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line 36 from line 22. This is your adjusted gross Income 37 Last name (2)Orneridenre Serial security number O.04endenEs relatkentalp 10 you Boxes aced on Ea and Ea No of children thig 6c ho. min age 17 p lend with you 1004019 NI hr4 did not Ma with grardt you due tO Ovate a Separatio
its 55 56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- IIII• At ► 56 487,479. 57 Self-employment tax. Attach Schedule SE 57 57,897. Other 58 Unreported social security and Medicare tax from Form: a04137 608919 58 Taxes 59 Additional tax on IRAs, other qualified
ndents social way numb. (310ependenrs m you asonsuo to IAm o Al Mid iallUil fleichl iaw 17 wow SON X d Total number of exemptions claimed Boxes checked en Ca and (1b No. of children on 6c who: * Ned with you • did nettle., with you OA to &KW9 Cr separation lane rtstructmal Oroenclant
s been applied against the activity's current net income, if any. Any unused carryover was then applied against other passive activities. (36505) Schedule SE. Schedule SE has not been prepared for the spouse because self-employment income is less than $400.00. If Schedule SE is desired, select Mandatory
ttach Schedule D if required. If not required, check here Other gains or (losses). Attach Form 4797 IRA distnbutians 1 151 I b Taxable amount Boxes checked on 6a and Etc No 01 children o 6c tio. *Pad with you %did not We with you due to OlvOrCe a Separation InStructiathl Dapanden% on 6c
6 or 210%62 Health savings account deduction. Attach Form 8889 Moving expenses. Attach Form 3903 Deductible part of self-employment tax. Attach Schedule SE Self-employed SEP, SIMPLE, and qualified plans Self-employed health insurance deduction Penalty on early withdrawal of savings Alimony paid b
Entities connected to both Boxes and Schedule SE

Joi Ito
PERSON
United States
LOCATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONC-EZ
ORGANIZATIONERO Signature
ORGANIZATION
U.S. Treasury
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONSpouse
ORGANIZATIONConservation Reserve Program
ORGANIZATIONUtilities
ORGANIZATIONConservation Reserve
ORGANIZATION
George W. Bush
PERSONFiler
PERSONJurat/Disclosure
ORGANIZATION
FinCEN
ORGANIZATION
Woody Allen
PERSON
Ghislaine Maxwell
PERSONBusiness Property
ORGANIZATIONColumn
PERSONAdjustme
LOCATION