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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
0k .00 601 Mental Illness AntiStigrna Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o .00 60 Total voluntary contributions (add tines 60a through 60o) 61 Total New York State, New York City, Yonkers, and sales or use ta
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
0k .00 601 Mental Illness Anti-Stigma Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o .00 60 Total voluntary contributions (add tines 60a through 60o) 61 Total New York State, New York City, Yonkers, and sales or use ta
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
0k .00 60I Mental Illness Anti-Stigma Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o 00 60 Total voluntary contributions (add fines 60a through 60o) 61 Total Now York State, New York City, Yonkers, and sales or use tax
Entities connected to both the Foreign Bank and Financial Accounts Report and Veterans'

U.S. Treasury
ORGANIZATIONFBAR S gnature
ORGANIZATIONForeign Bank
ORGANIZATIONBSA Efiling
ORGANIZATIONPreparer
ORGANIZATIONFiler
PERSONSpouse
ORGANIZATION
FinCEN
ORGANIZATION
NEW YORK NY
LOCATIONthe Dept. of Finance
ORGANIZATIONU.B.T.
ORGANIZATION
New York
LOCATIONNY State
ORGANIZATION
New York State
LOCATION
Empire State
LOCATIONthe U.S. Treasury Financial Agent
ORGANIZATIONConservation Reserve Program
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATIONNY City
LOCATION