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saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
m 15) employer's (En ity) name DAVID WEISS CPA, PLLC 25. Employer EIN **_*** 26. Preparers ignature DAVID WEISS Instructions for completing the FBAR S gnature Authorization Record This record may be completed by the individual or entity granting such authorization (Part I) OR the individuaVentity authorize
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
rs (item 15) employer's (En ity) name DAVID WEISS CPA, PLLC 25. Employer EIN 26. Preparers signature DAVID WEISS Instructions for completing the FBAR S gnature Authorization Record This record may be completed by the individual or entity granting such authorization (Part I) OR the individuaVentity authorize
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
5) employers (En ity) name DAVID WEISS CPA, PLLC 25. Employer EIN **-***2756 26. Preparers ignature DAVID WEISS Instructions for completing the FBAR S gnature Authorization Record This record may be completed by the individual or entity granting such authorization (Part I) OR the individuaVentity authorize
Entities connected to both the New York State Tax Department and FBAR S gnature

New York State
LOCATIONPreparer
ORGANIZATIONNew York State Sales Tax
ORGANIZATIONMaria Farmer
PERSON
NEW YORK NY
LOCATION
New York
LOCATIONSpouse
ORGANIZATION
New York City
LOCATION
United States
LOCATIONYonkers
LOCATIONPersonal Income Tax Information Center
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONERO EFIN/PIN
ORGANIZATIONNY State
ORGANIZATIONFirst Installment
ORGANIZATIONSafe Harbor Leasing
ORGANIZATION
Empire State
LOCATION
Joi Ito
PERSONBreast Cancer Research Fund
ORGANIZATIONTHE NY TAX DEPT
ORGANIZATION