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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
END THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. 720011 04.01.17 Rev. 10.7 May 21, 2015 EFTA00792092 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER, DAYTIME PHONE NUMBER, AND THE WORDS "2017 FORM 4868" ON YOUR CHECK. MAIL AS SOON AS POSSIBLE TO: INTERNAL R
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
END THIS RECORD TO FInCEN UNLESS REQUESTED TO DO SO. 720011 04-01.17 Rev. 10.7 May 21, 2015 EFTA00792182 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER, DAYTIME PHONE NUMBER, AND THE WORDS "2017 FORM 4868" ON YOUR CHECK. MAIL AS SOON AS POSSIBLE TO: INTERNAL R
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
SEND THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. 720011 0441.17 Rev. 10.7 May 21.2015 EFTA00792004 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER, DAYTIME PHONE NUMBER, AND THE WORDS "2017 FORM 4868" ON YOUR CHECK. MAIL AS SOON AS POSSIBLE TO: INTERNAL R
Entities connected to both ERO EFIN/PIN and THE UNITED STATES TREASURY

New York State
LOCATIONthe New York State Tax Department
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATIONPreparer
ORGANIZATION
NEW YORK NY
LOCATIONPersonal Income Tax Information Center
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONYonkers
LOCATIONNew York State Sales Tax
ORGANIZATIONAccelerated Cost Recovery System
ORGANIZATIONSafe Harbor Leasing
ORGANIZATIONthe Commercial Rent Tax Return
ORGANIZATIONMaria Farmer
PERSONForm NYC-
LOCATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONJohn O. Smith
PERSONConservation Reserve Program
ORGANIZATIONSpouse
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION