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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
January 15, 2019. Enter applicable payer ID number and to: NYS Estimated Income Tax, str) New Yolk Stale 0 00 New Yak City 0 00 Yonkon 00 KICTIM 00 Total payment 0 00 IT-2105 Estimated tax amounts STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792134 76f
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
tate NY ZIP code 10014 taxpayer s e-mail address IT-2105 Estimated tax amounts str) Now York Stale 0 00 New YQIk City 0 00 Yonkots 00 KICTIM 00 Total payment 0 00 STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792216 er NEW YORK STATE 2018 - Ti
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,
19. Enter applicable payer ID number and to: NYS Estimated Income Tax, stir) L 80000 00 Now York Stale New Y0.14 CRY 55000 00 Yonkots 00 KICTIM 00 Total payment 135000 00 IT-2105 Estimated tax amounts STOP: Pay this electronically on our vrebsite 0601181019 *****9816 9 EFTA00792043
Entities connected to both Spouse and KICTIM

New York City
LOCATION
United States
LOCATION
Joi Ito
PERSON
New York
LOCATION
U.S. Treasury
ORGANIZATION
NEW YORK NY
LOCATIONUtilities
ORGANIZATIONERO Signature
ORGANIZATIONC-EZ
ORGANIZATIONPreparer
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONSchedule SE
PERSON
FinCEN
ORGANIZATIONMaria Farmer
PERSONFiler
PERSONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONBSA Efiling
ORGANIZATIONTHE NY TAX DEPT
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATION
Empire State
LOCATION