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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
ANASTASIYA SIROOCHENKO Part Tax Computation Using Maximum Capital Gains Rates Complete Part III only if you are required to do so by line 31 or by the Foreign Earned Income Tax Worksheet in the instructions. ***-**-9816 Page 2 36 Enter the amount from Form 6251, line 30. If you are filing Form 2555 or 2555•EZ, enter the amount from
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
INE MAXWELL Page 2 Part 1111 Tax Computation Using Maximum Capital Gains Rates Complete Part III only if you are required to do so by line 31 or by the Foreign Earned Income Tax Worksheet in the instructions. 36 Enter the amount from Form 6251, line 30. If you are filing Form 2555 or 2555•EZ. enter the amount from line 3 of the works
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
the Foreign Earned Income Tax Worksheet 27. 5,448. 0. 0. 5,448. 14,238. 5,448. 'If you are filing Form 2555 or 2555-EZ see the footnote in the Foreign Earned Income Tax Worksheet before completing this line. 510.51 01.07.16 14 EFTA00026302 SCHEDULE E (Form 1040) Depattmeni ol the I mousy internal Revenue Service KR)
Entities connected to both Boxes and the Foreign Earned Income Tax Worksheet
Schedule SE
PERSON
United States
LOCATIONSpouse
ORGANIZATIONERO Signature
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATION
U.S. Treasury
ORGANIZATION
Joi Ito
PERSONC-EZ
ORGANIZATIONUtilities
ORGANIZATIONConservation Reserve
ORGANIZATIONConservation Reserve Program
ORGANIZATION
FinCEN
ORGANIZATIONJurat/Disclosure
ORGANIZATIONFiler
PERSONBox B
ORGANIZATIONBox E
ORGANIZATIONBox F
ORGANIZATIONSchedules 0
ORGANIZATIONIndividual, Estate
ORGANIZATIONExchanges of Property
ORGANIZATION