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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
Stop: enter line 11 amount on Form IT205, line 22 New York City full-year resident Individuals 12 Amount from Form IT•201. fine 49 13 Amount from Form IT-20VATT, line 32 14 Amount from Form IT-20VATT, line 33 15 Add lines 12. 13, and 14 16 Enter the lesser of line 11 or 15, and transfer the amount to Form
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
top: enter line 11 amount on Form IT-205, line 22 New York City full-year resident individuals 12 Amount from Form fT•201. line 49 13 Amount from Form IT-20VATT, line 32 14 Amount from Form IT-20VATT, line 33 15 Add lines 12. 13. and 14 16 Enter the lesser of line 11 or 15, and transfer the amount to Form
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
line 22 New York City full-year resident Individuals 12 Amount from Form IT•201. line 49 13 Amount from Form IT-201401T, line 32 14 Amount from Form IT-20VATT, line 33 15 Add Ines 12. 13. and 14 16 Enter the lesser of line 11 or 15, and transfer the amount to Form If-201•ATT, line 8 219001171019 III I
Entities connected to both FinCEN and Form IT-20VATT

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