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ICE. WE WILL THEN TRANSMIT YOUR FORM TO THE FINCEN. 700397 040147 EFTA00792087 FINANCIAL CRIMES ENFORCEMENT NETWORK BSA E-Filing - Report of Foreign Bank and Financial Accounts (FBAR) ANASTAS20170001 Filing Name ANASTASIYA SIROOCHENKO Submission Type NEW PIN NOT REQUIRED FinCEN Form 114 Check her
individual: Enter the amount from Form NYC-202. line 21, or Form NYC.202S. line 8 (see inStr.) Part-year resident Individual: Enter the amount from Worksheet A, line 5 (on page 2) 8 65206.00 Part 3 - Beneficiary's share of unincorporated business taxes(see Instructions) 7 Beneficiary - Enter your share o
UR OFFICE. WE WILL THEN TRANSMIT YOUR FORM TO THE FINCEN. 04 0t .7 EFTA00792177 FINANCIAL CRIMES ENFORCEMENT NETWORK BSA E-Filing - Report of Foreign Bank and Financial Accounts (FBAR) Filing Name ANASTASIYA SIROOCHENKO Submission Type NEW PIN NOT REQUIRED FInCEN Form 114 Check here if this report
individual: Enter the amount from Form NYC-202, line 21, or Form NYC-2025. line 8 (see Instr.) Part-year resident Individual: Enter the amount from Worksheet A, line 5 (on page 2) 65233.00 Part 3 - Beneficiary's share of unincorporated business taxes(soe Instructions) 7 Beneficiary - Enter your share of
T YOU RETAIN THIS COPY INDEFINITELY. VERY TRULY YOURS, DAVID WEISS EFTA00791999 FINANCIAL CRIMES ENFORCEMENT NETWORK BSA E-Filing - Report of Foreign Bank and Financial Accounts (FBAR) ANASTAS20170001 Filing Name ANASTASIYA SIROOCHENKO Submission Type NEW PIN NOT REQUIRED FinCEN Form 114 Check her
individual: Enter the amount from Form NYC-202. line 21, or Form NYC.202S. Lie 8 (see friStr.) Part-year resident Individual: Enter the amount from Worksheet A, line 5 (on page 2) el 65115.00 Part 3 - Beneficiary's share of unincorporated business taxes (see Instructions) 7 Beneficiary - Enter your share
Entities connected to both Foreign Bank and Worksheet A

U.S. Treasury
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
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