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END THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. 720011 04.01.17 Rev. 10.7 May 21, 2015 EFTA00792092 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES 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 R
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% (
END THIS RECORD TO FInCEN UNLESS REQUESTED TO DO SO. 720011 04-01.17 Rev. 10.7 May 21, 2015 EFTA00792182 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES 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 R
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
SEND THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. 720011 0441.17 Rev. 10.7 May 21.2015 EFTA00792004 ENCLOSE A CHECK FOR $500000, PAYABLE TO THE UNITED STATES 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 R
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 THE UNITED STATES TREASURY and NYS/NYC

United States
LOCATIONMaria Farmer
PERSONFiler
PERSON
U.S. Treasury
ORGANIZATIONUtilities
ORGANIZATIONYonkers
LOCATION
NEW YORK NY
LOCATION
FinCEN
ORGANIZATION
New York
LOCATIONNY State
ORGANIZATION
New York State
LOCATION
Empire State
LOCATIONthe U.S. Treasury Financial Agent
ORGANIZATIONConservation Reserve Program
ORGANIZATIONSpouse
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATIONNY City
LOCATIONthe New York State Department of Taxation and Finance
ORGANIZATIONWEISS
ORGANIZATION