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0k .00 601 Mental Illness AntiStigrna Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o .00 60 Total voluntary contributions (add tines 60a through 60o) 61 Total New York State, New York City, Yonkers, and sales or use ta
1 s 1T-201LATT Name(s) as shown on your Form IT•201 ANASTASIYA SIROOCHENKO A Have you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200. 496. or section 195.20)? (see instruction
0k .00 601 Mental Illness Anti-Stigma Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o .00 60 Total voluntary contributions (add tines 60a through 60o) 61 Total New York State, New York City, Yonkers, and sales or use ta
shown on your FormIT.201 ANASTASIYA SIROOCHENKO Your social security number. A Have you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200. 496. or section 195.20)? (see instruction
0k .00 60I Mental Illness Anti-Stigma Fund 601 .00 60m Women's Cancers Education and Prevention Fund 60m .00 60n Autism Fund 60n .00 60o Veterans' Homes 60o 00 60 Total voluntary contributions (add fines 60a through 60o) 61 Total Now York State, New York City, Yonkers, and sales or use tax
your Form IT•201 Your social security number ANASTASIYA SIROOCHENKO 9816 A Have you (or an entity of which you are an owner) been convicted of Bribery Involving Public Servants and Related Offenses, Corrupting the Government, or Defrauding the Government (NYS Penal Law Article 200, 496. or section 195.20)? (see instruction
Entities connected to both Veterans' and Bribery Involving Public Servants
THE NY TAX DEPT
ORGANIZATIONNYC-210
ORGANIZATIONOointly
ORGANIZATION
Empire State
LOCATIONNYS/NYC
ORGANIZATIONthe U.S. Treasury Financial Agent
ORGANIZATIONKICTIM
ORGANIZATIONBreast Cancer Research Fund
ORGANIZATION60e Olympic Fund
ORGANIZATIONConservation Reserve Program
ORGANIZATIONDefrauding the Government
ORGANIZATIONTotal New York State
ORGANIZATIONWorksheet A
ORGANIZATIONForm IT-20VATT
ORGANIZATIONFirst Installment
ORGANIZATIONSecond Installment
ORGANIZATIONU.B.T.
ORGANIZATIONSpouse
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONthe Dept. of Finance
ORGANIZATION