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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
York State column: subtract line 18 from line f 7; New York City column: enter amount from line 17) 20 Refundable credits (see instructions) 21 NYS/NYC estimated income tax (subtract line 20 front line 19) 22 Yonkers: (a) resident tax surcharge (multiply line 21, New York State column, by f 6.75% (
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
w York State column: subtract line 18 from line 17; New York City column: enter amount from line 17) 20 Refundable credits (see instructions) 21 NYS/NYC estimated income tax (subtract line 20 from line 19) 22 Yonkers: (a) resident tax surcharge (multiply line 21, New York State column, by 16.75% (16
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
w York State column: subtract line 18 from line 17; New York City column: enter amount from line 17) 20 Refundable credits (see instructions) 21 NYS/NYC estimated income tax (subtract line 20 (mm Nne 19) 22 Yonkers: (a) resident tax surcharge (multiply fine 21, New York State column, by 16.75% (1675
Entities connected to both C-EZ and NYS/NYC

U.S. Treasury
ORGANIZATIONthe Foreign Earned Income Tax Worksheet
ORGANIZATIONSchedule SE
PERSONthe U.S. Treasury Financial Agent
ORGANIZATION
United States
LOCATIONERO Signature
ORGANIZATIONSpouse
ORGANIZATION
FinCEN
ORGANIZATIONConservation Reserve
ORGANIZATIONJurat/Disclosure
ORGANIZATIONConservation Reserve Program
ORGANIZATIONUtilities
ORGANIZATIONFiler
PERSON
New York State
LOCATION
Empire State
LOCATIONthe Dept. of Finance
ORGANIZATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONJohn O. Smith
PERSONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION