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tion of the transmission, (b)the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicate
00. 32a M Invalmeni leaf ilLi. 32b Q is Some at Investrimpi not Fisk Schedule C (Form 1040) 2015 7 EFTA00026295 SCHEDULED (Form 1040) Department of the Rosary internal Revonuo Sable. Mg Capital Gains and Losses ► Attach to Form 1040 or Form 1040NR. IP, Information about Schedule D and its separate instr
Income (Loss) Rental Real Estate Inc. (Loss) Other Rental Income (Loss) Passive Activity Loss C/0 MIT Passive Activity Loss G/0 Interest US Treasury Bond Interest Dividends Royalties Shan-Tam Groom Daln1Loss) Net Long. orm coot. Gain Mos.) Gisafalt(141d Payment,' 10 Partner TP 3 3 A
ained UNITED KINGDOM, POUND (b) Foreign currency exchange rate used to convert to U.S. dollars (c) Source of exchange rate used if not from U.S. Treasury Department's Bureau of the Fiscal Service LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 8938 (2015) S2332 I 11-05-15 65 EFTA0
ttach Schedule D if required. If not required, check here Other gains or (losses). Attach Form 4797 IRA distnbutians 1 151 I b Taxable amount Boxes checked on 6a and Etc No 01 children o 6c tio. *Pad with you %did not We with you due to OlvOrCe a Separation InStructiathl Dapanden% on 6c
complete the 3rd party preparer section on page one of the report. The E-tile system will auto complete item 46. NOTE: The FBAR must be received by the Department of the Treasury on or before April 17. 2018. An automatic extension to October 15.2018 is available. This report filed late for the following reason (Check only on
ion of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. It applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicate
line 36 from line 22. This is your adjusted gross Income 37 Last name (2)Orneridenre Serial security number O.04endenEs relatkentalp 10 you Boxes aced on Ea and Ea No of children thig 6c ho. min age 17 p lend with you 1004019 NI hr4 did not Ma with grardt you due tO Ovate a Separatio
complete the 3rd party preparer section on page one of the report. The E-tile system will auto complete item 46. NOTE: The FBAR must be received by the Department of the Treasury on or before April 17, 2018. An automatic extension to October 15.2018 is available. This report filed late for the following reason (Check only on
ion of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. if applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicate
ndents social way numb. (310ependenrs m you asonsuo to IAm o Al Mid iallUil fleichl iaw 17 wow SON X d Total number of exemptions claimed Boxes checked en Ca and (1b No. of children on 6c who: * Ned with you • did nettle., with you OA to &KW9 Cr separation lane rtstructmal Oroenclant
Entities connected to both U.S. Treasury and Boxes

Jeffrey Epstein
PERSON
United States
LOCATION
George W. Bush
PERSON
Ghislaine Maxwell
PERSON
Joi Ito
PERSON
Woody Allen
PERSON
Eric Holder
PERSON
Adriana Ross
PERSONUtilities
ORGANIZATION
Lesley Groff
PERSON
FinCEN
ORGANIZATIONSpouse
ORGANIZATIONFiler
PERSONthe U.S. Treasury Financial Agent
ORGANIZATIONSchedule SE
PERSONC-EZ
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONERO Signature
ORGANIZATIONConservation Reserve Program
ORGANIZATIONLarry Visoski
PERSON