3
Shared Docs
3
Same-Page
3 / 3
Mentions
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
'YES', were all required Commercial Rent Tax Returns filed? Please enter Employer Identification Number or Social Security Number which was used on the Commercial Rent Tax Return: CERTIFICATION X NO X NO X NO YES X NO YES NO I hereby certify that this return, Including any accompanying rider, is, to the best of my kno
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
all required Commercial Rent Tax Returns filed? YES NO Please enter Employer Identification Number or Social Security Number which was used on the Commercial Rent Tax Return: CERTIFICATION I hereby certify that this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct and
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
'YES', were all required Commercial Rent Tax Returns filed? Please enter Employer Identification Number or Social Security Number which was used on the Commercial Rent Tax Return: CERTIFICATION X NO X NO X NO YES X NO YES NO I hereby certify that this return, including any accompanying rider, is, to the best of my kno
Entities connected to both FinCEN and the Commercial Rent Tax Return

United States
LOCATION
New York City
LOCATIONFiler
PERSON
New York
LOCATION
U.S. Treasury
ORGANIZATIONMaria Farmer
PERSON
Joi Ito
PERSONNew York State Sales Tax
ORGANIZATION
the Internal Revenue Service
ORGANIZATION
New York State
LOCATIONSpouse
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATION
George W. Bush
PERSONPreparer
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONForm NYC-
LOCATIONERO EFIN/PIN
ORGANIZATIONComplete Address
PERSONthe U.S. Treasury Financial Agent
ORGANIZATIONConservation Reserve Program
ORGANIZATION