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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
he following amount for your filing status: Married filing jointly $250,000 Married filing separately $125,000 Single, Head of household, or Qualifying widow(er) $200,000 5 6 Subtract line 5 from line 4. If zero or less. enter 0- 6 7 Additional Medicare Tax on Medicare wages. Multiply line 6 by 0.9% (0.0
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
he following amount for your filing status: Married filing jointly $250,000 Married filing separately $125,000 Single, Head of household, or Qualifying widow(er) $200,000 9 200,000. 10 Enter the amount from line 4 10 11 Subtract line 10 from line 9. If zero or less. enter .0- 11 200,000. 12 Subtract
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
he following amount for your filing status: Married filing jointly $250,000 Married filing separately $125,000 Single. Head of household, or Qualifying widow(er) $200,000 9 200,000. 10 Enter the amount from line 4 10 11 Subtract line 10 from line 9. If zero or less. enter .0- 11 200,000. 12 Subtract
Entities connected to both Preparer and Qualifying widow(er

United States
LOCATION
U.S. Treasury
ORGANIZATIONFiler
PERSONNew York State Sales Tax
ORGANIZATION
Joi Ito
PERSONthe New York State Tax Department
ORGANIZATIONSpouse
ORGANIZATION
New York State
LOCATION
NEW YORK NY
LOCATIONUtilities
ORGANIZATIONYonkers
LOCATION
FinCEN
ORGANIZATIONConservation Reserve Program
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATION
New York City
LOCATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATIONBSA Efiling
ORGANIZATIONMaria Farmer
PERSON