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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
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dividends 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 Other gains or (losses). Attach Form 4797 IRA distnbutians
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Entities connected to both C-EZ and Application for Automatic Extension of Time

U.S. Treasury
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONSchedule SE
PERSONERO Signature
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONSpouse
ORGANIZATION
United States
LOCATIONUtilities
ORGANIZATIONConservation Reserve
ORGANIZATION
FinCEN
ORGANIZATIONAlimony
ORGANIZATION
Joi Ito
PERSONJurat/Disclosure
ORGANIZATIONConservation Reserve Program
ORGANIZATIONFiler
PERSONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATIONBSA Efiling
ORGANIZATIONPreparer
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATION