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ntry AUSTRIA ISignature 144a Check here LXJ if this report is completed b a third party preparer and complete the third party preparer section. 44 Filer signature 1I. repon v. I be elocircniceny *kiwi when filed 45 Filer title. if not reporting a personal account 46 Dattlate wlepa Mn the HMO le a
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
ntry AUSTRIA Signature I 44a Check here LxJ if this report is completed b a third party preparer and complete the third party preparer section. 44 Filer signature Ilso ropon v. ii beeleCtrCnIcelly *IOW when Ned 45 Filer title. if not reporting a personal account 146 Date (MWDD Ma date will auto.I
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
untry AUSTRIA Signature I 44a Check here LXJ if this report is completed b a third party preparer and complete the third arty proposer section. 44 Filer signature naa rap I be eleCtranIcaily signed when sled 45 Filer title. if not reporting a personal account 146 Date (MM/DD Ma date will auloitn
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
Entities connected to both Filer and the New York State Tax Department

United States
LOCATION
FinCEN
ORGANIZATIONMaria Farmer
PERSON
George W. Bush
PERSON
New York City
LOCATIONLeon Black
PERSON
U.S. Treasury
ORGANIZATIONPreparer
ORGANIZATION
New York State
LOCATION
Joi Ito
PERSON
NEW YORK NY
LOCATION
New York
LOCATIONSpouse
ORGANIZATION
the Internal Revenue Service
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONNew York State Sales Tax
ORGANIZATION
Empire State
LOCATIONPersonal Income Tax Information Center
ORGANIZATIONYonkers
LOCATIONTHE NY TAX DEPT
ORGANIZATION