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46 47 209,297. 1,406,667. 0. 1,406,667. 512,859. 512,859. 55 56 57 58 59 60a 60b 61 62 63 512,859. 57 Self-employment tax. Attach Schedule SE Other 58 Unreported social security and Medicare tax from Form: a El 4137 b C 8919 gip Taxes 59 Additional tax on IRAs, other qualified retirem
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E CENTER P.O. BOX 37009 HARTFORD, CT 06176-7009 718711 06.15.17 • DETACH HERE • .4868 Dapartmon1 t'A TIBOSisy Intganal Finc.ILA Sqrvice SKS Application for Automatic Extension of Time To File U.S. Individual Income Tax Return Ft, <Macau pia. 7017 ar iffisr fa. year bnqnring anaing 2017 Part I I Identification Part II I Indivi
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
15 1.1 EFTA00026287 518711 05.12.15 ♦ DETACH HERE • Fo m 4868 Department of Ina Treastoy inward Revenue Senna 1991 (Part 1 YCkr narralS) Application for Automatic Extension of Time To File U.S. Individual Income Tax Return Fo cawaAr •?.i MI5 cr cfnur tax yam bAgnring 0Ii, andiro 2015 I Identification GHISLAINE MAXWELL C/
Entities connected to both Schedule SE and Application for Automatic Extension of Time
the Foreign Earned Income Tax Worksheet
ORGANIZATION
Joi Ito
PERSONMaria Farmer
PERSONYonkers
LOCATIONthe U.S. Treasury Financial Agent
ORGANIZATION
United States
LOCATIONERO Signature
ORGANIZATION
New York State
LOCATIONC-EZ
ORGANIZATION
U.S. Treasury
ORGANIZATIONSpouse
ORGANIZATIONUtilities
ORGANIZATIONConservation Reserve Program
ORGANIZATIONConservation Reserve
ORGANIZATIONINTERNAL REVENUE SERVICE CENTER
ORGANIZATIONAlimony
ORGANIZATIONQualifying widow(er
ORGANIZATIONCombine Ines 4a
ORGANIZATIONJurat/Disclosure
ORGANIZATION
FinCEN
ORGANIZATION