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ncorporated Business Tax Retum for the following years: 2015: X YES NO 2016: X YES NO — — If 'NO,' state reason: 4. Enter home address: NEW YORK NY 5. If business terminated during the current taxable year, state date terminated. (mmddiry) (Attach a statement showing disposition of business pro

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ax Return for the following years: 2016: X YES — — NO 2016: X YES NO If 'NO,' state reason: 4. 6. 6. Enter home address: 288 WEST 4TH ST NEW YORK NY ZIP Code: 10014 If business terminated during the current taxable year, state date terminated. (mmddly) (Attach a statement showing disposition o

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orated Business Tax Return for the following years: 2015: YES X NO 2016: YES X NO If 'NO.' state reason: Enter home address: 288 WEST 4TH ST NEW YORK NY ZIP Code: 10014 If business terminated during the current taxable year, state date terminated. (mmddly) (Attach a statement showing disposition o

ormation. 2017 Submission Identification Number (SID) Taxpayer's name ANASTASIYA SIROOCHENKO Spouses name Social security number ***4 "4-9816 Spouse's social security number IPartI Tax Return Information - Tax Year Ending December 31,2017 (whole dollars only) 1 Adjusted gross income (Form 1040,

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t I - j un; Business Name V 0'5 LA- Ci - FOR MARITAL PROPERTY STATES ONLY CI Married O Not Married O Legally Separated Name and Address of Spouse ACCOUNT RECORD CHANGES O Close Acct O Add Soc. Sec. No. • O Cards Returned O Cards Not Returned O Reopen Account O Remove Reissue Blodt O Add