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gning this Tax Return and Electronic Funds Withdrawal Consent, it applicable, by entering my Self-Select PIN below. Taxpayer's PIN: Date 09122018 Spouse's PIN: 719986 044)I.17 EFTA00792091 Form 114a Department of the Treasury Financial Crimes Enforcement Network (FinCEN) May 2015 Record of Au
/bsaefilinglincentreas.gov/main.html for registration). Read and complete the account owner statement in Part I. To authorize a third party to file the Foreign Bank and Financial Accounts Report (FBAR), the account owner should complete Part I. items 1 through 3 (as required), sign and date the document in Part I, items 7)8 and complete item
Information. 2017 Submission Identification Number (SID) Taxpayer's name ANASTASIYA SIROOCHENKO Social security number ***4**4. Spouses name Spouse's social secure num er . . liPart rl Tax Return Information - Tax Year Ending December 31, 2017 (Whole dollars only) 1 Adjusted gross income (F
bsaefiling.fincentreas.gov/main.html for registration). Read and complete the account owner statement in Part I. To authorize a third party to file the Foreign Bank and Financial Accounts Report (FBAR), the account owner should complete Part I. items 1 through 3 (as required), sign and date the document in Part I, items 7)8 and complete item
ormation. 2017 Submission Identification Number (SID) Taxpayer's name ANASTASIYA SIROOCHENKO Spouses name Social security number ***4 "4-9816 Spouse's social security number IPartI Tax Return Information - Tax Year Ending December 31,2017 (whole dollars only) 1 Adjusted gross income (Form 1040,
bsaefiling.fincentreas.gov/main.html for registration). Read and complete the account owner statement in Part I. To authorize a third party to file the Foreign Bank and Financial Accounts Report (FBAR), the account owner should complete Part I. items 1 through 3 (as required), sign and date the document in Part I. items 7/8 and complete item
port of Foreign Bank and Financial Account(s) 1. Owner last name or entity's legal name NEXT MANAGEMENT LLC 2. Owner first name 3. Owner M.I. 4. Spouse last name Of jointly filing FBAR - see instiuctions below) 5. Spouse first name 6. Spouse M.I. Vwe declare that Vwe have provided information conc
bsaefiling.fincentreas.gov/main.html for registration). Read and complete the account owner statement in Part I. To authorize a third party to file the Foreign Bank and Financial Accounts Report (FBAR), the account owner should complete Part I. items 1 through 3 (as required), sign and date the document in Part I. items 7/8 and complete item
Entities connected to both Spouse and the Foreign Bank and Financial Accounts Report

Joi Ito
PERSON
New York City
LOCATION
United States
LOCATION
New York
LOCATION
U.S. Treasury
ORGANIZATION
George W. Bush
PERSON
NEW YORK NY
LOCATIONPreparer
ORGANIZATION
FinCEN
ORGANIZATIONUtilities
ORGANIZATIONFiler
PERSONERO Signature
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONMaria Farmer
PERSONFBAR S gnature
ORGANIZATIONForeign Bank
ORGANIZATIONBSA Efiling
ORGANIZATIONSchedule SE
PERSONC-EZ
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATION