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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
f activities at each loca ion (manufacturing, sales office. executive , and number of employees, their " ages salaries and duties at each location. Complete Address Rent Nature of Activities Empioyees Wages, Salaries, Etc. Duties I I I I Total Illl• Part 2 List location of each place of business UU
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
e of activities at each loca ion (manufacturing, sales office. executive and number of employees, their wages salaries and duties at each location. Complete Address Rent Nature of Activities No ry Frnoioyeas Wages, Salaries, Etc. Duties I I I I Total Part 2 List location of each place of business UU I
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
e of activities at each loca ion (manufacturing, sales office, executive and number of employees, their wages salaries and duties at each location. Complete Address Rent Nature of Activities No Emoroyees Wages, Salaries, Etc. Duties I I I I Total I, Part 2 List location of each place of business UU
Entities connected to both BSA Efiling and Complete Address

New York
LOCATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONNew York State Sales Tax
ORGANIZATION
FinCEN
ORGANIZATION
United States
LOCATIONthe Commercial Rent Tax Return
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATION
U.S. Treasury
ORGANIZATIONMaria Farmer
PERSONBusiness Tax Credit
ORGANIZATIONFiler
PERSONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATIONPreparer
ORGANIZATION
Joi Ito
PERSONSpouse
ORGANIZATIONNY City
LOCATIONWEISS
ORGANIZATIONU.B.T.
ORGANIZATION