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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
certify that this return, Including any accompanying rider, is, to the best of my knowledge and belief, true, correct fin' and complete. I authorize the Dept. of Finance to discuss this return with the preparer listed below. (See Instr.) YES X man AllariltS9 SIGN HERE: Seamier° of laxpirear Tali) Data Presort(
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
reby certify that this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct and complete. I authorize the Dept. of Finance to discuss this return with the preparer listed below. (See Instr.) YES X Fin's Email Merin: SIGN HERE: Signature of taxPirra' Date Wenn(' sae
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
at this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct Firwsernmmosst and complete. I authorize the Dept. of Finance to discuss this return with the preparer listed below. (See Instr.) YES X INFO@DAVI DWE I S SCP SIGN HERE: Secretor° of !tapir/or Trio Data P
Entities connected to both C-EZ and the Dept. of Finance

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
PERSONU.B.T.
ORGANIZATION
New York State
LOCATION
Empire State
LOCATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONJohn O. Smith
PERSONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION