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gning this Tax Return and Electronic Funds Withdrawal Consent, it applicable, by entering my Self-Select PIN below. Taxpayer's PIN: Date 09122018 Spouse's PIN: 719986 044)I.17 EFTA00792091 Form 114a Department of the Treasury Financial Crimes Enforcement Network (FinCEN) May 2015 Record of Au
instructions) b Adjustment for net income or loss derived in the ordinary course of a non•section 1411 trade or business (see instructions) c Combine Ines 4a and 4b 6a Net gain or loss from disposition of property (see instructions) b Net gain or loss from disposition of property that is not subject
Information. 2017 Submission Identification Number (SID) Taxpayer's name ANASTASIYA SIROOCHENKO Social security number ***4**4. Spouses name Spouse's social secure num er . . liPart rl Tax Return Information - Tax Year Ending December 31, 2017 (Whole dollars only) 1 Adjusted gross income (F
40, line 17; or Form 1041, line 5) b Adjustment for net income or loss derived in the ordinary course of a ncri.section 1411 trade or business e Combine Ines 4a and 4b 5a Net gain or loss from disposition of property from Fenn 1040. combine lines 13 and 14; or from Form 1041. combine lines 4 and 7 b Net
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,
instructions) b Adjustment for net income or loss derived in the ordinary course of a non•section 1411 trade or business (see instructions) c Combine Ines 4a and 4b 6a Net gain or loss from disposition of property (see instructions) b Net gain or loss from disposition of property that is not subject
Entities connected to both Spouse and Combine Ines 4a

Joi Ito
PERSON
United States
LOCATION
New York City
LOCATION
New York
LOCATION
U.S. Treasury
ORGANIZATION
NEW YORK NY
LOCATIONUtilities
ORGANIZATIONSchedule SE
PERSONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONERO Signature
ORGANIZATIONConservation Reserve Program
ORGANIZATIONPreparer
ORGANIZATION
FinCEN
ORGANIZATIONConservation Reserve
ORGANIZATIONC-EZ
ORGANIZATIONMaria Farmer
PERSONFiler
PERSONthe U.S. Treasury Financial Agent
ORGANIZATIONFBAR S gnature
ORGANIZATIONYonkers
LOCATION