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le. if not reporting a personal account 46 Dattlate wlepa Mn the HMO le aottonelIteignel Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 MI 50 Check LJ if selfomployedp0096 51 TIN 2062 51a TIN type I XI PTIN 0 SSNATIN Foreign 52 Contact phone no. 212-
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
sonal account 146 Date (MWDD Ma date will auto.I N Men the FBAR is ay.t.tionaiit ore, Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 M 50 Check if self -employed x 51a TIN type I I PTIN SSNATIN Foreign 52 Contact phone no. sza Ext. 53 Firm's name
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
ing a personal account 146 Date (MM/DD Ma date will auloitnneMn the nswisaanuol el gnea Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 MI 50 Checks I if so-mow/3O)00962062 51 TIN 51a TIN type I XI PTIN SSNATIN Foreign 52 Contact phone no. 212-695-577
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 WEISS and FBAR S gnature

United States
LOCATIONMaria Farmer
PERSON
George W. Bush
PERSON
NEW YORK NY
LOCATION
New York City
LOCATION
Joi Ito
PERSON
U.S. Treasury
ORGANIZATIONUtilities
ORGANIZATIONSpouse
ORGANIZATIONFiler
PERSON
FinCEN
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATIONBSA Efiling
ORGANIZATIONPreparer
ORGANIZATION
New York
LOCATIONPersonal Income Tax Information Center
ORGANIZATIONERO EFIN/PIN
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONNew York State Sales Tax
ORGANIZATION