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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
unknown 16 Type of account aLLI Bank bLJ Securities cl I Other Enter type below Lai 17 Name of financial institution in which account is held UNICREDIT BANK AUSTRIA AG 18 Account number i nation ******** 19 Mailing address (number, street, apt. or suite no.) of financial institution in which account is held SCH
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
own 16 Type of account aLLI Bank bU Securities cl I Other Enter type below 11,781. Li 17 Name of financial institution In which account is held UNICREDIT BANK AUSTRIA AG 18 Account number or other designation *********6463 19 Mailing address (number, street, apt. or suite no.) of financial institution in which acco
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
nown 16 Type of account aLXJ Bank bU Securities cl I Other Enter type below 11,781. Li 17 Name of financial institution In which account is held UNICREDIT BANK AUSTRIA AG 18 Account number or other designation *********6463 19 Mailing address (number, street, apt. or suite no.) of financial institution in which acco
Entities connected to both the U.S. Treasury Financial Agent and UNICREDIT BANK AUSTRIA AG

U.S. Treasury
ORGANIZATIONC-EZ
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONERO Signature
ORGANIZATION
United States
LOCATIONSpouse
ORGANIZATIONSchedule SE
PERSONFiler
PERSON
FinCEN
ORGANIZATIONConservation Reserve
ORGANIZATIONUtilities
ORGANIZATIONJurat/Disclosure
ORGANIZATIONConservation Reserve Program
ORGANIZATION
New York State
LOCATION
Empire State
LOCATIONthe Dept. of Finance
ORGANIZATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONJohn O. Smith
PERSONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION