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$ 0 SEPTEMBER 17, 2018 No. 4 $ 0 JANUARY 15, 2019 Make check payable to UNITED STATES TREASURY Mail voucher and check (if applicable) to INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 Special Instructions INCLUDE YOUR SOCIAL SECURITY NUMBER AND THE 1040-ES" ON YOUR CHECK. VOUCHERS NEED
9 blank 4 , Voluntary contributions] (see page 27) 60a Return a Gift to Wildlife 60a .00 60b Missing/Exploited Children Fund 60b .00 60c Breast Cancer Research Fund 60c .00 60d Alzheimer's Fund 60d .00 60e Olympic Fund ($2 or $4; see page 27) 60e .00 601 Prostate and Testicular Cancer Research and Ed
SEPTEMBER 17, 2018 No. 4 $ 443,400 JANUARY 15, 2019 Make check payable to UNITED STATES TREASURY Mail voucher and check (if applicable) to INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 Special Instructions INCLUDE YOUR SOCIAL SECURITY NUMBER AND THE 1040-ES" ON YOUR CHECK. VOUCHERS NEED
9 blank ) 04'pr Voluntary contributions (see page 27) 60a Return a Gift to Wildlife 60a .00 60b Missing/Exploited Children Fund 60b .00 60c Breast Cancer Research Fund 60c .00 60d Alzheimer's Fund 60d .00 60e Olympic Fund ($2 a $4; see page 27) 60e .00 601 Prostate and Testicular Cancer Research and Edu
S 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 REVENUE SERVICE CENTER III. BOX 37009 HARTFORD, CT 06176-7009 718711 06.15.17 • DETACH HERE • 4868 Department Otte, Traaluy Intornal Inryinnun Snrvictr Fix Cale A
9 blank ) 04'pr Voluntary contributions (see page 27) 60a Return a Gift to Wildlife 60a .00 60b Missing/Exploited Children Fund 60b .00 60c Breast Cancer Research Fund 60c .00 60d Alzheimer's Fund 60d .00 60e Olympic Fund (52 a $4; see page 27) 60e .00 601 Prostate and Testicular Cancer Research and Edu
Entities connected to both INTERNAL REVENUE SERVICE CENTER and Breast Cancer Research Fund

New York State
LOCATIONYonkers
LOCATIONSchedule SE
PERSONNY State
ORGANIZATIONMaria Farmer
PERSONWomen's Cancers Education and Prevention Fund
ORGANIZATIONNYC-210
ORGANIZATIONPersonal Income Tax Information Center
ORGANIZATIONNY City
LOCATIONFirst Installment
ORGANIZATIONTHE NY TAX DEPT
ORGANIZATION
Empire State
LOCATION
New York
LOCATIONSpouse
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONthe New York State Department of Taxation and Finance
ORGANIZATIONWEISS
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATION