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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. TM form 114a may be digitally signed Part I I Persons who have an obligation to file a Report of Foreign Bank a
Partnership c Corporation d U Consolidated e Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Numbs *** -** -9816 If filer has no U S Identification 3a TIN type 4 Foreign identification (Complete only if item 3 is not applicable) 5 Individual's date of birth MWDD/YYYY In SSNATIN a Type' Pass
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
vidual b O Partnershp c Corporation d O Consolidated e 0 Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Number If filer has no U S Identification 3a TIN type 4 Foreign identification (Complete only it item 3 is not applicable) 5 Individuals date of birth MWDD/YYYY SSN/ITIN a Type: Q Passp
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. NEXTMAN20160001 The form 114a may be digitally signed Part I Persons who have an obligation to file a Report
artnership c 0 Corporation d D Consolidated e Q Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Numbs 133495607 O If filer has no U S Identification 3a TIN type 4 Foreign identification (Complete only if item 3 is not applicable) 5 Individual's date of birth MWDD/YYYY SSNATIN a Type: Passpor
Entities connected to both FinCEN and U S Identification

United States
LOCATION
New York City
LOCATIONFiler
PERSON
U.S. Treasury
ORGANIZATION
Joi Ito
PERSONSpouse
ORGANIZATIONFOREIGN BANK AND FINANCIAL
ORGANIZATIONPreparer
ORGANIZATIONERO Signature
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONConservation Reserve Program
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATIONBSA Efiling
ORGANIZATIONConservation Reserve
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONJurat/Disclosure
ORGANIZATIONSchedule SE
PERSONC-EZ
ORGANIZATION