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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

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n, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant (continued) Preparer's Contact Information 4. Preparer's Daytime Telephone Number 6. Preparer's Email Address (if any) A- 5. Preparer's Mobile Telephone Number (if any) Preparer's Statement 7. A. K

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return and payment to: NYS TAX DEPARTMENT SALES TAX DESK AUDIT ASUAL SALES UNIT dUILDING 9 3RD FLOOR W A HARRIMAN CAMPUS ALBANY NY 12227-0125 Preparer's social security number 153-38-2770 Date Employer identification number 13-3959372 STF NY40568F EFTA_R1_01947145 EFTA02672895 THOMAS TURRIN

not reporting a personal account 146 Date (MWDD Ihka date will auto-I N Men the HMO is asyttionaIlt signed Third Party Preparer Use Only 47 Preparer's last name PRESS 48 First name GARY 49 MI W 50 Checks I if 51 TIN self-employed 51a TIN type I XI PTIN 0 SSNATIN C Foreign Wa Ext. 53 Fi

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