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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
2. Exemption (see instructions) 3. Line 1 less line 2 (estimated taxable business income) 4. Tax • enter 4% of line 3(see instructions) 5a. Business Tax Credit (00 ) (Check applicable box below and enter credit amount) Tax on line 4 is $3,400 or less. Your credit is the entire amount of tax on line 4. Tax
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
ORDS • 1. Net income from business expected in 2018 (see instructions) 1. 2. 3. 4. Tax • enter 4% of line 3(see Instructions) 4, 5a. Business Tax Credit (00 ) (Check applicable box below and enter credit amount) Tax on line 4 is $3,400 or less. Your credit is the entire amount of tax on line 4. Tax
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
2. Exemption (see instructions) 3. Line 1 less line 2 (estimated taxable business income) 4. Tax • enter 4% of line 3(see instructions) 5a. Business Tax Credit (00 ) (Check applicable box below and enter credit amount) Tax on line 4 is $3,400 or less. Your credit is the entire amount of tax on line 4. Tax
Entities connected to both FinCEN and Business Tax Credit

United States
LOCATION
New York City
LOCATIONFiler
PERSON
New York
LOCATION
U.S. Treasury
ORGANIZATIONMaria Farmer
PERSON
Joi Ito
PERSONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATION
George W. Bush
PERSONSpouse
ORGANIZATION
New York State
LOCATIONERO Signature
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONConservation Reserve Program
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATIONJurat/Disclosure
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONBSA Efiling
ORGANIZATION