the New York State Department of Taxation and Finance
ORGANIZATIONBribery Involving Public Servants
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xable year, state date terminated. (mmddiry) (Attach a statement showing disposition of business property.) 6. Has the Internal Revenue Service or the New York State Department of Taxation and Finance Increased or decreased any taxable Income (loss) reported in any tax period, or are you currently being audited?,„ YES X NO If 'YES', by whom? I
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
t taxable year, state date terminated. (mmddly) (Attach a statement showing disposition of business property.) Has the Internal Revenue Service or the New York State Department of Taxation and Finance Increased or decreased any taxable Income (loss) reported in any tax period, or are you currently being audited?. YES X NO If 'YES", by whom? In
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
t taxable year, state date terminated. (mmddly) (Attach a statement showing disposition of business property.) Has the Internal Revenue Service or the New York State Department of Taxation and Finance increased or decreased any taxable income (loss) reported in any tax period, or are you currently being audited?. YES X NO If 'YES", by whom? In
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
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