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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
January 15, 2019. Enter applicable payer ID number and to: NYS Estimated Income Tax, str) New Yolk Stale 0 00 New Yak City 0 00 Yonkon 00 KICTIM 00 Total payment 0 00 IT-2105 Estimated tax amounts STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792134 76f
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
tate NY ZIP code 10014 taxpayer s e-mail address IT-2105 Estimated tax amounts str) Now York Stale 0 00 New YQIk City 0 00 Yonkots 00 KICTIM 00 Total payment 0 00 STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792216 er NEW YORK STATE 2018 - Ti
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
19. Enter applicable payer ID number and to: NYS Estimated Income Tax, stir) L 80000 00 Now York Stale New Y0.14 CRY 55000 00 Yonkots 00 KICTIM 00 Total payment 135000 00 IT-2105 Estimated tax amounts STOP: Pay this electronically on our vrebsite 0601181019 *****9816 9 EFTA00792043
Entities connected to both FinCEN and KICTIM

United States
LOCATION
New York City
LOCATIONFiler
PERSON
New York
LOCATION
U.S. Treasury
ORGANIZATIONMaria Farmer
PERSONSpouse
ORGANIZATION
Joi Ito
PERSONPreparer
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONFBAR S gnature
ORGANIZATION
New York State
LOCATIONthe U.S. Treasury Financial Agent
ORGANIZATIONConservation Reserve Program
ORGANIZATIONConservation Reserve
ORGANIZATIONERO Signature
ORGANIZATIONC-EZ
ORGANIZATIONJurat/Disclosure
ORGANIZATIONForeign Bank
ORGANIZATION