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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
Stop: enter line 11 amount on Form IT205, line 22 New York City full-year resident Individuals 12 Amount from Form IT•201. fine 49 13 Amount from Form IT-20VATT, line 32 14 Amount from Form IT-20VATT, line 33 15 Add lines 12. 13, and 14 16 Enter the lesser of line 11 or 15, and transfer the amount to Form
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
top: enter line 11 amount on Form IT-205, line 22 New York City full-year resident individuals 12 Amount from Form fT•201. line 49 13 Amount from Form IT-20VATT, line 32 14 Amount from Form IT-20VATT, line 33 15 Add lines 12. 13. and 14 16 Enter the lesser of line 11 or 15, and transfer the amount to Form
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
line 22 New York City full-year resident Individuals 12 Amount from Form IT•201. line 49 13 Amount from Form IT-201401T, line 32 14 Amount from Form IT-20VATT, line 33 15 Add Ines 12. 13. and 14 16 Enter the lesser of line 11 or 15, and transfer the amount to Form If-201•ATT, line 8 219001171019 III I
Entities connected to both Bribery Involving Public Servants and Form IT-20VATT
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
ORGANIZATIONVeterans'
ORGANIZATIONDefrauding the Government
ORGANIZATIONTotal New York State
ORGANIZATIONWorksheet A
ORGANIZATIONFirst Installment
ORGANIZATIONSecond Installment
ORGANIZATIONU.B.T.
ORGANIZATIONSpouse
ORGANIZATIONthe New York State Tax Department
ORGANIZATIONthe Dept. of Finance
ORGANIZATION