Attached is the Form I-918B, which needs to be completed and signed by the law enforcement agency. I have completed the parts I need to complete, but please make sure that the FBI completes the following:

1. Part 2. Agency Information:

a. (questions 1-3) Please complete the full name and title of the FBI agent signing the Form.

b. (questions 4.2.-5.h.) include the name of the Head of the FBI and the address for the FBI Office

c. (question 9.) include the court case number for defendant Ghislaine Maxwell

2. Part 3. Criminal Acts:

a. (question 1.-3) I listed sexual exploitation and trafficking as the criminal activity for parts 2.a.-2.d. please list the dates the criminal activity occurred as alleged in the Indictment and the section of the USC code she is charged with

b. (question 4.b.) list the city and state where the violations occurred

c. (question 6.) Please describe the criminal activity being investigated according to the charges and allegations in the indictment

d. (question 7) describe the injury to Ms.|



3. Part 6. Certification

a. Have the FBI agent sign, date and include his telephone and fax number

EFTA00039844

SECURITY

# Supplement B, U Nonimmigrant Status Certification

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS
Form I-918
OMB No. 1615-0104
Expires 04/30/202

For USCIS Use Only:
Remarks



START HERE - Type or print in black or blue ink.

## Part 1. Victim Information

1. Alien Registration Number (A-Number) (if any)
► A-

2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)

2.c. Middle Name

Other Names Used (Include maiden names, nicknames, and aliases, if applicable.)

If you need extra space to provide additional names, use the space provided in Part 7. Additional Information.

3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)

3.c. Middle Name

4. Date of Birth (mm/dd/yyyy)

5. Gender Male Female

## Part 2. Agency Information

1. Name of Certifying Agency
Federal Bureau of Investigations
Name of Certifying Official
2.a. Family Name (Last Name):<empty>
2.b. Given Name (First Name):<empty>
2.c. Middle Name:<empty>
3. Title and Division/Office of Certifying Official:<empty>

Name of Head of Certifying Agency

4.a. Family Name
(Last Name)

4.b. Given Name
(First Name)

4.c. Middle Name

## Agency Address

5.a. Street Number
and Name

5.b. Apt. Ste. Flr.

5.c. City or Town

5.d. State 4.f. ZIP Code

5.f. Province

5.g. Postal Code

5.h. Country

# Supplement B, U Nonimmigrant Status Certification (cont.)

## Other Agency Information

6. Agency Type

Federal State Local

7. Case Status
 On-going  Completed

 Other

8. Certifying Agency Category

Judge Law Enforcement Prosecutor

Other

9. Case Number

10. FBI Number or SID Number (if applicable)

Form I-918 Supplement B 04/24/2019

Page 15

EFTA00039845

# Supplement B, U Nonimmigrant Status Certification (cont.)

## Part 3. Criminal Acts

If you need extra space to complete this section, use the space provided in Part 7. Additional Information.

1. The petitioner is a victim of criminal activity involving a
violation of one of the following Federal, state, or local
criminal offenses (or any similar activity). (Select all
applicable boxes)

Abduction Manslaughter
Abusive Sexual Contact Murder

Attempt to Commit Obstruction of Justice
Any of the Named
Crimes Peonage
Being Held Hostage Perjury
ㅁㅁㅁ Blackmail Prostitution
Conspiracy to Commit Rape
Any of the Named Sexual Assault
Crimes
Domestic Violence  Sexual Exploitation
Extortion ХПП Slave Trade
Solicitation to
ㅁㅁㅁㅁㅁ False Imprisonment
Commit Any of the
Felonious Assault Named Crimes

Female Genital Stalking
Mutilation
Torture
 Fraud in Foreign Labor    
Contracting Trafficking
Unlawful Criminal
Incest
Restraint
ㅁㅁㅁ Involuntary Servitude
Witness Tampering
Kidnapping

Provide the dates on which the criminal activity occurred.

2.a. Date (mm/dd/yyyy)

2.b. Date (mm/dd/yyyy)

2.c. Date (mm/dd/yyyy)

2.d. Date (mm/dd/yyyy)

3. List the statutory citations for the criminal activity being
investigated or prosecuted, or that was investigated or
prosecuted.

# Supplement B, U Nonimmigrant Status Certification (cont.)

## Part 3. Criminal Acts (cont.)

- 4.a. Did the criminal activity occur in the United States (including Indian country and military installations) or the territories or possessions of the United States?

Yes

No

4.b. If you answered "Yes," where did the criminal activity occur?

- 5.a. Did the criminal activity violate a Federal extraterritorial
jurisdiction statute? Yes  No

- 5.b. If you answered "Yes," provide the statutory citation providing the authority for extraterritorial jurisdiction.

6. Briefly describe the criminal activity being investigated and/or prosecuted and the involvement of the petitioner named in Part 1. Attach copies of all relevant reports and findings.

7. Provide a description of any known or documented injury to the victim. Attach copies of all relevant reports and findings.

Form I-918 Supplement B 04/24/2019

# Supplement B, U Nonimmigrant Status Certification (cont.)

## Part 3. Criminal Acts (cont.)

Page 25

EFTA00039846

<table><tr><th>Part 4. Helpfulness Of The Victim</th><th rowspan="8">4. Other. Include any additional information you would like
to provide.</th></tr><tr><td>For the following questions, if the victim is under 16 years of
age, incompetent or incapacitated, then a parent, guardian, or
next friend may act on behalf of the victim.</td></tr><tr><td>1. Does the victim possess information concerning the
criminal activity listed in Part 3.? Yes No</td></tr><tr><td>2. Has the victim been helpful, is the victim being helpful, or
is the victim likely to be helpful in the investigation or
prosecution of the criminal activity detailed above?
Yes No</td></tr><tr><td>3. Since the initiation of cooperation, has the victim refused
or failed to provide assistance reasonably requested in the
investigation or prosecution of the criminal activity
detailed above?  Yes No</td></tr><tr><td>If you answer "Yes" to Item Numbers 1.-3., provide an
explanation in the space below. If you need extra space to
complete this section, use the space provided in Part 7.</td></tr><tr><td>Additional Information.</td></tr><tr><td></td></tr></table>

Form I-918 Supplement B 04/24/2019

Page 3 of 5

EFTA00039847

# Supplement B, U Nonimmigrant Status Certification (cont.)

## Part 5. Family Members Culpable In Criminal
Activity

1. Are any of the victim's family members culpable or believed to be culpable in the criminal activity of which the petitioner is a victim? Yes No

If you answered "Yes," list the family members and their criminal involvement. (If you need extra space to complete this section, use the space provided in Part 7. Additional Information.)

2.a. Family Name
(Last Name)

2.b. Given Name
(First Name)

2.c. Middle Name

2.d. Relationship

2.e. Involvement

3.a. Family Name
(Last Name)

3.b. Given Name
(First Name)

3.c. Middle Name

3.d. Relationship

3.e. Involvement

4.a. Family Name
(Last Name)

4.b. Given Name
(First Name)

4.c. Middle Name

4.d. Relationship

4.e. Involvement

# Supplement B, U Nonimmigrant Status Certification (cont.)

## Part 6. Certification

I am the head of the agency listed in Part 2. or I am the person in the agency who was specifically designated by the head of the agency to issue a U Nonimmigrant Status Certification on behalf of the agency. Based upon investigation of the facts, I certify, under penalty of perjury, that the individual identified in Part 1. is or was a victim of one or more of the crimes listed is Part 3. I certify that the above information is complete, true and correct to the best of my knowledge, and that I have made and will make no promises regarding the above victim's ability to obtain a visa from U.S. Citizenship and Immigration Services (USCIS), based upon this certification. I further certify that it the victim unreasonably refuses to assist in the investigation of prosecution of the qualifying criminal activity of which he or she is a victim, I will notify USCIS.

1. Signature of Certifying Official (sign in ink)

2. Date of Signature (mm/dd/yyyy)

3. Daytime Telephone Number

4. Fax Number

Form I-918 Supplement B 04/24/2019

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EFTA00039848

# Supplement B, U Nonimmigrant Status Certification (cont.)

## Part 7. Additional Information

If you need extra space to complete any item within this supplement, use the space below or attach a separate sheet of paper; type or print the agency's name, petitioner's name, and the Alien Registration Number (A-Number) (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. If you need more space than what is provided, you may also make copies of this page to complete and file with this supplement.

5.a. Page Number 5.b. Part Number 5.c. Item Number

5.d.

1. Agency Name

Federal Bureau of Investigations

## Petitioner's Name

2.a. Family Name
(Last Name)

2.b. Given Name
(First Name)|

2.c. Middle Name

3. A-Number (if any)

6.a. Page Number 6.b. Part Number 6.c. Item Number

4.a. Page Number 4.b. Part Number 4.c. Item Number

6.d.

4.d.

Form I-918 Supplement B 04/24/2019

Page 5 of 5

EFTA00039849