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v. riven 2055) I FILER'S name 1 EPSTEIN INTERESTS Street address (Including room or suite number) 457 MADISON AVENUE City, state, and ZIP code LNEW YORK, NY 1 0 02 2 I Name of person to contact Telephone number For Official Use Only Email address Fax number Oli ( ) I EmptoyeriangiCation hun
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original document to us. EFTA00233099 EFTA00233100 LAW OFFICES Of GERALD B. Lzarcovirr, P.C. A PROFESSIONAL CORPORATION 148 EAST 78TH STREET TfEW YORK, NEW YORK 10081 GERALD B. LEFCOLIRT SHERY . RENATO C. STABILE FAITH A. FRIEDMAN BY FEDERAL EXPRESS Assistant United States Attorney Office of
°, Austin, TX 73301 North Carolina, Texas, Virginia Arkansas, Connectiout, Delaware, Kentucky, Maine, Massachusetts, Now Hampshire, New Jersey, Now York, Ohio, Pennsyivan'a, Rhode Island, Vermont, West Virginia Cincinnati, OH 48999 Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Maoist, Neb
rm W4SS. FTE0003 EFTA00233117 22222 }tollare, n n•imhte P NI mpoyeris name, 3CICM119, andLP coda FINANCIAL 1 Em oat and IP code last name CORNELIUS OMB No. 154-0320 1 Wagea epq ollt7COMPOOSIOSI 2 M Income tax withheld 36501.04 5365.00 3 Soots oacedty wages 4 scaled security tax wiltald 39
III I III II III 288602 11,19-'2 CONFIDENTIAL SDNY_GM_00033086 EFTA_(() 143699 EFTA01280226 11-204-IP (2012) Pago 3 of 4 Partner's share of Now York modifications (continued) 22 New York State subtractions Number A - Total amount 22a ES- 21 110. 22b ES- 22c ES- 22d ES- 22e ES- 22f ES- - New
FORMATION and end n6 Federal Employer ID Number 263172589 Partnership's Name, Address, and Zip Code LEVEL MANAGEMENT LLC 19401 OLD JETTON ROAD CORNELIUS NC 28031 Amount -72 51 0 0 0 0 0 CONFIDENTIAL Individuals Filing Form DADE Enter Amount on: Page 2, Line 35 Page 2, Line 36 Page 2, Lin
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