3
Shared Docs
3
Same-Page
3 / 3
Mentions
017) 62 Enter amount from line 61 Payments and refundable credits (see pages 28 through 31) 76801). It -ti -17 62 193792.00 63 64 65 66 67 Empire State child credit NYS/NYC child and dependent care credit 63 .00 64 .00 NYS earned income credit (BC) 65 .00 NYS noncustodial parent EIC Real
the best of my knowledge and belief. it is true. correct, and complete. This declaration is based on all information of which I have any knowledge. ERO Signature I am signing this Tax Return by entering my PIN below. ERO's PIN (enter EFIN plus 5 sell-selected numerics) Taxpayer Declarations Perjury Statem
Page 4 of 4 IT-201 (2017) 768001 11-17-N. 62 Enter amount from line 61 Payments and refundable credits (see pages 28 through 31) 62 1938750o 63 Empire State child credit 63 .00 64 NYS/NYC child and dependent care credit 64 .00 65 NYS earned income credit (BC) 65 .00 66 NYS noncustodial parent E
the best of my knowledge and belief. it is true, correct. and complete. This declaration is based on all information of which I have any knowledge. ERO Signature I am signing this Tax Return by entering my PIN below. ERO's PIN (enter EFIN plus 5 self-selected numerics) Taxpayer Declarations Perjury Statem
security umber 765004 11.17.17 62 Enter amount from line 61 816 IPayments and refundable credltel (see pages 28 through 31) 63 64 65 66 67 Empire State child credit NYS/NYC child and dependent care credit 63 .00 64 .00 NYS earned income credit (BC) 65 .00 NYS noncustodial parent EIC Real
the best of my knowledge and belief. it is true. correct. and complete. This declaration is based on all information of which I have any knowledge. ERO Signature I am signing this Tax Return by entering my PIN below. ERO's PIN 13769913349 (enter EFIN plus 5 self-selected numerics) Taxpayer Declarations P
Entities connected to both Empire State and ERO Signature

United States
LOCATIONSpouse
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONC-EZ
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONFiler
PERSONSchedule SE
PERSON
U.S. Treasury
ORGANIZATIONTHE NY TAX DEPT
ORGANIZATIONJurat/Disclosure
ORGANIZATION
New York
LOCATIONNY State
ORGANIZATION
New York State
LOCATIONConservation Reserve Program
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATIONFirst Installment
ORGANIZATIONNY City
LOCATIONConservation Reserve
ORGANIZATIONBreast Cancer Research Fund
ORGANIZATION