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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
n $400, you dont owe selfemployment tax:don't file this schedule unless you have an amount on line 1 b ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line 1 b, see instructions 5 Self-employment tax. If the amount on Me 4 is: • $127.200 or less, multiply line 4 by 15.3% (0.153). Enter
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
n $400, you dont owe selfemployment tax;don't file this schedule unless you have an amount on line 1 b ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line 1 b, see instructions 5 Self-employment tax. If the amount on line 4 is: • $127.200 or less, multiply line 4 by 15.3% (0.153). Ent
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
an $400, you dont owe selfemployment tax;don't file this schedule unless you have an amount on Nne 1 b ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line lb, see instructions 5 Self-employment tax. If the amount on Me 4 is: • $127.200 or less, multiply line 4 by 15.3% (0.153). Enter
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
400„ you don't owe self-employment tax: don't file this schedule unless you have an amount on line lb ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line 1 b, see instructions 5 Self-employment tax. If the amount on line 4 is: • $127200 or less, multiply line 4 by 15.3% (0.153). Ente
Entities connected to both FinCEN and Conservation Reserve Program

United States
LOCATION
New York City
LOCATIONFiler
PERSON
U.S. Treasury
ORGANIZATION
New York
LOCATIONMaria Farmer
PERSON
Joi Ito
PERSONSpouse
ORGANIZATIONConservation Reserve
ORGANIZATIONSchedule SE
PERSONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONERO Signature
ORGANIZATIONC-EZ
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONJurat/Disclosure
ORGANIZATIONCombine Ines 4a
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATIONBSA Efiling
ORGANIZATION