3
Shared Docs
3
Same-Page
6 / 3
Mentions
complete the 3rd party preparer section on page one of the report. The E-tile system will auto complete item 46. NOTE: The FBAR must be received by the Department of the Treasury on or before April 17. 2018. An automatic extension to October 15.2018 is available. This report filed late for the following reason (Check only on
ion of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicate
certify that this return, Including any accompanying rider, is, to the best of my knowledge and belief, true, correct fin' and complete. I authorize the Dept. of Finance to discuss this return with the preparer listed below. (See Instr.) YES X man AllariltS9 SIGN HERE: Seamier° of laxpirear Tali) Data Presort(
complete the 3rd party prepare, section on page one of the report. The E-tile system will auto complete item 46. NOTE: The FBAR must be received by the Department of the Treasury on or before April 17. 2018. An automatic extension to October 15.2018 is available. This report tiled late for the following reason (Check only on
ion of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. tt applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicate
reby certify that this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct and complete. I authorize the Dept. of Finance to discuss this return with the preparer listed below. (See Instr.) YES X Fin's Email Merin: SIGN HERE: Signature of taxPirra' Date Wenn(' sae
complete the 3rd party preparer section on page one of the report. The E-tile system will auto complete item 46. NOTE: The FBAR must be received by the Department of the Treasury on or before April 17. 2018. An automatic extension to October 15.2018 is available. This report filed late for the following reason (Check only on
ion of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. It applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicate
at this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct Firwsernmmosst and complete. I authorize the Dept. of Finance to discuss this return with the preparer listed below. (See Instr.) YES X INFO@DAVI DWE I S SCP SIGN HERE: Secretor° of !tapir/or Trio Data P
Entities connected to both U.S. Treasury and the Dept. of Finance

United States
LOCATION
New York
LOCATION
Joi Ito
PERSONMaria Farmer
PERSON
NEW YORK NY
LOCATION
New York City
LOCATION
the Internal Revenue Service
ORGANIZATION
New York State
LOCATIONUtilities
ORGANIZATIONChang
PERSON
FinCEN
ORGANIZATIONYonkers
LOCATIONSpouse
ORGANIZATIONFiler
PERSONthe U.S. Treasury Financial Agent
ORGANIZATIONPreparer
ORGANIZATIONC-EZ
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONSchedule SE
PERSONERO Signature
ORGANIZATION