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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
mated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment I must contact the U.S. Treasury Financial Agent at 1-888-3534537. Payment cancellation
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
mated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellatio
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
mated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellatio
n 114 and 8938 - Foreign Assets worksheet, Form 114 Filer Information section, Date Signed by Filer-Override field. Future dates are not allowed by FinCEN. (24421) • Massachusetts. For the 2017 tax year taxpayers must file and make extension payments electronically if making a payment of $5,000 or m
mated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellati
Entities connected to both FinCEN and the U.S. Treasury Financial Agent

Ghislaine Maxwell
PERSON
United States
LOCATIONFiler
PERSON
New York City
LOCATION
U.S. Treasury
ORGANIZATION
New York
LOCATIONMaria Farmer
PERSON
Joi Ito
PERSONSpouse
ORGANIZATIONERO Signature
ORGANIZATIONC-EZ
ORGANIZATIONSchedule SE
PERSONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONConservation Reserve Program
ORGANIZATION
George W. Bush
PERSON
Adriana Ross
PERSONConservation Reserve
ORGANIZATIONJurat/Disclosure
ORGANIZATIONUtilities
ORGANIZATIONFBAR S gnature
ORGANIZATION