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EFTA00086375

143 sivua
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UNITED STATES DISTRICT COURT 
SOUTHERN DISTRICT OF FLORIDA 
NORTHERN (WEST PALM BEACH) DIVISION 
FGJ NO. 07-103 (WPB) 
IN RE: 
GRAND JURY PROCEEDINGS 
APPLICATION FOR ORDER COMPELLING WITNESS TESTIMONY 
The United States of America, through its undersigned attorney, makes application to this 
Court for an Order pursuant to the provisions of Title 18, United States Code, Section 6001, et seq., 
compelling 
to give testimony and provide other information, which she is likely to 
refuse to give or provide, on the matters about which she may be interrogated before the United 
States District Court for the Southern District of Florida, including a Grand Jury impaneled therein, 
as well as subsequent proceedings or trial, and respectfully alleges as follows: 
1. 
That 
has been called to testify and provide other information before 
the United States District Court for the Southern District of Florida, including before a Grand Jury 
impaneled therein. 
2. 
That, in the judgment of the undersigned, the testimony and other information from 
may be necessary to the public interest. 
3. 
That 
is likely to refuse to testify and provide other information on the 
basis of her privilege against self-incrimination. 
4. 
That Ibis Application is made with the approval of the Assistant Attorney General 
in charge of the Criminal Division of the Department of Justice or a duly designated Acting 
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Assistant Attorney General, pursuant to the authority vested in him by Tide 18, United States Code, 
Section 6003, and Title 28, Code of Federal Regulations, Sections 0.175 and 0.132(e). A copy of 
the letter from said Assistant Attorney General or his designee expressing such approval iS attached 
hereto. 
5. 
That counsel for 
has informed the undersigned that an Order 
compelling testimony is required before 
will appear and testify before the Grand Jury. 
Upon receipt of the Court's Order compelling such testimony, a Subpoena to Testify before Grand 
Jury 07-103 (WPB) will be issued commanding 
appearance on Tuesday, April 24, 
2007 at 1:00 p.m. 
By: 
2 
Respectfully submitted, 
R. ALEXANDER ACOSTA 
UNITED STATES ATTORNEY 
MEW 
ASSISTANT UNITED STATES ATTORNEY 
Florida Bar No. 
500 S. Australian Ave, Suite 400 
West Palm Beach, FL 33132 
FAX 
Case No. 08-80736-CV-MARRA 
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pirm—Au —evict 
U.S. Department et JliSrICC 
Criminal Division 
WiedlOPUM.PIAWARIIIMOORIrel 
The Honorable R. Alexander Acosta 
. United States Attorney 
, 
{r.; 
• • 
west Palm Beach, Florida 33401 
Attention: 
Assistant United States Attorney 
Re: 
Grand fury Investigation, 
Joints/S.226n. et 41.
Dear Mr. At0Sra: 
MoMmihmiDC.M3AOMPI 
APR 13 2001 
Pursuant to the authority vested in me by 18 U.S.C. § 6011100 and 28 C.F.R_ § 0.17500, 
I hereby approve your request for authority to apply to the United Stites District Court for 
the Southern District of Ronda for an order pursuant to 18 U.S.C. §§ 6002-6003 requiring 
to give testimony or provide other information in the above matter and in any 
further proceedings resulting therefrom or ancillary thereto. 
Sincerely. 
Assistant Attorney General 
Case No 08-80736-CV-MARRA 
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UNITED STATES DISTRICT COURT 
SOUTHERN DISTRICT OF FLORIDA 
NORTHERN (WEST PALM BEACH) DIVISION 
FGJ 07-1 03(WPB) 
IN RE: 
GRAND JURY PROCEEDINGS 
BALED ORDER 
On Application of the United States Attorney for the Southern District of Florida, and it 
appearing to the satisfaction of the Court: 
I. 
That 
has been called to testify and to provide other information before 
the United States District Court for the Southern District of Florida, including a Grand Jury 
impaneled therein; and 
2. 
That in the judgment of the said United States Attorney, 
has refused 
to testify and provide other information on the basis of her privilege against self-incrimination; and 
3. 
That in the judgment of the said United States Attorney, the testimony and other 
information from 
may be necessary to the public interest; and 
4. 
That the aforesaid Application has been made with the approval of the Assistant 
Attorney General in charge of the Criminal Division of the Department of Justice or a duly 
designated Acting Assistant Attorney General, pursuant to the authority vested in him by Title 18, 
United States Code, Section 6003, and Title 28, Code of Federal Regulations, Sections 0.175 and 
0. I 32(e). 
NOW, THEREFORE, it is ordered pursuant to Title 18, United States Code, Section 6002, 
that 
give testimony and provide other information which she refuses to give or to 
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provide on the basis of her privilege against self-incrimination, as to all matters about which she may 
be interrogated before said United States District Court, including a Grand Jury impaneled therein, 
as well as any subsequent proceeding or trial. 
However, no testimony or other information compelled under this Order (or any information 
directly or indirectly derived from such testimony or other information) may be used against 
in any criminal case, except a prosecution for perjury, giving a false statement, or otherwise 
failing to comply with this Order. 
IT IS FURTHER ORDERED the this Order shall be SEALED in accordance with Fed. 
R. Crim. P. 6(e)(6), except that a copy of this Order shall be provided to counsel for the United 
States, who may disclose the existence of the Order to members of the Grand Jury, to the witness, 
to counsel for the witness, and to law enforcement officers engaged in the investigation pending 
before the Grand Jury. Those persons may review the Order, but may not retain a copy of the Order, 
nor may they disclose the existence of the Order to any others. 
DONE and ORDERED this 
day of April, 2007, at West Palm Beach, Florida. 
DONALD M. MIDDLEBROOKS 
UNITED STATES DISTRICT JUDGE 
cc: 
, AUSA 
2 
Case No. 08-80736-CV-MARRA 
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EISENBERG & FOUTS, P.A. 
Attorneys At Law 
JAMES L. EISENBERG 
Florida Bar Board Certified Criminal Trial Lawyer 
National Board Of Trial Advocacy Cellfiled Criminal Mal Advocate 
KAI LI ALOE FOUTS 
Oat ClearlakeCentre, Suite 704,250Australian Avenue South,WestPalm Beach, FL3340I 
Fax: 
February 12, 2007 
Asst. U.S. Attorney 
500 South Australian Avenue, Suite 400 
West Palm Beach, FL 33401 
Re: 
Grand Jury Subpoena for 
Dear 
As always, it was a pleasure speaking to you the other dilursuant to our telephone conference 
I am writing this letter to proffer my concerns for 
should she testify without immunity 
before a federal grand jury. Therefore, allow me to reiterate that Ms. 
will refuse to voluntarily 
cooperate with the federal government. She has a good faith basis for her position under the Fifth 
Amendment to the United States Constitution. 
We, of course, do not live or work in a vacuum. We have read many inflammatory remarks the 
Town of Palm Beach Police Chief has made to the media about the state court's handling of the 
Jeffrey Epstein investigation. The police chiefs remarks frighten both mysel rand my client. I am 
aware that the town police have prepared documents to charge at least one of Mr. Epstein's lady 
friends in state court. If they can push to have one lady charged I remain unconvinced that they do 
not have the ability or political clout to push to have other ladies such as Ms.= 
charged. 
The proffered facts that raise my concerns are being provided via this proffer letter. Pursuant to our 
telephone conference agreement, this letter and its contents cannot be used against Mr. =. 
Ms.= 
is not at all certain of dates. She does remember meeting Mr. Epstein about three years 
ago. She is not certain of her age. it could have been when she was sixteen. A girlfriend asked her 
if she wanted a job giving massages. Ms.= 
agreed because she had knowledge of massages 
through her mother, who was a masseuse. 
Ms. = 
went to Mr. Epstein's house via taxi. Ms. 
girlfriend instructed Ms.=r that, 
if asked, she had to tell Mr. Epstein that she 
was eighteen years old. The friend was 
nineteen years old and 
looked old for her age, so passing for eighteen was not a problem. At 
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the home Ms.= 
met Mr. Epstein and later „Tim a massage. The friend had told Ms. 
to give the message topless. Mr. Epstein told 
that if she were at all uncomfortable being 
topless, not to do it and it was not a requirement of employment as a masseuse. Ms. 
never 
touched Mr. Epstein in a sexual way and Mr. is. 
never 
touched 
Ms. 
/et 
all. 
At 
one 
point,
Mr. Epstein did ask Ms. 
her age. Ms. 
insisted that she was eighteen years old. 
Ms. = 
continued to see Mr. Epstein over time and massages were given in a similar fashion. 
She was later asked if her friends wanted to work in a similar way and she asked some girls who did 
give Mr. Epstein massages. Ms.=r was never asked to bring girls of any age to Mr. Epstein's 
home. When she did have her friends come over, she instructed all of them that if asked, they insist 
that they were eighteen years old. She is not certain at all of any of these girls' real ages. 
In summary, our concern is that if the government believes that Mr. Epstein comm itted some federal 
offense, then Ms.= 
could he considered a co-conspirator. We believe no crime was committed. 
The Fifth Amendment was not intended to protect the guilty, however. It was enacted to protect 
citizens who fear prosecution notwithstanding their innocence. Our fear of any prosecution, 
especiallyjltt ligh f the Town police chiefs public remarks, is clearly in good faith. 
Sincer 
ISENE5R6r---
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EISENBERG & FOUTS, P.A. 
Attorneys At Law 
JAMES L. EISENBERG 
Florida Bar Board Certified Crimisal trial Lawyer 
National Board Of Trial Advocacy Certified ethnical Trial Advocate 
KAI LI ALOE POUTS 
OneClear lake Centre,Su ite 704,250 Australian Avenue Sou CIL, West Palm Beach, FL 33401 
Fax: 
February 1,2007 
Asst. U.S. Attorney 
500 South Australian Avenue, Suite 400 
West Palm Beach, FL 33401 
Re: 
Grand Jury Subpoena for 
Dear 
I received your letter dated January 24, 2007 with regard to ME= 
I must admit I forced 
myself to wait several days to respond in order to "cool off' and not say anything I would regret 
later. Now that time has passed, allow me to respond appropriately. 
I. If you want to force Ms. MI 
to come to the grand jury room to 
personally invoke her Fifth Amendment ri lts, she will be there. That does remain her position. 
M onl re uest is that 
provide 
I will be there, but I am not 
It is this type of attitude, that your
and Ms. 
should not have 
office refuses to accept the fact that it is Ms. 
decision not to cooperate with the government 
tkai
sets her. Your office fails to recognize that merely corning to court is a problem for
like Ms. M: and, under these circumstances, appears to be a waste of time at best and, in 
her mind, personal harassment. 
2. Rest assured that there is no conflict of interest in my representation of Ms. I= 
In this 
case I have always been asked and always will exercise independent judgment to follow my client's 
independent will. The remainder of your questions as to this matter arc really none of the 
Government's business. 
3. 1 will share with you that one of the reasons for our firm position that Ms. 
will 
invoke her Fifth Amendment right and choose not to voluntarily cooperate with the Government is 
our concern that the Government is not exercising independent judgment in this case. 
The history of this case has been in the newspapers. The case is being prosecuted in State court. 
Despite the state court prosecution, the Town of Palm Beach Police Chief went on what can only be 
Case No. 08-80736-CV-MARRA 
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, Asst. U.S. Attorney 
February 1, 2007 
Page 'Iwo 
described as a public rampage in the newspaper when the case was not prosecuted to his liking that 
reminded me of a small child having a public temper tantrum. In my thirty years of experience, T 
have never seen a law enforcement officer like this publicly make what appeared to be a political 
ease in the newspaper for a prosecution and publicly criticize anyone who got in his way, including 
the elected State Attorney. This resulted in a federal investigation on a topic no one remembers the 
Federal Government ever being interested in prosecuting before. Although I am certain that you 
personally have not had your decision-making process compromised, the appearance that your office 
is being influenced by the Town of Palm Beach Police Chief's agenda is very real. Under these 
circumstances I don't see how any lawyer could advise any client to voluntarily cooperate. Of 
special concern is that the Town of Palm Beach Police have promoted prosecuting at least one of the 
girls who allegedly gave massages. 
One final thought. My client and my fear that Ms. 
could be prosecuted is enhanced by the 
demand for the personal appearance made in your letter. Your initial Kastiger letter fell far short 
of granting the functional equivalent of DOJ immunity. Several months ago I was given the distinct 
impression through our conversations that you were going to obtain DOJ immunity for Ms. 
Now the government is changing course for no apparent reason. This leads to speculation that the 
only reason for the nuriabout is that prosecution in either state or federal court is being considered 
by someone. 
directed at you personally. I want to repeat that you have always treated us with 
office should advise the Town Police Chief to act in a similar fashion. 
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09/06/2006 14:53 FAX 
USA0 ISPB FL 
2001 
*** 
TX REPORT 
sea 
TRANSMISSION OK 
TX/RX. NO 
2683 
CONNECTION TEL 
6592380 
SUBADDRESS 
CONNECTION ID 
ST. TIME 
09/06 14:62 
USAGE T 
01'00 
PGS. SENT 
2 
RESULT 
OK 
U.S. Department of Justice 
United States Attorney 
Southern District of Florida 
500 South Australian Ave, Suite 400 
West Palm Beach, Florida 33401 
Facsimile 
. FACSIMILE COVER SHEET 
TO: 
JIM EISENBERG; ESO. 
DATE: 
September 6. 2006 
FAX NO. 
# OF PAGES: 
2 
PHONE NO. 
RE: 
FROMt 
PRONE NO. 
ASSISTANT U.S. ATTORNEY 
commas; Dear Jim: Here is the copy of the original subpoena that you 
requested. Also, I confirmed with the secretary who rod 
the 
September 8th subpoena that it was signed by AUSA 
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U.S. Department of Justice 
United States Attorney 
Southern District of Florida 
500 South Australian Ave, Suite 400 
West Palm Beach, Florida 33401 
Facsimile 
FACSIMILE COVER SHEET 
TO: 
JIM EISENBERG, ESQ.
FAX NO, 
PHONE NO. 
DATE: 
# OF PAGES: 
RE: 
September 6, 2006 
2 
FROM: 
PHONE NO. 
ASSISTANT U.S. ATTORNEY  
COMMENTS: Dear Jim: Here is the copy of the original subpoena that you 
requested. Also, I confirmed with the secretary who re ared the 
September 8th subpoena that it was signed by AUSA 
As we discussed. 
does not need to appear before the 
grand jury until you have had a chance to confer with her and we 
have spoken and agreed to a mutually convenient date. 
Thank you for your assistance. 
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U.S. Department of Justice 
United States Attorney 
Southern District of Florida 
500 South Australian Ave., Suite 400 
West Palm Beach, FL 33401 
Facsimile: 
January 24, 2007 
DELIVERY BY HAND 
James L. Eisenberg, Esq. 
250 S Australian Ave, Ste 704 
West Palm Beach, FL 33401-5007 
Re: 
Federal Grand Jury Subpoena 
Dear Jim: 
A new grand jury has been tided 
and I have enclosed a new subpoena for= 
MI. As 1 mentioned earlier, Ms 
is not a target of this investigation and the United 
States seeks her testimony solely as a victim/winless. During our last conversation regarding 
Ms. 
, you indicated that she was unwilling to speak with us pursuant to a Kastigar 
letter and that she also was unwilling to speak with the grand jury and intends to invoke the 
Fifth Amendment if questioned. Please confer with her to confirm whether this remains her 
position. If it is, please advise in writing. Even if Ms.= 
is inclined to invoke her Fifth 
Amendment rights, she must still appear pursuant to the subpoena so that I may ask her 
questions that would not require the invocation of the Fifth Amendment. If she still invokes, 
I intend to move to compel her answers. If you or your client is unavailable on February 6, 
2007, please let me know of another Tuesday when you are available. 
I also am concerned about a potential conflict of interest in your representation of Ms. 
In case of future litigation regarding this issue, please provide me with information 
regarding who is paying (directly or indirectly) for your services on behalf of Ms. MI, the 
scope of your representation and whether you are taking direction on this matter from 
anyone other than Ms. =. 
If any formal or informal joint defense agreements exist, 
whether in writing or otherwise, please provide a copy of such agreements. If the agreement 
is purely oral, please provide a written summary of its terms. 
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JAMES EISENBERG, ESQ. 
JANUARY 24, 2007 
PAGE 2 
I look forward to your response. 
Sincerely, 
R. Alexander Acosta 
By: 
04 
k44 
 
Assistant United States Attorney 
Case No. 08-80736-CV-MARRA 
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This subpoena is issued upon application 
United States District Court 
SOUTHERN DISTRICT OF FLORIDA 
TO: 
SUBPOENA TO TESTIFY 
BEFORE GRAND JURY 
FGJ 07-103(WPB)-TuesJNo. OLY-13/2 
SUBPOENA FOR: 
PERSON 
X 
DOCUMENTS OR OBJECT[SI 
YOU ARE HEREBY COMMANDED to appear and testify before the Grand Jury oftheUniteri States District 
Court at the place, date and time specified below. 
PLACE: 
United States District Courthouse 
701 Clematis Street 
West Palm Beach, Florida 33401 
ROOM: 
Grand Jury Room 
DATE AND TIME: 
February 6, 2007 
1:0Oprn* 
YOU ARE ALSO COMMANDED to bring with you the following document(s) or object(s): 
ANY AND ALL NOTES, LEVIERS, CARDS, GIFTS, PAYMENTS. AND PHOTOGRAPHS YOU HAVE RECEIVED 
FROM JEFFREY EPSTEIN 
ANY AND ALL PHOTOGRAPHS WHETHER PRINTED OR DIGITAL, OF JEFFREY EPSTEIN 
ANY AND ALL E-MAILS, INSTANT MESSAGES, CHATS, TEXT MESSAGES, VOICEMAILS OR TELEPHONE 
MESSAGES THAT YOU HAVE SENT TO AND/Oft RECEIVED FROM JEFFREY EPSTELN, 
*Please coordinate your compliance with this subpoena and confirm the date and time , and location of 
our a earance with Special Agent 
Federal Bureau of Investigation, Telephone: 
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. 
DATE: 
January 23, 2007 
Narns_Address and Phone Number of Assistant U.S. Attorney 
Ann= 
C. 
Assistant U.S. Attorney 
500 So. Australian Avenue, Suite 400 
West Palm Beach FL 33401.6235 
Fax: (561) 802-1787 
nr not applicable, cola None. 
To In teal a acv ofA0110 
Case No. 08-80736-CV-MARRA 
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U.S. Department of Justice 
United States Attorney 
Southern District of Florida 
500 South Australian Ave., Suite 400 
West Palm Beach, FL 33401 
Facsimile: 
February 5, 2007 
DELIVERY BY HAND 
Ms. 
do James L. Eisenberg, Esq. 
250 S Australian Ave, Ste 704 
West Palm Beach, FL 33401-5007 
Re: 
Grand Jury Testimony of
Dear Ms. M: 
This letter confirms the understanding between yourself and the United States Attorney's 
Office for the Southern District of Florida. 
You have represented that you will truthfully answer questions of the federal government in 
its investigation of the procurement of prostitutes, amongst others. You will supply complete and 
truthful information to the attorneys and law enforcement officers of the federal government and to 
any Federal Grand Jury which may conduct an investigation, as welt as in any other proceeding 
related to or growing out of this investigation. The obligation of truthful disclosure includes your 
obligation to provide the attorneys and law enforcement officers of the federal government with any 
documents, records or other tangible evidence within your custody or control relating to the matters 
about which you are questioned. You will neither attempt to protect any person or entity through 
false information or omission, nor falsely implicate any person or entity. 
No statements provided by you on this date in this matter pursuant to this agreement will be 
offered into evidence in any criminal case against you, except during a prosecution for perjuryand/or 
giving a false statement. However, if it is determined that you have materially violated any provision 
of this agreement, all statements made by you shall be admissible in evidence against you in any 
proceeding. 
The federal government remains free to use information derived from the grand jury 
testimony directly or indirectly for the purpose of obtaining leads to other evidence, which may be 
used against you. You expressly waive any right to claim that such evidence should not be 
introduced because it was obtained as a result of the grand jury testimony. Furthermore, the federal 
government may use statements made in the grand jury testimony and all evidence derived directly 
or indirectly therefrom for the purpose of cross-examination, if you testify at any trial or if you 
Case No. 08-80736-CV-MARRA 
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Ms. 
FEBRUARY 5, 2007 
PAGE 2 
suborn testimony that contradicts your prior statements and testimony. 
No additional promises, agreements and conditions have been entered into other than those 
set forth in this letter and none will be entered into unless in writing and signed by all parties. 
Sincerely, 
R. Alexander Acosta 
United States Attorney 
By: 
Assistant United States Attorney 
I have read this agreement and discussed it with my attorney, and I hereby acknowledge that it 
fully sets forth my agreement with the office of the United Stales Attorney for the Southern District of 
Florida. I state that there have been no additional promises, agreements or representations made to me 
by any officials of the United States in connection with this matter. 
Dated: February 
2007 
West Palm Beach, Florida 
Witnessed by: 
James L Eisenber Es 
• 
Attorney for 
Case No. 08-80736-CV-MARRA 
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U.S. Department of Justice 
United States Attorney 
Southern District of Florida 
DELIVERY BY HAND 
James L. Eisenberg, Esq. 
250 S Australian Ave, Ste 704 
West Palm Beach, FL 33401-5007 
Re: 
Dear Mr. Eisenberg: 
500 South Australian Ave., Suite 400 
West Palm Beach, Ft 33401 
Facsimile: 
February 5, 2007 
I am writing to clarify the ground rules for the interview with your client, 
("your client"), to occur February 
, 2007. 
As I mentioned earlier, Ms. 
is not a target or subject of this investigation, but 
instead is being interviewed solely as a victim/witness. However, to address your concern 
about criminal exposure, if your client complies with every provision of this agreement, then 
the United States Attorney's Office for the Southern District of Florida ("this Office") will 
treat all statements made by your client during the interview as statements made pursuant to 
Rule 11(0 of the Federal Rules of Criminal Procedure. This is not a grant of immunity, 
which can be given only with approval of the Justice Department, but protects your client 
from having the statements made by her during the interview from being used against her 
directly. To guard against any misunderstandings concerning the interview of your client, 
this letter sets forth the terms of this agreement. 
Your client agrees to be fully interviewed, that is, to provide information concerning 
your client's knowledge of, and participation in criminal activity, including but not limited 
to the procurement of prostitutes. The protection of this letter applies to an interview that 
will be conducted by this Office, Special Agents of the Federal Bureau of investigation, and 
any other federal law enforcement agency this Office may require. Under this agreement, 
no information disclosed by your client during the interview will be offered in evidence 
against her in any criminal or civil proceeding, provided that your client complies with this 
agreement and that the information your client furnishes is truthful, complete, and accurate. 
I f, however, your client gives materially false, incomplete, or misleading information, 
Case No. 08-80736-CV-MARRA 
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JAMES L. EISENBERG, ESQ. 
RE: 
FEBRUARY 2, 2007 
PAGE 2 
then this Office may use such information in any matter or proceeding and your client is 
subject to prosecution for perjury, obstruction of justice, and making false statements to 
government agencies. Any such prosecution may be based upon information provided by 
your client during the course of the interview, and such information, including your client's 
statements, will be admissible against your client in any grand jury or other proceeding. 
The government also may use statements made by your client in the interview and all 
evidence derived directly or indirectly therefrom for the purpose of impeachment or 
cross-examination if she testifies at any trial or hearing, and/or in any rebuttal case against 
your client in a criminal trial in which she is a defendant or a witness. These provisions are 
necessary to ensure that your client does not make or offer any false representation or 
statement in any proceeding or to a government agency or commit perjury during any 
testimony. 
Your client further agrees that attorneys for the United States may be present at the 
interview, and agrees not to seek disqualification of any such govermnent attorney from any 
proceeding or trial because of their participation at the interview. 
The entire agreement between the United States and your client is set forth in this 
letter. No additional promises, agreements, or conditions have been entered into and none 
will be entered into unless in writing and signed by all parties. 
If the foregoing accurately reflects the understanding and agreement between this 
Office and your client, it is requested that you and your client execute this letter as provided 
below. 
Sincerely, 
R. Alexander Acosta 
United States Attorney 
By: 
Assistant United States Attorney 
have received this letter from my attorney, James L. Eisenberg, Esquire, have read 
it and discussed it with my attorney, and I hereby acknowledge that it fully sets forth my 
understanding and agreement with the Office of the United States Attorney for the Southern 
Case No. 08-80736-CV-MARRA 
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JAMES L. EISENBERG, ESQ. 
RE: 
FEBRUARY 2, 2007 
PAGE 3 
District of Florida. I state that there have been no additional promises or representations 
made to me by any official of the United States Government or by my attorney in connection 
with this matter. 
Dated: 
Witnessed by: 
James L. Eisenberg, Esquire 
Case No. 08-80736-CV-MARRA 
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U.S. Department of Justice 
Authorization for Reimbursement 
of Unusual Expenses of Fact Witnesses 
Request for Unusual Expense(s) of Fact Witness 
(For United States Attorney's Office Use Only) 
1. Case Name 
9. Payment to be made to: 
4. Lbcatlonof Court 
task Pole-n 
2. Court Docket Number 
5. Contact Person 
Control if 
• 
3. Requesting AUSA 
6, contact Person Number 
8. Vendor Name & Address. Phone #, TIN/SSN 
10. Receiptfinvolce Is: 
11. Type of Unusual Expense: 
El Medically Necessary Item 
(Attached Supporting Statement) 
• 
Excess Lodging/Per Diem 
Ei Travel & Transportation 
• 
Pretrial Conference Waiver 
• 
Other 
12. Explanation: 
1 
13. Start Date of Service (MO/DA/YR) 
14. End Data of Senile. (MOIDANR) 
15. Amount 
2-A/O 7 
1 24 
/0 7 
16. Justification: 
17. I hereby certify that the eXpenses and services listed on thls document are appropriate and are within the Federal laws 
and regulations. I fully understand that I can be held personally liable or be subject to disciplinary action for improperly using 
government funds or services that exceed delegated authority or that violate Federal laws or regulations. 
Signature of Requesting AUSA 
Date 
18. Name & Title of Approving Official 19. Date (MO/DA/YR) 
20. Signature of Approving Official 
UfVVE Form 
Case No. 08-80736-CV-MARRA 
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