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1615964 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
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(
1616657 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
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
1540837 0 1. 2. 3. 4. 5. Part B Declaration of taxpayer and authorizations for Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Under penalty of perjury, I declare that I have examined the information on my 2017 New York State electronic personal income tax return, including
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 NYC-210 and the Dept. of Finance
Yonkers
LOCATION
New York State
LOCATIONSpouse
ORGANIZATION
Empire State
LOCATIONthe New York State Tax Department
ORGANIZATIONWomen's Cancers Education and Prevention Fund
ORGANIZATION
New York
LOCATIONPersonal Income Tax Information Center
ORGANIZATIONNY City
LOCATIONFirst Installment
ORGANIZATIONBreast Cancer Research Fund
ORGANIZATIONTHE NY TAX DEPT
ORGANIZATIONNY State
ORGANIZATIONTaxpayer for Forms NYC-202, NYC-202S
ORGANIZATIONJohn O. Smith
PERSONthe New York State Department of Taxation and Finance
ORGANIZATIONWEISS
ORGANIZATIONFBAR S gnature
ORGANIZATIONthe Foreign Bank and Financial Accounts Report
ORGANIZATIONForeign Bank
ORGANIZATION