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en filed 45 Filer title. if not reporting a personal account 46 Dattlate wlepa Mn the HMO le aottonelIteignel Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 MI 50 Check LJ if selfomployedp0096 51 TIN 2062 51a TIN type I XI PTIN 0 SSNATIN Foreign 52 Cont
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
if not reporting a personal account 146 Date (MWDD Ma date will auto.I N Men the FBAR is ay.t.tionaiit ore, Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 M 50 Check if self -employed x 51a TIN type I I PTIN SSNATIN Foreign 52 Contact phone no. sza Ex
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
r title. if not reporting a personal account 146 Date (MM/DD Ma date will auloitnneMn the nswisaanuol el gnea Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 MI 50 Checks I if so-mow/3O)00962062 51 TIN 51a TIN type I XI PTIN SSNATIN Foreign 52 Contact pho
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
Entities connected to both Preparer and Bribery Involving Public Servants

United States
LOCATION
U.S. Treasury
ORGANIZATIONFiler
PERSON
New York State
LOCATIONNew York State Sales Tax
ORGANIZATION
NEW YORK NY
LOCATIONSpouse
ORGANIZATIONthe New York State Tax Department
ORGANIZATION
FinCEN
ORGANIZATIONMaria Farmer
PERSONPersonal Income Tax Information Center
ORGANIZATIONERO EFIN/PIN
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONAccelerated Cost Recovery System
ORGANIZATIONSafe Harbor Leasing
ORGANIZATIONthe Commercial Rent Tax Return
ORGANIZATIONForm NYC-
LOCATIONBSA Efiling
ORGANIZATION
Joi Ito
PERSONthe New York State Department of Taxation and Finance
ORGANIZATION