3
Shared Docs
3
Same-Page
3 / 3
Mentions
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
END THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. 720011 04.01.17 Rev. 10.7 May 21, 2015 EFTA00792092 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER, DAYTIME PHONE NUMBER, AND THE WORDS "2017 FORM 4868" ON YOUR CHECK. MAIL AS SOON AS POSSIBLE TO: INTERNAL R
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
END THIS RECORD TO FInCEN UNLESS REQUESTED TO DO SO. 720011 04-01.17 Rev. 10.7 May 21, 2015 EFTA00792182 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER, DAYTIME PHONE NUMBER, AND THE WORDS "2017 FORM 4868" ON YOUR CHECK. MAIL AS SOON AS POSSIBLE TO: INTERNAL R
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
SEND THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. 720011 0441.17 Rev. 10.7 May 21.2015 EFTA00792004 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER, DAYTIME PHONE NUMBER, AND THE WORDS "2017 FORM 4868" ON YOUR CHECK. MAIL AS SOON AS POSSIBLE TO: INTERNAL R
Entities connected to both Complete Address and THE UNITED STATES TREASURY

New York
LOCATIONthe New York State Department of Taxation and Finance
ORGANIZATION
United States
LOCATIONthe Commercial Rent Tax Return
ORGANIZATIONDOTTED LINE & MAIL UPPER PORTION
ORGANIZATIONNew York State Sales Tax
ORGANIZATIONBusiness Tax Credit
ORGANIZATIONMaria Farmer
PERSONTotal New York State
ORGANIZATIONWorksheet A
ORGANIZATIONForm IT-20VATT
ORGANIZATIONFirst Installment
ORGANIZATIONSecond Installment
ORGANIZATIONU.B.T.
ORGANIZATION
Empire State
LOCATIONthe U.S. Treasury Financial Agent
ORGANIZATIONthe Dept. of Finance
ORGANIZATIONConservation Reserve Program
ORGANIZATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONSpouse
ORGANIZATION