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saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
$ 0 SEPTEMBER 17, 2018 No. 4 $ 0 JANUARY 15, 2019 Make check payable to UNITED STATES TREASURY Mail voucher and check (if applicable) to INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 Special Instructions INCLUDE YOUR SOCIAL SECURITY NUMBER AND THE 1040-ES" ON YOUR CHECK. VOUCHERS NEED
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
SEPTEMBER 17, 2018 No. 4 $ 443,400 JANUARY 15, 2019 Make check payable to UNITED STATES TREASURY Mail voucher and check (if applicable) to INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 Special Instructions INCLUDE YOUR SOCIAL SECURITY NUMBER AND THE 1040-ES" ON YOUR CHECK. VOUCHERS NEED
saction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electroni
S TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER, DAYTIME PHONE NUMBER, AND THE WORDS "2017 FORM 4868" ON YOUR CHECK. MAIL AS SOON AS POSSIBLE TO: INTERNAL REVENUE SERVICE CENTER III. BOX 37009 HARTFORD, CT 06176-7009 718711 06.15.17 • DETACH HERE • 4868 Department Otte, Traaluy Intornal Inryinnun Snrvictr Fix Cale A
Entities connected to both the New York State Tax Department and INTERNAL REVENUE SERVICE CENTER

New York State
LOCATIONYonkers
LOCATIONMaria Farmer
PERSONSchedule SE
PERSONNew York State Sales Tax
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATIONPreparer
ORGANIZATION
NEW YORK NY
LOCATION
the Internal Revenue Service
ORGANIZATIONNY State
ORGANIZATION
New York
LOCATION
United States
LOCATION
George W. Bush
PERSON
New York City
LOCATION
Empire State
LOCATIONSpouse
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATIONNY City
LOCATIONthe New York State Department of Taxation and Finance
ORGANIZATION