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A00791946 SCHEDULEA (Form 1040) Department ol Ito Ramify internal Revenue Service DR) Itemized D
enalty (unless box B.C. or D applies). LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 2210 (2014) 412501 12-23-14 8.1 SIROOCHENKO 2014.03000 SIROOCHENKO, ANASTASIYA SIROOCH1 EFTA00791944 Form2210(2M4) ANASTASIYA SIROOCHENKO Regular Method (See the instructions if you aro f
ements of the Practitioner PIN method and Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns. ERO's signature Ito. DAVID WEISS CPA, PLLC Date ► 719995 11-10.17 ERO Must Retain This Form - See Instructions Don't Submit This Form to the IRS Unless Requested To
YYY In SSNATIN a Type' Passport IMI Foreign TIN Other ON b Number c Country of Issue number complete item 4 6 Last name or organization name SIROOCHENKO 7First name ANASTAS I YA 8 Middle initial 8a Suffix 9 Mailing address (number, street. and apt. or suite no.) 10 City NEW YORK 11 State NY 1
and 67 through 73. These are your total payments Ito 74 547,000. Refund 75 If line 74 is more than
7 Passport c Other In SSNATIN a Type: CI Foreign TIN EIN b Number Country of Issue number complete item 4 6 Last name or organization name SIROOCHENKO 7First name ANASTAS I YA 8 Middle initial 8a Suffix 9 Mailing address (number, street. and apt. or suite no.) 288 WEST 4TH ST 10 City NEW YORK
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United States
LOCATION
NEW YORK NY
LOCATIONMaria Farmer
PERSON
U.S. Treasury
ORGANIZATION
New York
LOCATION
New York State
LOCATIONUtilities
ORGANIZATIONChang
PERSONSpouse
ORGANIZATIONYonkers
LOCATIONSchedule SE
PERSONFiler
PERSONWEISS
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATION
FinCEN
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONConservation Reserve Program
ORGANIZATIONPreparer
ORGANIZATIONConservation Reserve
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATION