3
Shared Docs
3
Same-Page
3 / 3
Mentions
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
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
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
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
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
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 Filer and Qualifying widow(er

United States
LOCATION
FinCEN
ORGANIZATIONMaria Farmer
PERSON
U.S. Treasury
ORGANIZATION
New York City
LOCATION
Joi Ito
PERSONPreparer
ORGANIZATIONSchedule SE
PERSONthe Foreign Earned Income Tax Worksheet
ORGANIZATION
New York
LOCATIONConservation Reserve
ORGANIZATION
NEW YORK NY
LOCATIONConservation Reserve Program
ORGANIZATIONSpouse
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONCombine Ines 4a
ORGANIZATIONForeign Bank
ORGANIZATIONJurat/Disclosure
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATION