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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
2 Total tax (Form 1040, line 63; Form 1040A. line 39; Form 1040EZ, line 12; Form 1040NR. line 61) 2 584,587. 3 Federal income tax withheld from Forms W2 and 1099 (Form 1040, line 64; RIM 1040A, line 40; Form 1040EZ. line 7; Form 1040NR, lie 62a) 4 Refund (Form 1040, line 76a; Form 1040A. line 48a;
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
2 Total tax (Form 1040. line 63; Form 1040A, line 39; Form 1040EZ, line 12; Form 1040NR, line 61) 2 584,894. 3 Federal income tax withheld from Forms W2 and 1099 (Form 1040• line 64; Form 1040A, line 40; Form 1040€2, line 7; Form 104014R, line 62a) 4 Refund (Form 1040, line 76a; Form 1040A, line 48
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
2 Total tax (Form 1040. line 63; Form 1040A, line 39; Form 1040EZ, line 12; Form 1040NR, line 61) 2 556,671. 3 Federal income tax withheld from Forms W2 and 1099 (Form 1040, line 64; Ft:10111040A, line 40; Form 1040EZ, line 7; Form 104014R, line 62a) 4 Refund (Form 1040, line 76a; Form 1040A, line
Entities connected to both the U.S. Treasury Financial Agent and Forms W2

U.S. Treasury
ORGANIZATION
United States
LOCATIONSpouse
ORGANIZATIONSchedule SE
PERSONC-EZ
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONERO Signature
ORGANIZATIONFiler
PERSONUtilities
ORGANIZATION
FinCEN
ORGANIZATIONConservation Reserve Program
ORGANIZATIONConservation Reserve
ORGANIZATIONJurat/Disclosure
ORGANIZATIONMaria Farmer
PERSON
Joi Ito
PERSONYonkers
LOCATION
NEW YORK NY
LOCATION
New York
LOCATIONNY State
ORGANIZATION
New York State
LOCATION