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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
1615964 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
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
1616657 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
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
1540837 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
Entities connected to both Filer and NYC-210

United States
LOCATION
FinCEN
ORGANIZATIONMaria Farmer
PERSON
U.S. Treasury
ORGANIZATION
New York City
LOCATION
Joi Ito
PERSON
New York
LOCATIONSpouse
ORGANIZATIONPreparer
ORGANIZATION
NEW YORK NY
LOCATION
Empire State
LOCATIONBreast Cancer Research Fund
ORGANIZATIONConservation Reserve Program
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATIONNY City
LOCATIONFirst Installment
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATION