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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
ty claim of right credit 17 Yonkers claim of right credit 17a MCTMT (metropolitan commuter transportation mobility tax) claim of right credit 18 Total New York State, New York City, Yonkers, and MCTMT other refundable credits (add lines 14 through 17a; enter here and on Form IT-201, One 71) Part 2 - Other New
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
ty claim of right credit 17 Yonkers claim of right credit 17a MCTMT (metropolitan commuter transportation mobility tax) claim of right credit 18 Total New York State, New York City, Yonkers, and MCTMT other refundable credits (add lines 14 through 17a; enter here and onForm 1T-201, One 71) Part 2 - Other New Y
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
ty claim of right credit 17 Yonkers claim of right credit 17a MCTMT (metropolitan commuter transportation mobility tax) claim of right credit 18 Total New York State, New York City, Yonkers, and MCTMT other refundable credits (add lines 14 through 17a; enter here and onForm IT-201, One 71) Part 2 - Other New Y
Entities connected to both FinCEN and Total New York State

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