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f activities at each loca ion (manufacturing, sales office. executive , and number of employees, their " ages salaries and duties at each location. Complete Address Rent Nature of Activities Empioyees Wages, Salaries, Etc. Duties I I I I Total Illl• Part 2 List location of each place of business UU
above P"' Taxable refunds, credits, or offsets of state and local income taxes Alimony received Business income or (loss). Attach Schedule C or C-EZ Capital gain or (loss). Attach Schedule D if required. If not required, check here ► 7 8a 740. 9a 10 11 12 13 14 15b 16b 17 18 19
e of activities at each loca ion (manufacturing, sales office. executive and number of employees, their wages salaries and duties at each location. Complete Address Rent Nature of Activities No ry Frnoioyeas Wages, Salaries, Etc. Duties I I I I Total Part 2 List location of each place of business UU I
through 35 Taxable refunds, credits, or offsets of state and local income taxes Alimony received Business income or (loss). Attach Schedule C or C-EZ ► 7 8a 755. 9a 10 11 12 13 14 15b 16b 17 18 19 20b 21 22 1,645,828. ► 1,646,583. Adjusted Gross Income 23 24 25 26 2
e of activities at each loca ion (manufacturing, sales office, executive and number of employees, their wages salaries and duties at each location. Complete Address Rent Nature of Activities No Emoroyees Wages, Salaries, Etc. Duties I I I I Total I, Part 2 List location of each place of business UU
ets of state and local income taxes 10 1099-R if tax was withheld. 11 Alimony received 11 12 Business income or (loss). Attach Schedule C or C-EZ 12 13 Capital gain or (loss). Attach Schedule D U required. If not required, ohm* here 13 If you did not get a W-2, 14 Other gains or (los
Entities connected to both Complete Address and C-EZ

United States
LOCATIONERO Signature
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONSchedule SE
PERSONthe U.S. Treasury Financial Agent
ORGANIZATION
New York
LOCATION
Joi Ito
PERSON
U.S. Treasury
ORGANIZATIONSpouse
ORGANIZATION
FinCEN
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONNew York State Sales Tax
ORGANIZATIONJurat/Disclosure
ORGANIZATIONFiler
PERSONthe Commercial Rent Tax Return
ORGANIZATIONBusiness Tax Credit
ORGANIZATIONMaria Farmer
PERSONUtilities
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATIONConservation Reserve
ORGANIZATION