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en filed 45 Filer title. if not reporting a personal account 46 Dattlate wlepa Mn the HMO le aottonelIteignel Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 MI 50 Check LJ if selfomployedp0096 51 TIN 2062 51a TIN type I XI PTIN 0 SSNATIN Foreign 52 Cont
above P"' Taxable refunds, credits, or offsets of state and local income taxes Alimony received Business income or (loss). Attach Schedule C or C-EZ Capital gain or (loss). Attach Schedule D if required. If not required, check here ► 7 8a 740. 9a 10 11 12 13 14 15b 16b 17 18 19
if not reporting a personal account 146 Date (MWDD Ma date will auto.I N Men the FBAR is ay.t.tionaiit ore, Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 M 50 Check if self -employed x 51a TIN type I I PTIN SSNATIN Foreign 52 Contact phone no. sza Ex
through 35 Taxable refunds, credits, or offsets of state and local income taxes Alimony received Business income or (loss). Attach Schedule C or C-EZ ► 7 8a 755. 9a 10 11 12 13 14 15b 16b 17 18 19 20b 21 22 1,645,828. ► 1,646,583. Adjusted Gross Income 23 24 25 26 2
r title. if not reporting a personal account 146 Date (MM/DD Ma date will auloitnneMn the nswisaanuol el gnea Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 MI 50 Checks I if so-mow/3O)00962062 51 TIN 51a TIN type I XI PTIN SSNATIN Foreign 52 Contact pho
ets of state and local income taxes 10 1099-R if tax was withheld. 11 Alimony received 11 12 Business income or (loss). Attach Schedule C or C-EZ 12 13 Capital gain or (loss). Attach Schedule D U required. If not required, ohm* here 13 If you did not get a W-2, 14 Other gains or (los
Entities connected to both Preparer and C-EZ

United States
LOCATION
U.S. Treasury
ORGANIZATIONFiler
PERSONSpouse
ORGANIZATION
Joi Ito
PERSON
FinCEN
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONSchedule SE
PERSONNew York State Sales Tax
ORGANIZATION
New York State
LOCATIONthe U.S. Treasury Financial Agent
ORGANIZATION
NEW YORK NY
LOCATIONthe New York State Tax Department
ORGANIZATIONERO Signature
ORGANIZATIONJurat/Disclosure
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATIONForm NYC-
LOCATIONBSA Efiling
ORGANIZATION