DOJ-OGR-00015171.jpg
562 KB
Extraction Summary
2
People
4
Organizations
1
Locations
0
Events
1
Relationships
3
Quotes
Document Information
Type:
Legal form (attestation/signature page for claim form)
File Size:
562 KB
Summary
This document is page 1 of 2 of the 'Attestations/Signature Page' for the Epstein Victims' Compensation Program (Epstein VCP). It is a legal form requiring a wet signature and notarization, wherein the claimant certifies the truthfulness of their claim under penalty of perjury and authorizes the Administrator (Jordana H. Feldman) to process the claim and resolve liens (Medicare/Medicaid). The document includes warnings against fraud and establishes confidentiality protocols.
People (2)
| Name | Role | Context |
|---|---|---|
| Jeffrey Epstein | Perpetrator |
Named in the program title: 'For Victims-Survivors of Sexual Abuse by Jeffrey Epstein'
|
| Jordana H. Feldman | Administrator |
Administrator of the Epstein Victims' Compensation Program, listed in the footer address block.
|
Organizations (4)
| Name | Type | Context |
|---|---|---|
| Epstein Victims' Compensation Program |
The organization managing the claims and forms.
|
|
| Medicare |
Mentioned regarding the resolution of applicable liens.
|
|
| Medicaid |
Mentioned regarding the resolution of applicable liens.
|
|
| Department of Justice (DOJ) |
Inferred from 'DOJ REDACTION' and Bates stamp 'DOJ-OGR'.
|
Locations (1)
| Location | Context |
|---|---|
|
|
Mailing address for the Epstein Victims' Compensation Program.
|
Relationships (1)
Listed as 'Administrator' in the footer.
Key Quotes (3)
"I hereby certify that the information provided in this Claim Form... are true and accurate... and declare under penalty of perjury that the foregoing is true and correct."Source
DOJ-OGR-00015171.jpg
Quote #1
"I understand that false statements or claims... may result in fines, imprisonment and/or any other remedy available by law"Source
DOJ-OGR-00015171.jpg
Quote #2
"Note: The claim file is not available for inspection, review, or copying by the Estate, the Claimant or the Claimant's representatives."Source
DOJ-OGR-00015171.jpg
Quote #3
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