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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
ve proper credit, you must enter your correct Social Security Number or Employer Identification Number on your declaration and remittance. DETACH ON DOTTED LINE & MAIL UPPER PORTION. RETAIN LOWER PORTION FOR YOUR RECORDS 05 ESTIMATED TAX WORKSHEET • KEEP THIS PORTION FOR YOUR RECORDS • 1. Net income from business expected in
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
ve proper credit, you must enter your correct Social Security Number or Employer Identification Number on your declaration and remittance. DETACH ON DOTTED LINE & MAIL UPPER PORTION. RETAIN LOWER PORTION FOR YOUR RECORDS 05 11. ESTIMATED TAX WORKSHEET • KEEP THIS PORTION FOR YOUR RECORDS • 1. Net income from business expect
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
ve proper credit, you must enter your correct Social Security Number or Employer Identification Number on your declaration and remittance. DETACH ON DOTTED LINE & MAIL UPPER PORTION. RETAIN LOWER PORTION FOR YOUR RECORDS 05 ESTIMATED TAX WORKSHEET • KEEP THIS PORTION FOR YOUR RECORDS • 1. Net income from business expected in
Entities connected to both BSA Efiling and DOTTED LINE & MAIL UPPER PORTION
the New York State Department of Taxation and Finance
ORGANIZATIONPreparer
ORGANIZATIONNew York State Sales Tax
ORGANIZATIONMaria Farmer
PERSON
Joi Ito
PERSONthe New York State Tax Department
ORGANIZATIONBusiness Tax Credit
ORGANIZATIONthe Commercial Rent Tax Return
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATIONERO EFIN/PIN
ORGANIZATION
New York City
LOCATION
NEW YORK NY
LOCATION
FinCEN
ORGANIZATIONSpouse
ORGANIZATIONForm NYC-
LOCATION
New York
LOCATIONFiler
PERSON
New York State
LOCATIONComplete Address
PERSONSafe Harbor Leasing
ORGANIZATION