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ncorporated Business Tax Retum for the following years: 2015: X YES NO 2016: X YES NO — — If 'NO,' state reason: 4. Enter home address: NEW YORK NY 5. If business terminated during the current taxable year, state date terminated. (mmddiry) (Attach a statement showing disposition of business pro
forcement Network (FinCEN) May 2015 Record of Authorization to Electronically File FBARs (See instructions below for completion) Do not send to FinCEN. Retain this form for your records. ANASTAS20170001 The form 114a may be digitally signed Part I I Persons who have an obligation to file a Report
ax Return for the following years: 2016: X YES — — NO 2016: X YES NO If 'NO,' state reason: 4. 6. 6. Enter home address: 288 WEST 4TH ST NEW YORK NY ZIP Code: 10014 If business terminated during the current taxable year, state date terminated. (mmddly) (Attach a statement showing disposition o
forcement Network (FinCEN) May 2015 Record of Authorization to Electronically File FBARs (See instructions below for completion) Do not send to FinCEN. Retain this form for your records. TM form 114a may be digitally signed Part I I Persons who have an obligation to file a Report of Foreign Bank a
orated Business Tax Return for the following years: 2015: YES X NO 2016: YES X NO If 'NO.' state reason: Enter home address: 288 WEST 4TH ST NEW YORK NY ZIP Code: 10014 If business terminated during the current taxable year, state date terminated. (mmddly) (Attach a statement showing disposition o
cement Network (FinCEN) I May 2015 Record of Authorization to Electronically File FBARs (See instructions below for completion) Do not send to FinCEN. Retain this form for your records. ANASTAS20170001 The fomi 114a may be digitally signed Part I I Persons who have an obligation to file a Report
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