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o the best of my knowledge and belief, the return is true, correct, and complete. I have based this declaration on all information available to me. ERO EFIN/PIN: Enter your sixdigit EFIN followed by your five digit PIN: DAVID WEISS CPA, PLLC DAVID WEISS CPA, PLLC ERO's Signature Print Name Date DAVID WE
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
the paper return. If I am the paid preparer, filed unincorporated business tax return or other based this declaration on all information available ERO EFIN/PIN: Enter your six•cligit EFIN followed DAVID WEISS CPA, PLLC contained in the above named taxpayers 2017 New York City electronically filed checked
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
the paper return. If I am the paid preparer, filed unincorporated business tax return or other based this declaration on all information available ERO EFIN/PIN: Enter your six-digit EFIN followed DAVID WEISS CPA, PLLC contained in the abovenamed taxpayers 2017 New York City electronically filed checked ab
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 ERO EFIN/PIN and Bribery Involving Public Servants

New York State
LOCATIONthe New York State Tax Department
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATIONPreparer
ORGANIZATION
NEW YORK NY
LOCATIONPersonal Income Tax Information Center
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONYonkers
LOCATIONNew York State Sales Tax
ORGANIZATIONAccelerated Cost Recovery System
ORGANIZATIONSafe Harbor Leasing
ORGANIZATIONthe Commercial Rent Tax Return
ORGANIZATIONMaria Farmer
PERSONForm NYC-
LOCATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONJohn O. Smith
PERSONConservation Reserve Program
ORGANIZATIONSpouse
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION