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/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
en filed 45 Filer title. 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 Cont
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
if not reporting a personal 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 Ex
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
r title. if not reporting 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 pho
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
not reporting a personal account 146 Date (MWDD Ihka date will auto-I N Men the HMO is asyttionaIlt signed Third Party Preparer Use Only 47 Preparer's last name PRESS 48 First name GARY 49 MI W 50 Checks I if 51 TIN self-employed 51a TIN type I XI PTIN 0 SSNATIN C Foreign Wa Ext. 53 Fi
Entities connected to both the Foreign Bank and Financial Accounts Report and Preparer

United States
LOCATIONFiler
PERSON
U.S. Treasury
ORGANIZATIONSpouse
ORGANIZATIONBSA Efiling
ORGANIZATION
Joi Ito
PERSON
New York State
LOCATIONthe New York State Tax Department
ORGANIZATION
New York City
LOCATIONFBAR S gnature
ORGANIZATIONForeign Bank
ORGANIZATION
FinCEN
ORGANIZATIONNew York State Sales Tax
ORGANIZATION
NEW YORK NY
LOCATIONthe New York State Department of Taxation and Finance
ORGANIZATIONAccelerated Cost Recovery System
ORGANIZATIONSafe Harbor Leasing
ORGANIZATIONthe Commercial Rent Tax Return
ORGANIZATIONMaria Farmer
PERSONForm NYC-
LOCATION