EFTA00029692.pdf
365 KB
Extraction Summary
3
People
2
Organizations
4
Locations
3
Events
2
Relationships
3
Quotes
Document Information
Type:
U.s. passport application (ds-11)
File Size:
365 KB
Summary
A U.S. Passport Application (DS-11) for Ghislaine Noelle Maxwell dated November 27, 2002. The document lists her residence as St. Thomas, USVI (c/o American Yacht Harbor), her occupation as 'Business Woman', and indicates she became a naturalized citizen on the same day (11/27/2002). It also notes upcoming travel plans to the United Kingdom starting December 5, 2002.
People (3)
| Name | Role | Context |
|---|---|---|
| Ghislaine Noelle Maxwell | Applicant |
Applying for US Passport, lists occupation as Business Woman
|
| Robert Maxwell | Father |
Listed as father, born in Czech, not US citizen
|
| Elisabeth Maynard | Mother |
Listed as mother, born in France, not US citizen
|
Organizations (2)
| Name | Type | Context |
|---|---|---|
| U.S. Department of State | ||
| American Yacht Harbor |
Locations (4)
| Location | Context |
|---|---|
|
Applicant's residence and mailing address; Place of issue for Naturalization Certificate
|
|
|
Applicant's place of birth
|
|
|
Intended travel destination
|
|
|
Mailing address location
|
Relationships (2)
Listed as father on passport application
Listed as mother on passport application
Full Extracted Text
Complete text extracted from the document (2,307 characters)
PRISM Scanned Document Page 1 of 1
U.S. Department of State
APPLICATION FOR [X] U.S. PASSPORT [ ] REGISTRATION
(Type or print all capital letters in blue or black ink in white areas only)
APPLICATION FOR [X] U.S. PASSPORT [ ] REGISTRATION
(Type or print all capital letters in blue or black ink in white areas only)
1. NAME (First and Middle)
GHISLAINE NOELLE
LAST
MAXWELL
GHISLAINE NOELLE
LAST
MAXWELL
2. MAIL PASSPORT TO: STREET / RFD OR P.O. BOX
[Redacted]
CITY: ST THOMAS
STATE: USVI
ZIP CODE: 00802
COUNTRY / IN CARE OF (if applicable): C/O AMERICAN YACHT HARBOR
[Redacted]
CITY: ST THOMAS
STATE: USVI
ZIP CODE: 00802
COUNTRY / IN CARE OF (if applicable): C/O AMERICAN YACHT HARBOR
3. SEX: [ ] M [X] F
4. PLACE OF BIRTH (City & State or City & Country): MAISONS LAFFITTE FRANCE
5. DATE OF BIRTH: 12/25/1961
6. SOCIAL SECURITY NUMBER: [Redacted]
4. PLACE OF BIRTH (City & State or City & Country): MAISONS LAFFITTE FRANCE
5. DATE OF BIRTH: 12/25/1961
6. SOCIAL SECURITY NUMBER: [Redacted]
7. HEIGHT: 5 Feet 8 Inches
8. HAIR COLOR: BROWN
9. EYE COLOR: BROWN
10. HOME TELEPHONE: [Redacted]
11. BUSINESS TELEPHONE: [Redacted]
12. OCCUPATION: BUSINESS WOMAN
8. HAIR COLOR: BROWN
9. EYE COLOR: BROWN
10. HOME TELEPHONE: [Redacted]
11. BUSINESS TELEPHONE: [Redacted]
12. OCCUPATION: BUSINESS WOMAN
13. PERMANENT ADDRESS (DO NOT LIST P.O. BOX): ST THOMAS
STATE: USVI
ZIP CODE: 00802
STATE: USVI
ZIP CODE: 00802
14. FATHER'S FULL NAME: MAXWELL, ROBERT
BIRTHPLACE: CZECH
BIRTHDATE: [Blank]
U.S. CITIZEN: [ ] Yes [X] No
BIRTHPLACE: CZECH
BIRTHDATE: [Blank]
U.S. CITIZEN: [ ] Yes [X] No
15. MOTHER'S FULL MAIDEN NAME: MAYNARD, ELISABETH
BIRTHPLACE: FRANCE
BIRTHDATE: [Blank]
U.S. CITIZEN: [ ] Yes [X] No
BIRTHPLACE: FRANCE
BIRTHDATE: [Blank]
U.S. CITIZEN: [ ] Yes [X] No
16. HAVE YOU EVER BEEN MARRIED? [ ] Yes [X] No
17. OTHER NAMES YOU HAVE USED: (1) [Blank] (2) [Blank]
17. OTHER NAMES YOU HAVE USED: (1) [Blank] (2) [Blank]
18. HAVE YOU EVER BEEN ISSUED A U.S. PASSPORT? [ ] Yes [X] No
19. EMERGENCY CONTACT: [Redacted]
20. TRAVEL PLANS (not mandatory)
Date of Trip: 12/05/2002
Length of Trip: 1 week
COUNTRIES TO BE VISITED: United Kingdom
Date of Trip: 12/05/2002
Length of Trip: 1 week
COUNTRIES TO BE VISITED: United Kingdom
21. STOP. DO NOT SIGN APPLICATION UNTIL REQUESTED TO DO SO BY PERSON ADMINISTERING OATH.
[OATH TEXT VISIBLE]
Applicant's Signature - age 14 or older: [Signature: Ghislaine Maxwell]
Date: 11/27/2002
[OATH TEXT VISIBLE]
Applicant's Signature - age 14 or older: [Signature: Ghislaine Maxwell]
Date: 11/27/2002
[Official Signature illegible]
(Signature of person authorized to accept application)
(Signature of person authorized to accept application)
23a. Applicant's or Father's Identifying Documents
[ ] Driver's License [ ] Passport [X] Other (Specify): Nat. Cert.
Issue Date: 11/27/2002
Expiration Date: [Blank]
Place of Issue: St. Thomas, VI
Name: Ghislaine N. Maxwell
ID No: 27524548
[ ] Driver's License [ ] Passport [X] Other (Specify): Nat. Cert.
Issue Date: 11/27/2002
Expiration Date: [Blank]
Place of Issue: St. Thomas, VI
Name: Ghislaine N. Maxwell
ID No: 27524548
24. FOR ISSUING OFFICE USE ONLY (Applicant's evidence of citizenship)
Naturalization/Citizenship Cert. No: 27524548
Attached: [Checked]
Naturalization/Citizenship Cert. No: 27524548
Attached: [Checked]
25. FEE
MJ 1 12/3/02 14:11 657 IA CK $0.00
AG1 1406 046842429 OTHER
MJ 1 12/3/02 14:11 657 IA CK $0.00
AG1 1406 046842429 OTHER
DS-11
OMB No. 1405-0004 Expires: 12/31/2001 Estimated Burden - 20 Minutes
Page 3 of 4
OMB No. 1405-0004 Expires: 12/31/2001 Estimated Burden - 20 Minutes
Page 3 of 4
https://ccdi.state.osis.gov/pls/PPT/rpt_passport_images.display_doc?p_hash=9722EF4329... 2/24/2020
EFTA00029692
EFTA00029692
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