Foreign Accounts

If you had, in all foreign accounts combined, over $10,000 at any time during Tax Year, please provide information below for each account. This is required to be reported to the Treasury Department. Noncompliance could result in penalties.

Taxpayer(T), Spouse(S), Joint(J)

T/S/J	Type of Account:	Account Number:	Name of Financial Institution
	Bank Security Other	Maximum Acct Value in Tax Year US $	Address of Financial Institution
T/S/J	Type of Account:	Account Number:	Name of Financial Institution
	Bank Security Other	Maximum Acct Value in Tax Year US $	Address of Financial Institution
T/S/J	Type of Account:	Account Number:	Name of Financial Institution
	Bank Security Other	Maximum Acct Value in Tax Year US $	Address of Financial Institution
T/S/J	Type of Account:	Account Number:	Name of Financial Institution
	Bank Security Other	Maximum Acct Value in Tax Year US $	Address of Financial Institution
T/S/J	Type of Account:	Account Number:	Name of Financial Institution
	Bank Security Other	Maximum Acct Value in Tax Year US $	Address of Financial Institution

Education

Foreign Income

Foreign Income
Foreign Accounts (FBAR Purpose)

Self-Employment

Self-Employment Income
Self-Employment Expenses
Self-Employed Retirement Plan (Keogh&SEP)
Home Office
Vehicle Expenses
Estimated Tax Payments

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