name and Address of Financial Institution:** Artin; Subpoena Compliance - Capital One, 15000 Capital One Drive, Richmond, VA 23238 - Fax 888-259-3021 5. **Deliver To:** Special Agent - Federal Bureau of Investigation, 505 South Flagler Drive, - Suite 500, Florida 33401, Tel.: 7. **Remarks:** FOR REINSURMENT PLEASE RETURN THIS FORM, THE RECORD OF SERVICES, AND A COPY OF THE SUBPOENA. 8. **Name of Requester:** (Type or Print) - AUSA 9. **Telephone Number:** 10 Date of request: 08/02/2006 ## Section B - Financial Institution Invoice No Payment shall be made unless Expenses are Implanted Below Or On Your Form To Be Amended. | Service/Financial Records Provided | Quantity | Unit Price | Amount | | :--- | :--- | :--- | :--- | | Please note that reimbursement cannot be made for the records pertaining to corporations or large partnerships of six or more. IMPORTANT: The DCIA Mandates the use of EPT/DD. In order to receive payment complete the attached EPT enrollment Form. | | 0.25 | Copy | | | | 11.00 | Hour Clinical Tech | | | | 17.00 | Hour Manager or Supervisor | Do not present with camperies. If cost will exceed $300 without prior approval of AMERICAN AMBULANCE RESPONDING OFFICE. PLEASE REFERENCE THE ABOVE DCN8 ON YOUR INVOICE FOR PAYMENT. 12a. Signature of Financial Institution Official: 12b. Phone of Financial Institution Official: 13d. Signature: Total Amount Claimed By Financial Institution 16. Disclosure (See Attached) ## Section – Receiving Report 14. I certify that the articles and services listed were received: 15. Date Received: 17 Not to Financial Institution 18. Right to Financial Privacy Act - Public Law 85-430 (12 U.S.C. 3014-342) Request Permanent Tc (Check One Only) SECTION 19. Signature of Approval Officer: 20. Accounting Classification Code 21. Schedule and Voucher Number DCN 22. Remarks: - Funds Available - Date - Badge Officer This form was electronically produced by Eliza Federal Forms, Inc. EFTA00185534 AUG 09 2006 11:39 FR FRAUD DSRU 08/09/2006 WED 11:30 FAA P.05 ## GENERAL This is a multi-purpose form designed to serve as an Authorization, Purchase Order, Itemized Invoice, receiving Report and Payment voucher in conjunction with "requests for financial information," pursuant to the Right to Financial Privacy Act of 1978, P.L. 95-630, Title XL, 12 U.S.C. 3415. Payments under this purchase order will be due on the 30th calendar day after the date of actual receipt of a proper invoice in the office designated to receive the invoice. The Prompt Payment Act, Public Law 97-177, 96 Stat. 85 (31 U.S.C. 180), is applicable to payments under this purchase order and requires the payment to contractors of interest or overdue payments and improperly taken discounts. Determination of interest due will be made in accordance with the provision of the Prompt Payment Act and the Office of Management and Budget Circular A-125. ## PREPARATION INSTRUCTIONS ITEM 1 - A Purchase Order Number will be preprinted on each form. This number will be used for reference purposes on any correspondence relating to this specific request for financial information. ITEM 2 - Self explanatory. ITEM 3 - This block may be used to identify the specific case for which the financial information is required. This block may be left blank. SECTION A - AUTHORIZATION AND PURCHASE ORDER (To be completed by the requesting official). IBM 4 - Enter the name and mailing address of the financial institution being requested to furnish financial information. ITEM 5 - Enter the and address to which the financial information is to be sent by the financial institution. This will normally be the name and the address of the requesting official. ITEM 6 - Enter the date the financial information is required. IBM 7 – Include, if appropriate, any pertinent information related to the purchase order not provided for elsewhere on the form. ITEM 14 and 15 - Self-explanatory. ITEM 8, 9 and 10 - Self-explanatory. SECTION C - RECEIVING REPORT (To be completed by the requesting official, when the requested financial information has been delivered). SECTION B - FINANCIAL INSTITUTION INVOICE (To be completed by the financial institution), ITEM 11 - Self-explanatory. Completion of this block constitutes an itemized bill or invoice for reimbursement for the costs incurred in providing the information requested. The DCIA Mandates the use of EFT/DD. In order to receive payment complete the attached EFT enrollment Form. ITEM 16 - This block should be used to reflect any differences between the amount claimed by the financial institution and the correct amount to be reimbursed. Differences may result from computation errors, or failure of the financial institution to deliver information requested. ITEM 12 and 13 - Self-explanatory. ITEM 17 - Enter the amount certified to be proper for payment. ITEM 18 - Check the box which identifies the appropriate procedure authorized by the Act, which necessitates the request for financial information. ITEM 19 and 20 - These blocks must be signed and dated by an official of the organization whose funds will be charged. His or her signature constitutes a statement that the records to which the invoice refers were required for official business and were provided by the financial institution in accordance with the ordering instrument. ITEM 21 - The Schedule and Voucher Number will be entered by the office which actually schedules the approved amount for payment by the Treasury Department. ITEM 22 - Enter, if appropriate, any data not provided for elsewhere on the receiving report, such as, reasons for any claim amounts disallowed. ```markdown FORM CED-311 APR. 84 Page 2 of 3 ``` EFTA00185535 AUG 09 2006 11:39 FR FRAUD DSRU TO P.06 VENDOR ELECTRONIC FUNDS TRANSFER (EFT) ENROLLMENT FORM ## Please comply to this information if you have not done so already PAYEE/COMPANY INFORMATION:
Vendor Company Name:
Address:
Taxpayer ID Number
Contact Person Name
Telephone Number
E-mail Address(If you would like to be notified via e-mail)
Bank Name
Bank Address
Bank Phone Number
Nine Digit ABA Routing Transit Number
Type of Account(Checking or Saving)
Depositor Account Number
Signature of Vendor's Authorizing Official
Name & Title of Authorizing Official
Please Return or Fax to: U.S. Attorney's Office Southern District of Florida 99 NE 4 street, Suite 200 Miami, FL. 33182 Attention: ## Fax Number: The Debt Collection Improvement Act of 1995 requires that payments made by the Federal government, including vendor payments, must be made by electronic funds transfer (EFT). A benefit of receiving payments by EFT is that your funds are directly deposited to your account at a financial institution and are available to you on the date of payment. If you have questions regarding the delivery of the remittance information, please contact the financial institution where your account is held. If you have any questions on the completion of this form, please contact ```markdown FORM 4 CBD-211 APR. 84 Page 3 of 3 ``` EFTA00185536 AUG 09 2006 11:40 FR FRAUD DSRU 08/08/2006 TW 24:94 40F Request for Financial Information (Authorization, P. 07 # Purchase Order, Receiving Report ## Section A - Authorization and Purchase Order 4 Names and Address of Financial Institution: ATM Subpoena Compliance Capital One, 15000 Capital One Drive, Richmond, VA 22338 - Fax 888-259-3021 5 Delivery To: Special Agent Nehtil Kuvykendall, Federal Bureau of Investigation, 505 South Flipter Drive, Suite 500, Florida 33403, Tel.: 7 Reworks: FOR REIMBURSEMENT PLEASE RETURN THIS FORM, THE RECORD OF SERVICES, AND A COPY OF THE SUBPOENA. 8 Name of Requester: (Type or Profit) AUUSA 9 Telephone Number: 10 Date of request: 08/02/2006 ## Section B - Financial Institution Invoice No Payment shall Be Made Unless Expenses Are Immediately Below Or On Your Poem To Be Attached. ### 11 Service/Financial Records Provided: | Quantity | Unit Price | Amount | | :--- | :--- | :--- | | | Cost | Fee | | Please note that reimbursement cannot be made for the records pertaining to corporations or large partnerships of six or more. IMPORTANT! The DCIA Mandates the use of EFT/DD. In order to receive payment complete the attached EFT enrollment Form. | 0.25 | Copy | | | 11.00 | Hour Clerical Tech | | | 17.00 | Hour Manager or Supervisor | Do not record with compliance; if cost will exceed $300 without prior approval of Assistant U.S. Attorney/Budget Officer. PLEASE REFERENCE THE ABOVE DCW ON YOUR INVOICE FOR PAYMENT. ### 12 Signature of Financial Institution Official: 12b Please of Financial Institution Official: 13 Date Signed: Total Amount Claimed By Financial Institution ### 14 I certify that the articles and services listed were received: 15 Date Received: Not to Financial Institution ### 15 Right to Financial Privacy Act - Public Law 52-638 (12 U.S.C. 3401-3422) Request Permanent Tc (Check One Only) **OBJECT CLASS** - 3404 Customer Authorization - 3405 Administrative Subpoena or Simulations - 3406 Samb Warrant - 3407 Judicial Subpoena - 3408 Formal Written Request - 3413 I Grand Jury Subpoena - 3414 Special Procedures ### 19 Signature of Approval Official: - 80 Accounting Classification Code - FY PC 1 2 3 4 5 PRO1 ### 21 Schedule and Voucher Number: DC# ### 22 Rewrites: - Funds Available - Date - Budget Officer This item was electronically produced by Ellie Federal Forms, Inc. EFTA00185537 AUG 09 2006 11:40 FR FRAUD DSRU TO P.08 ## GENERAL This is a multi-purpose form designed to serve as an Authorization, Purchase Order, formized Invoice, receiving Report and Payment voucher in conjunction with "requests for financial information," pursuant to the Right to Financial Privacy Act of 1978, P.L. 95-630, Title XL., 12 U.S.C. 3415. Payments under this purchase order will be due on the 30th calendar day after the date of actual receipt of a proper invoice in the office designated to receive the invoice. The Prompt Payment Act, Public Law 97-177, 96 Stat. 85 (31 U.S.C. 180), is applicable to payments under this purchase order and requires the payment to contractors of interest or overdue payments and improperly taken discounts. Determination of interest due will be made in accordance with the provision of the Prompt Payment Act and the Office of Management and Budge Circular A-125. ## PREPARATION INSTRUCTIONS ITEM 1 - A Purchase Order Number will be preprinted on each form. This number will be used for reference purposes on any correspondence relating to this specific request for financial information. ITEM 2 - Self explanatory. ITEM 3 - This block may be used to identify the specific case for which the financial information is required. This block may be left blank. SECTION A - AUTHORIZATION AND PURCHASE ORDER (To be completed by the requesting official). ITEM 4 - Enter the name and mailing address of the financial institution being requested to furnish financial information. ITEM 5 - Enter the and address to which the financial information is to be sent by the financial institution. This will normally be the name and the address of the requesting official. ITEM 6 - Enter the data the financial information is required. ITEM 7 - Include, if appropriate, any pertinent information related to the purchase order not provided for elsewhere on the form ITEM 8,9 and 10 - Self-explanatory. SECTION B - FINANCIAL INSTITUTION INVOICE (To be completed by the financial institution). ITEM 11 • Self-explanatory. Completion of this block constitutes an loanized bill or invoice for reimbursement for the costs incurred in providing the information requested. The DCIA Mandates the use of EFT/DD. In order to receive payment complete the attached EFT enrollment Form. ITEM 12 and 13 - Self-explanatory. SECTION C - RECEIVING REPORT (To be completed by the requesting official), when the requested financial information has been delivered). ITEM 14 and 15 - Self-explanatory. ITEM 16 - This block should be used to reflect any differences between the amount claimed by the financial institution and the correct amount to be reimbursed. Differences may result from computation errors, or failure of the financial institution to deliver information requested. ITEM 17 - Enter the amount certified to be proper for payment. ITEM 18 • Check the box which identifies the appropriate procedure authorized by the Act, which necessitates the request for financial information. ITEM 19 and 20 - These blocks must be signed and dated by an official of the organization whose funds will be charged. His or her signature constitutes a statement that the records to which the invoice refers were required for official business and were provided by the financial institution in accordance with the ordering instrument. ITEM 21 - The Schedule and Voucher Number will be entered by the office which actually schedules the approved amount for payment by the Treasury Department. ITEM 22 - Enter, if appropriate, any data not provided for elsewhere on the receiving report, such as, reasons for any claim amounts disallowed. ```markdown FORM CHD-211 APR. 04 Page 2 of 3 ``` EFTA00185538 AUG 09 2006 11:40 FR FRAUD DSRU 08/08/2006 NEW ALIVE ```markdown B TO ``` P.09 ## VENDOR ELECTRONIC FUNDS TRANSFER (EFT) ENROLLMENT FORM ## Please comply to this information if you have not done so already ## PAYEE/COMPANY INFORMATION:
Vendor Company Name:
Address:
Taxpayer ID Number
Contact Person Name
Telephone Number
E-mail Address(If you would like to be notified via e-mail)
FINANCIAL INSTITUTION INFORMATION:
Bank Name
Bank Address
Bank Phone Number
Nine Digit ABA Routing Transit Number
Type of Account(Checking or Saving)
Depositor Account Number
Signature of Vendor's Authorizing Official
Name & Title of Authorizing Official
Please Return or Fax to: U.S. Attorney's Office Southern District of Florida 89 NE 4 street, Suite 200 Miami, FL. 33132 Attention: ## Fax Number: The Debt Collection Improvement Act of 1996 requires that payments made by the Federal government, including vendor payments, must be made by electronic funds transfer (EFT). A benefit of receiving payments by EFT is that your funds are directly deposited to your account at a financial institution and are available to you on the date of payment. If you have questions regarding the delivery of the remittance information, please contact the financial institution where your account is held. If you have any questions on the completion of this form, please contact Claudia Castellanos, et ```markdown FORM OGB-211 APR 84 Page 3 of 3 ``` ```markdown ** TOTAI PAGE.99 ** ``` EFTA00185539 FD-448 (Rev. 6-2-97) ## FBI FACSIMILE ```markdown R SHEET ``` PRECEDENCE ```markdown □ Immediate ``` CLASS' $$ \begin{array}{l} F A P \\ 8 / 9 \end{array} $$ ```markdown □ Top Secret ``` ```markdown □ Priority ``` ```markdown Secret ``` Routine ```markdown □ Confidential ``` ```markdown Sensitive ``` --for you ```markdown Unclassified ``` Transmitted: ___ **ader's Initials:** ___ Number of Pages: 6 (including cover sheet) Date: 08/08/2006 From: FBI Name of Office Subject: Subpoena Request ___ ___ Special Handling Instructions: ___ I was 0's office Originator's Name: SA Originator's Facsimile Number: ___ Approved: ___ Brief Description of Communication Faxed: ___ ```markdown ``` ## WARNING Information attached to the cover sheet is U.S. Government Property. If you are not the intended recipient of this information, disclosure, reproduction, distribution, or use of this information is prohibited (18.USC, § 641). Please notify the originator or the local FBI Office immediately to arrange for proper disposition. EFTA00185540