3
Shared Docs
3
Same-Page
3 / 3
Mentions
n $400, you dont owe selfemployment tax:don't file this schedule unless you have an amount on line 1 b ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line 1 b, see instructions 5 Self-employment tax. If the amount on Me 4 is: • $127.200 or less, multiply line 4 by 15.3% (0.153). Enter
1 s 1T-201LATT Name(s) as shown on your Form IT•201 ANASTASIYA SIROOCHENKO A Have you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200. 496. or section 195.20)? (see instruction
n $400, you dont owe selfemployment tax;don't file this schedule unless you have an amount on line 1 b ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line 1 b, see instructions 5 Self-employment tax. If the amount on line 4 is: • $127.200 or less, multiply line 4 by 15.3% (0.153). Ent
shown on your FormIT.201 ANASTASIYA SIROOCHENKO Your social security number. A Have you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200. 496. or section 195.20)? (see instruction
an $400, you dont owe selfemployment tax;don't file this schedule unless you have an amount on Nne 1 b ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line lb, see instructions 5 Self-employment tax. If the amount on Me 4 is: • $127.200 or less, multiply line 4 by 15.3% (0.153). Enter
your Form IT•201 Your social security number ANASTASIYA SIROOCHENKO 9816 A Have you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200, 496. or section 195.20)? (see instruction
Entities connected to both Conservation Reserve Program and Bribery Involving Public Servants
the Foreign Earned Income Tax Worksheet
ORGANIZATIONSchedule SE
PERSONConservation Reserve
ORGANIZATION
FinCEN
ORGANIZATIONQualifying widow(er
ORGANIZATIONCombine Ines 4a
ORGANIZATIONSpouse
ORGANIZATIONUtilities
ORGANIZATIONJurat/Disclosure
ORGANIZATIONERO Signature
ORGANIZATION
U.S. Treasury
ORGANIZATION
United States
LOCATIONC-EZ
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONFiler
PERSONthe Dept. of Finance
ORGANIZATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONJohn O. Smith
PERSONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION