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mated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment I must contact the U.S. Treasury Financial Agent at 1-888-3534537. Payment cancellation
'YES', were all required Commercial Rent Tax Returns filed? Please enter Employer Identification Number or Social Security Number which was used on the Commercial Rent Tax Return: CERTIFICATION X NO X NO X NO YES X NO YES NO I hereby certify that this return, Including any accompanying rider, is, to the best of my kno
mated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellatio
all required Commercial Rent Tax Returns filed? YES NO Please enter Employer Identification Number or Social Security Number which was used on the Commercial Rent Tax Return: CERTIFICATION I hereby certify that this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct and
mated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellatio
'YES', were all required Commercial Rent Tax Returns filed? Please enter Employer Identification Number or Social Security Number which was used on the Commercial Rent Tax Return: CERTIFICATION X NO X NO X NO YES X NO YES NO I hereby certify that this return, including any accompanying rider, is, to the best of my kno
Entities connected to both the U.S. Treasury Financial Agent and the Commercial Rent Tax Return

U.S. Treasury
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONC-EZ
ORGANIZATIONERO Signature
ORGANIZATION
United States
LOCATION
Joi Ito
PERSONSchedule SE
PERSONthe New York State Department of Taxation and Finance
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONSpouse
ORGANIZATIONNew York State Sales Tax
ORGANIZATION
NEW YORK NY
LOCATIONAccelerated Cost Recovery System
ORGANIZATION
New York State
LOCATION
FinCEN
ORGANIZATIONConservation Reserve Program
ORGANIZATIONPreparer
ORGANIZATIONJurat/Disclosure
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATIONERO EFIN/PIN
ORGANIZATION