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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
January 15, 2019. Enter applicable payer ID number and to: NYS Estimated Income Tax, str) New Yolk Stale 0 00 New Yak City 0 00 Yonkon 00 KICTIM 00 Total payment 0 00 IT-2105 Estimated tax amounts STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792134 76f
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
tate NY ZIP code 10014 taxpayer s e-mail address IT-2105 Estimated tax amounts str) Now York Stale 0 00 New YQIk City 0 00 Yonkots 00 KICTIM 00 Total payment 0 00 STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792216 er NEW YORK STATE 2018 - Ti
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
19. Enter applicable payer ID number and to: NYS Estimated Income Tax, stir) L 80000 00 Now York Stale New Y0.14 CRY 55000 00 Yonkots 00 KICTIM 00 Total payment 135000 00 IT-2105 Estimated tax amounts STOP: Pay this electronically on our vrebsite 0601181019 *****9816 9 EFTA00792043
Entities connected to both C-EZ and KICTIM

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