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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
ake sure that your name is spelled correctly. You should enter your first name, middle initial, then last name in the spaces provided (for example, John O. Smith). Your name must agree with the name on your New York State income tax return. • Foreign addresses - Enter the information in the following order:
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
ake sure that your name is spelled correctly. You should enter your first name, middle initial, then last name in the spaces provided (for example, John O. Smith). Your name must agree with the name on your New York State income tax return. • Foreign addresses - Enter the information in the following order:
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
ake sure that your name is spelled correctly. You should enter your first name, middle initial, then last name in the spaces provided (for example, John O. Smith). Your name must agree with the name on your New York State income tax return. • Foreign addresses - Enter the information in the following order:
Entities connected to both U.S. Treasury and John O. Smith

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