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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
arm partnerships. Schedule K1 (Form 1065), box 14, code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F. line 4b. or listed on Schedule K1 (Form 1065), box 20, code Z 2 Net profit or (loss) from Schedule C. lin
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
arm partnerships, Schedule K1 (Form 1065), box 14, code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F. line 4b. or listed on Schedule K1 (Form 1065), box 20, code Z 2 Net profit or (loss) from Schedule C, lin
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
d farm partnerships, Schedule (Form 1065), box 14, code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F. line 4b. or listed on Schedule K-1 (Form 1065), box 20. code Z 2 Net profit or (loss) from Schedule C. l
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
rm partnerships. Schedule K-1 (Form 1065), box 14. code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F, line 4b, or listed on Schedule K.1 (Form 1085). box 20, code Z 2 Net profit or (loss) from Schedule C. l
Entities connected to both FinCEN and Conservation Reserve

United States
LOCATIONFiler
PERSON
New York City
LOCATION
U.S. Treasury
ORGANIZATION
New York
LOCATIONMaria Farmer
PERSON
Joi Ito
PERSONSchedule SE
PERSONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONConservation Reserve Program
ORGANIZATIONSpouse
ORGANIZATIONC-EZ
ORGANIZATIONERO Signature
ORGANIZATIONJurat/Disclosure
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONQualifying widow(er
ORGANIZATIONCombine Ines 4a
ORGANIZATIONPreparer
ORGANIZATIONBSA Efiling
ORGANIZATIONForeign Bank
ORGANIZATION