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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-
arm partnerships. Schedule K1 (Form 1065), box 14, code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F. line 4b. or listed on Schedule K1 (Form 1065), box 20, code Z 2 Net profit or (loss) from Schedule C. lin
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
arm partnerships, Schedule K1 (Form 1065), box 14, code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F. line 4b. or listed on Schedule K1 (Form 1065), box 20, code Z 2 Net profit or (loss) from Schedule C, lin
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
d farm partnerships, Schedule (Form 1065), box 14, code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F. line 4b. or listed on Schedule K-1 (Form 1065), box 20. code Z 2 Net profit or (loss) from Schedule C. l
Entities connected to both WEISS and Conservation Reserve

United States
LOCATIONMaria Farmer
PERSON
NEW YORK NY
LOCATION
Joi Ito
PERSON
New York City
LOCATION
U.S. Treasury
ORGANIZATIONUtilities
ORGANIZATIONConservation Reserve Program
ORGANIZATIONSchedule SE
PERSONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONSpouse
ORGANIZATIONJurat/Disclosure
ORGANIZATION
FinCEN
ORGANIZATIONCombine Ines 4a
ORGANIZATIONC-EZ
ORGANIZATIONQualifying widow(er
ORGANIZATION
New York
LOCATIONFiler
PERSONERO Signature
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATION