Epstein File EFTA00619489: Submission and Tokyo (DS9)

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Epstein File EFTA00619489: Submission and Tokyo (DS9)

Financial RecordDate unavailableEFTA006194891 keyword hits

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This document is a FinCEN Form 114 (FBAR - Foreign Bank Account Report) for THE BLACK FAMILY 1997 TRUST, filed in January 2014. The form discloses a financial account held at a financial institution located at 1-22-8 Nishi-Ikebukuro, Toshima-ku, Tokyo, Japan. The document authorizes a preparer to receive information from FinCEN and resolve issues relating to the submission.

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submission Tokyo

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Financial FinCEN Form 114 Accounts (FBAR) OMB Control Number: 1506-0009 THEBLAC20140001 Effective January 2014 Filing Name THE BLACK FAMILY 1997 TRUST **Submission**

Excerpt 2

provided; and that I/we authorize the preparer listed in Part Il to receive information from FinCEN, answer inquiries and resolve issues relating to this **submission**

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financial institution in which account is held 2137270 1-22-8 NISHI-IKEBUKURO TOSHIMA-KU 20 City 21 State, if known 22 ZIP/Postal Code, if known 23 Country **TOKYO**