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lost (Replacement requested) Late receiving missing required account information Unable to obtain joint spouse signature in time Unable to access BSA Efiling system Other (please provide explanation below) 773151 05-21-17 EFTA00792088 FinCEN Form 114 REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS Do
o the best of my knowledge and belief, the return is true, correct, and complete. I have based this declaration on all information available to me. ERO EFIN/PIN: Enter your sixdigit EFIN followed by your five digit PIN: DAVID WEISS CPA, PLLC DAVID WEISS CPA, PLLC ERO's Signature Print Name Date DAVID WE
lost (Replacement requested) Late receiving missing required account information Unable to obtain joint spouse signature in time Unable to access BSA Efiling system Other (please provide explanation below) 773151 05-21-17 EFTA00792178 FinCEN Form 114 REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS Do
the paper return. If I am the paid preparer, filed unincorporated business tax return or other based this declaration on all information available ERO EFIN/PIN: Enter your six•cligit EFIN followed DAVID WEISS CPA, PLLC contained in the above named taxpayers 2017 New York City electronically filed checked
lost (Replacement requested) Late receiving missing required account information Unable to obtain joint spouse signature in time Unable to access BSA Efiling system Other (please provide explanation below) 773151 05-21-17 EFTA00792000 FinCEN Form 114 REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS Do
the paper return. If I am the paid preparer, filed unincorporated business tax return or other based this declaration on all information available ERO EFIN/PIN: Enter your six-digit EFIN followed DAVID WEISS CPA, PLLC contained in the abovenamed taxpayers 2017 New York City electronically filed checked ab
Entities connected to both BSA Efiling and ERO EFIN/PIN
Preparer
ORGANIZATIONYonkers
LOCATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATION
NEW YORK NY
LOCATIONSpouse
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONNew York State Sales Tax
ORGANIZATIONAccelerated Cost Recovery System
ORGANIZATIONSafe Harbor Leasing
ORGANIZATIONthe Commercial Rent Tax Return
ORGANIZATIONMaria Farmer
PERSONForm NYC-
LOCATIONFiler
PERSONthe New York State Tax Department
ORGANIZATION
FinCEN
ORGANIZATION
New York State
LOCATION
U.S. Treasury
ORGANIZATION