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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
you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200. 496. or section 195.20)? (see instructions) Your social secumy number Part 1 - 0 her New York State, New York City, an
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
you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200. 496. or section 195.20)? (see instructions) Part 1 - O her New York State, New York City, and Yonkers ax credits Secti
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
you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200, 496. or section 195.20)? (see instructions) Department of Taxation and Finance Other Tax Credits and Taxes Attachment
Entities connected to both the Foreign Bank and Financial Accounts Report and Defrauding the Government

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