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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
o the best of my knowledge and belief, the return is true, correct, and complete. I have based this declaration on all information available to me. ERO EFIN/PIN: Enter your sixdigit EFIN followed by your five digit PIN: DAVID WEISS CPA, PLLC DAVID WEISS CPA, PLLC ERO's Signature Print Name Date DAVID WE
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
the paper return. If I am the paid preparer, filed unincorporated business tax return or other based this declaration on all information available ERO EFIN/PIN: Enter your six•cligit EFIN followed DAVID WEISS CPA, PLLC contained in the above named taxpayers 2017 New York City electronically filed checked
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
the paper return. If I am the paid preparer, filed unincorporated business tax return or other based this declaration on all information available ERO EFIN/PIN: Enter your six-digit EFIN followed DAVID WEISS CPA, PLLC contained in the abovenamed taxpayers 2017 New York City electronically filed checked ab
Entities connected to both FinCEN and ERO EFIN/PIN

United States
LOCATION
New York City
LOCATIONFiler
PERSON
New York
LOCATION
U.S. Treasury
ORGANIZATIONMaria Farmer
PERSON
Joi Ito
PERSONSpouse
ORGANIZATION
New York State
LOCATION
George W. Bush
PERSONPreparer
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONConservation Reserve Program
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONERO Signature
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATION