the New York State Tax Department
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATION3
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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
/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
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
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
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
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 the New York State Tax Department and the Foreign Bank and Financial Accounts Report

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