Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agency specifications. When using Acrobat 9.x products and later products, select "None"in the "Page Scaling" selection box in the Adobe "Print" dialog. CLIENT'S COPY EFTA00792171
Direct Deposit/Debit Report ANASTASIYA SIROOCHENKO ***_**_ IDNuntor U. i t Form Name of Financial Institution Account Type Routing Number Account Number Date Debi posit Amount FED 1040 CHECKING a ■ S lill ■ *** AIM _m t DEBIT 10/04/18 38,594. EFTA00792172
DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 (212) 695-5771 OCTOBER 4, 2018 ANASTASIYA SIROOCHENKO 288 WEST 4TH ST NEW YORK, NY 10014 DEAR ANASTASIYA: ENCLOSED ARE YOUR 2017 INCOME TAX RETURN AND 2018 ESTIMATED TAX VOUCHERS. SPECIFIC FILING INSTRUCTIONS ARE AS FOLLOWS. FEDERAL INCOME TAX RETURN: THIS RETURN HAS QUALIFIED FOR ELECTRONIC FILING AND THE PRACTITIONER PIN PROGRAM HAS BEEN ELECTED. AFTER REVIEWING THE RETURN FOR COMPLETENESS AND ACCURACY, PLEASE SIGN AND RETURN FORM 8879 TO OUR OFFICE BY MAIL, E-MAIL ([email protected]), OR FAX (212-695-5772). WE WILL THEN TRANSMIT YOUR RETURN ELECTRONICALLY TO THE IRS, AND NO FURTHER ACTION IS REQUIRED. RETURN FEDERAL FORM 8879 TO US AS SOON AS POSSIBLE (BY OCTOBER 15, 2018). YOUR BALANCE DUE OF $38,594 WILL BE AUTOMATICALLY WITHDRAWN FROM YOUR ACCOUNT ENDING IN 0359 ON OR AFTER OCTOBER 4, 2018. REFER TO FORM 1040 ON THE DIRECT DEPOSIT/DEBIT REPORT FOR COMPLETE ACCOUNT INFORMATION. FEDERAL ESTIMATED TAX VOUCHERS: SEPARATELY MAIL VOUCHER 4 OF FORM 1040-ES BY JANUARY 15, 2019. MAIL TO - INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 ENCLOSE YOUR CHECK FOR $443,400, PAYABLE TO THE UNITED STATES TREASURY. INCLUDE YOUR SOCIAL SECURITY NUMBER AND THE WORDS "2018 FORM 1040-ES" ON YOUR CHECK. RETAIN THE REMAINING VOUCHERS IN YOUR FILES AND MAIL TO THE ABOVE ADDRESS ON OR BEFORE THE DATE INDICATED. EFTA00792173
FOR YOUR REFERENCE WE HAVE LISTED ALL ESTIMATED TAX PAYMENTS AND THEIR ORIGINAL DUE DATES BELOW. VOUCHERS REQUIRING NO PAYMENT SHOULD NOT BE FILED. VOUCHER NO. 1 BY 04/17/18 NO PAYMENT REQUIRED VOUCHER NO. 2 BY 06/15/18 NO PAYMENT REQUIRED VOUCHER NO. 3 BY 09/17/18 NO PAYMENT REQUIRED VOUCHER NO. 4 BY 01/15/19 $443,400 YOUR COPY OF THE RETURN IS ENCLOSED FOR YOUR FILES. WE SUGGEST THAT YOU RETAIN THIS COPY INDEFINITELY. VERY TRULY YOURS, DAVID WEISS EFTA00792174
2017 TAX RETURN FILING INSTRUCTIONS U.S. INDIVIDUAL INCOME TAX RETURN FOR THE YEAR ENDING DECEMBER 31, 2017 Prepared for 111.101 Prepared by DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 Amount of tax Total tax $ 584,894 Less: payments and credits $ 547,000 Plus: interest and penalties $ 700 BALANCE DUE $ 38,594 Overpayment Miscellaneous Donations Credited to your estimated tax $ Refunded to you $ Make check payable to NOT APPLICABLE Mail tax return and check (if applicable) to THIS RETURN HAS QUALIFIED FOR ELECTRONIC FILING AND THE PRACTITIONER PIN PROGRAM HAS BEEN ELECTED. AFTER REVIEWING T1 RETURN, PLEASE SIGN AND RETURN FORM 8879 TO OUR OFFICE. WE W] THEN TRANSMIT YOUR RETURN ELECTRONICALLY TO THE IRS. Return must be mailed on or before RETURN FEDERAL FORM 8879 TO US BY OCTOBER 15, 2018. Special Instructions DO NOT MAIL THE PAPER COPY OF THE RETURN TO THE IRS. YOUR BALANCE DUE OF $38,594 WILL BE AUTOMATICALLY WITHDRAWN FROM YOUR ACCOUNT ENDING IN 0359 ON OR AFTER OCTOBER 4, 2018. REFER TO FORM 1040 ON THE DIRECT DEPOSIT/DEBIT REPORT FOR COMPLETE ACCOUNT INFORMATION. E LL 700351 04-01.17 EFTA00792175
2018 ESTIMATED TAX FILING INSTRUCTIONS U.S. ESTIMATED INDIVIDUAL INCOME TAX FOR THE YEAR ENDING DECEMBER 31, 2018 Prepared for ANASTASIYA SIRO• HENKO Prepared by DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 Amount of tax Total Estimated Tax S 643,400 ..... Less credit from prior year $ 0 Less amount already paid on 2018 estimate S 200,000 Balance due $ 443,400 It ipplir Payable in full or in installments as follows: fr Installment Amount Due Date No. 1 $ 0 APRIL 17 , 2018 No. 2 $ 0 JUNE 15, 2018 No. 3 $ 0 SEPTEMBER 17, 2018 No. 4 $ 443,400 JANUARY 15, 2019 Make check payable to UNITED STATES TREASURY Mail voucher and check (if applicable) to INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 Special Instructions INCLUDE YOUR SOCIAL SECURITY NUMBER AND THE 1040-ES" ON YOUR CHECK. VOUCHERS NEED NOT BE SIGNED. WORDS "2018 FORM 700021 044)I.1T EFTA00792176
TAX RETURN FILING INSTRUCTIONS REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS Prepared for ANASTASIYA SIROOCHENKO Prepared by DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 Form must be filed on or before RETURN FORM 114A TO US ON OR BEFORE OCTOBER 15, 2018. Special Instructions YOUR FORM 114 HAS BEEN PREPARED FOR ELECTRONIC FILING. PLEASE SIGN, DATE, AND RETURN FORM 114A TO OUR OFFICE. WE WILL THEN TRANSMIT YOUR FORM TO THE FINCEN. 04 0t .7 EFTA00792177
FINANCIAL CRIMES ENFORCEMENT NETWORK BSA E-Filing - Report of Foreign Bank and Financial Accounts (FBAR) Filing Name ANASTASIYA SIROOCHENKO Submission Type NEW PIN NOT REQUIRED FInCEN Form 114 Check here if this report is submitted by an authorized third party, and complete the 3rd party prepare, section on page one of the report. The E-tile system will auto complete item 46. NOTE: The FBAR must be received by the Department of the Treasury on or before April 17. 2018. An automatic extension to October 15.2018 is available. This report tiled late for the following reason (Check only one): a Forgot to file b d O O O Did not know that I had to file Thought account balance was below reporting threshold Did not know that my account qualified as foreign e Account statement not received in time z Account statement lost (Replacement requested) Late receiving missing required account information Unable to obtain joint spouse signature in time Unable to access BSA Efiling system Other (please provide explanation below) 773151 05-21-17 EFTA00792178
FinCEN Form 114 REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS Do NOT tile with your Federal Tax Return 1 This report is for calendar year ended 12/31 2017 Ame n art er intormation 2 Type of filer a W Individual b Partnership c Corporation d U Consolidated e Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Numbs *** -** -9816 If filer has no U S Identification 3a TIN type 4 Foreign identification (Complete only if item 3 is not applicable) 5 Individual's date of birth MWDD/YYYY In SSNATIN a Type' Passport IMI Foreign TIN Other ON b Number c Country of Issue number complete item 4 6 Last name or organization name SIROOCHENKO 7First name ANASTAS I YA 8 Middle initial 8a Suffix 9 Mailing address (number, street. and apt. or suite no.) 10 City NEW YORK 11 State NY 12 ZIP/Postal Code 10014 13 Country USA 14 a) Does the filer have a financial interest in 25 or more financial accounts? Yes I= Enter number of accounts Do not complete Part II or Part III, but maintain records of the Information. No IM b) Does the filer have signature authority over but no financial Interest in 25 or more financial accounts? Yes 0 Enter number of accounts Comp. Part IV, items 34 through 43 for each person on whose behalf the filer has sign. authority. No IM I Part III Information on financial account(s) owned separately 15 Maximum value of account during calendar year 15a Amount unknown 16 Type of account aLLI Bank bU Securities cl I Other Enter type below 11,781. Li 17 Name of financial institution In which account is held UNICREDIT BANK AUSTRIA AG 18 Account number or other designation *********6463 19 Mailing address (number, street, apt. or suite no.) of financial institution in which account is held SCHOTTENGASSE 6-8 20 City VIENNA 21 State, if known 22 Foreign postal code, if known 1010 WIEN 23 Country AUSTRIA Signature I 44a Check here LxJ if this report is completed b a third party preparer and complete the third party preparer section. 44 Filer signature Ilso ropon v. ii beeleCtrCnIcelly *IOW when Ned 45 Filer title. if not reporting a personal account 146 Date (MWDD Ma date will auto.I N Men the FBAR is ay.t.tionaiit ore, Third Party Preparer Use Only 47 Preparer's last name WEISS 48 First name DAVID 49 M 50 Check if self -employed x 51a TIN type I I PTIN SSNATIN Foreign 52 Contact phone no. sza Ext. 53 Firm's name DAVID WEISS CPA, PLLC 54 Firm's TIN **-***IIIII 54a TIN type LxJ EIN Foreign 55 Mailing address (number, scree . apt. or suite no 56 City 183 MADISON AVE SUITE 803 VIEW YORK 57 State NY 58 ZIP/Postal Code 10016-4403 59 Country US 723141 04.01-17 EFTA00792179
OMB No. 1545 0074 as my signature on my tax year 2017 electronically filed income tax return. Form 8879 Department of the Treasury Internal Revenue Service IRS e-file Signature Authorization ► Return completed Form 8879 to your ERO. (Do not send to IRS.) ► Go to www.Irs.gov/Form8879 for the latest Information. 2017 Submission Identification Number (SID) Taxpayer's name ANASTASIYA SIROOCHENKO Social security number ***4**4. Spouses name Spouse's social secure num er . . liPart rl Tax Return Information - Tax Year Ending December 31, 2017 (Whole dollars only) 1 Adjusted gross income (Form 1040. line 38; Form 1040A, line 22; Form 1040€Z. line 4; Form 1040NR. line 37) 1,616,657. 2 Total tax (Form 1040. line 63; Form 1040A, line 39; Form 1040EZ, line 12; Form 1040NR, line 61) 2 584,894. 3 Federal income tax withheld from Forms W2 and 1099 (Form 1040• line 64; Form 1040A, line 40; Form 1040€2, line 7; Form 104014R, line 62a) 4 Refund (Form 1040, line 76a; Form 1040A, line 48a; Form 1040EZ, fine 13a; Form 1040-5S, Part I, line 13a; Form 1040NR. line 73a) 5 Amount you owe (Form 1040. line 78: Form 1040A. tine 50: Form 1040EZ. line 14: Form 1040NR. line 75) 5 38,594. Part III Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return) Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements for the tax year ending December 31, 2017, and to the best of my knowledge and belief, it is true, correct and accurately lists all amounts and sources of income I received during the tax year. I further declare that the amounts in Part I above are the amounts from my electronic income tax return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. tt applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellation requests must be received no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent Taxpayer's PIN: check one box only M I authorize DAVID WEISS CPA, PLLC to enter or generate my PIN ERO firm name as my signature on my tax year 2017 electronically filed income tax return. Enter five digits, but don't enter all zeros I will enter my PIN as my signature on my tax year 2017 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below. Your signature ► Date Ilso 10/04/2018 Spouse's PIN: check one box only I authorize to enter or generate my PIN ERO firm name Enter five digits, but don't enter all zeros CI I will enter my PIN as my signature on my tax year 2017 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below. Spouse's signature ► Date ► Practitioner PIN Method Returns Only - continue below Part III I Certification and Authentication - Practitioner PIN Method Only ERO's EFIN/PIN. Enter your six•digit EFIN followed by your frve•digit self•selected PIN. Don't enter all zeros I certify that the above numeric entry is my PIN. which is my signature for the tax year 2017 electronically filed income tax return for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns. ERO's signature Ito. DAVID WEISS CPA, PLLC Date ► 719995 11-10.17 ERO Must Retain This Form - See Instructions Don't Submit This Form to the IRS Unless Requested To Do So LHA For Paperwork Reduction Act Notice, see your tax return instructions. Form 8879 (2017) EFTA00792180
Tax Year 2017 e-file Jurat/Disclosure for Form 1040, 1040A, 1040EZ, or 1040NR using Practitioner PIN method (with or without Electronic Funds Withdrawal) ERO Declaration I declare that the information contained in this electronic tax return is the information furnished to me by the taxpayer. If the taxpayer furnished me a completed tax return, I declare that the information contained in this electronic tax return is identical to that contained in the return provided by the taxpayer. If the furnished return was signed by a paid preparer, I declare I have entered the paid preparer's identifying information in the appropriate portion of this electronic return. If I am the paid preparer. under the penalties of perjury I declare that I have examined this electronic return, and to the best of my knowledge and belief. it is true, correct. and complete. This declaration is based on all information of which I have any knowledge. ERO Signature I am signing this Tax Return by entering my PIN below. ERO's PIN (enter EFIN plus 5 self-selected numerics) Taxpayer Declarations Perjury Statement Under penalties of perjury. I declare that I have examined this return and accompanying schedules and statements. and to the best of my knowledge and belief, they are true, correct and accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other than the taxpayer) Is based on all information of which the preparer has any knowledge. Consent to Disclosure I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send my return/fonn to IRS and to receive the following information from IRS: a) an acknowledgment of receipt or reason for rejection of transmission: b) the reason for any delay in processing or refund: and. c) the date of any refund. I am signing this Tax Return and Electronic Funds Withdrawal Consent, it applicable, by entering my Self-Select PIN below. Taxpayer's PIN: Date 10042018 Spouse's PIN: 719966 044)1.17 EFTA00792181
Form 114a Department of the Treasury Financial Crimes Enforcement Network (FinCEN) May 2015 Record of Authorization to Electronically File FBARs (See instructions below for completion) Do not send to FinCEN. Retain this form for your records. TM form 114a may be digitally signed Part I I Persons who have an obligation to file a Report of Foreign Bank and Financial Account(s) 1. Owner last name or entity s legal name S I ROOCHENKO 2. Owner first name ANASTASIYA 3. Owner . 4. Spouse last name Of jointly filing FBAR • see instructions below) 5. Spouse first name 6. Spouse Vwe declare that Vwe have provided information concerning 1 (enter number of accounts) foreign bank and financial account(s) for the filing year ending December 31, 2 017 to the preparer listed in Part It that this information is to the best of my/our knowledge true. correct, and complete; that Vwe authorize the preparer listed in Part II to complete and submit to the Financial Crimes Enforcement Network (FinCEN) a Report of Foreign Bank and Errands] Accounts (FBAR) based on the information that Vwe have provided: and that Vwe authorize the preparer listed in Part II to receive information from FinCEN. answer inquiries and resolve issues relating to this submission. Vwe acknowledge that, notwithstanding this declaration, it is my/our legal responsibility, not that of the preparer listed in Part II, to timely file an FBAR if required by law to do so. 7. Owner signature (Authorized representative if entity) 8. Date 9. Owner or entity TIN *** -** -9816 10. TIN a type b c L_I Ill O ON SSWITiN, Foreign MM DD YYYY 11. Spouse signature 12. Date 13. Spouse TIN 14. TIN a L_I ON type b O SSNATIN c O Foreign MM DD YYYY Part II I Individual or Entity Authorized to File FBAR on behalf of Persons who have an obligation to file. 15. Preparer last name WEISS 16. Preparer first name DAVID 17. Preparer 18. Preparer PTIN 19. Address 183 MADISON AVE SUITE 803 20. City NEW YORK 21. State NY 22 ZIP/postal code 10016-4403 23. Country code US 24. Preparers (item 15) employer's (En ity) name DAVID WEISS CPA, PLLC 25. Employer EIN 26. Preparers signature DAVID WEISS Instructions for completing the FBAR S gnature Authorization Record This record may be completed by the individual or entity granting such authorization (Part I) OR the individuaVentity authorized to perform such services. The completed record must be signed by the individuaksyentity grant ng the authorization (Part I) and the individuaVentity that will file the FBAR. TM Preparer/filing entity must be registered with FinCEN BSA EFile system. (See http://bsaefiling.fincentreas.gov/main.html for registration). Read and complete the account owner statement in Part I. To authorize a third party to file the Foreign Bank and Financial Accounts Report (FBAR), the account owner should complete Part I. items 1 through 3 (as required), sign and date the document in Part I, items 7)8 and complete items 9 and 10. Item 7 may be digitally signed. Accounts Jointly Owned by Spouses (see exceptions in the FBAR instructions) If the account owner is filing an FBAR jointly with his/her spouse, the spouse must also complete Part I, items 4 through 6. The spouse must also sign and date the report in items 11/12. (item 11 may be digitally signed) and complete items 13 and 14. A third party preparer may be one of the spouses of the jointly owned foreign account. In this case, both spouses must complete Part I of form 114a in its entirety. The third party preparer (spouse) that will file the FBAR on behalf of both spouses will complete Part II in its entirety (do not use such terms as see above, or same as item number a. Complete Part II, items 15 through 18 with the preparer's information. The address, items 19 through 23. is that of the preparer or the preparer's employer if the preparer is an employee. Record the employer's information (if any) in items 24 and 25. If the preparer does not have a PTIN. leave item 18 blank The third party preparer must sign in item 26 (digital signature acceptable) of Part II indicating that the FBAR will be filed as directed by the authorizing authority. The person(s) listed in Part I, and the person listed it Part II as authorized to file on behalf of the person(s) listed in Part I. should retain copies of this record of authorization and the filing itself, both for a period of 5 years. See 31 CFR 1010.430(d). DO NOT SEND 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 REVENUE SERVICE CENTER P.O. BOX 37009 HARTFORD, CT 06176-7009 718711 06.15.17 • DETACH HERE • .4868 Dapartmon1 t'A TIBOSisy Intganal Finc.ILA Sqrvice SKS Application for Automatic Extension of Time To File U.S. Individual Income Tax Return Ft, <Macau pia. 7017 ar iffisr fa. year bnqnring anaing 2017 Part I I Identification Part II I Individual Income Tax 4 Estimate of total tax liability for 2017 547,000. 5 Total 2017 payments 47,000. 6 Balance due. Subtract line 5 from line4 500,000. 7 Amount you are paying ► 500,000. 8 Check here if you are 'out of the country and a U.S. citizen or resident 9 Cada bona n you file Fpm 11)40fIR a 1040NR.E7 and did not roman 1 taananWs) ANASTASIYA SIROOCHENKO 2 You' social security nit a 3 Spouses Social security nurrbee sagas as an enacts. StanjaC110 U.S. Into no tax volthalling ********* YF SIRO 30 0 201712 670 EFTA00792183
2018 Estimated Tax Worksheet Keep for Your Records 1 Adjusted gross income you expect in 2018 (see instructions) 2a Deductions • If you plan to itemize deductions, enter the estimated total of your Itemized deductions. These include qualifying home mortgage interest, charitable contributions, state and local taxes (up to $10,000). and medical expenses in excess of 7.5% of your income.' • If you dont plan to itemize deductions. enter your standard deduction. b If you qualify for the deduction under section 199A, enter the estimated amount of the deduction you are allowed on your qualified business income from a qualified trade or business c Add lines 2a and 2b ► 3 Subtract line 2c from line 1 4 Tax. Figure your tax on the amount on line 3 by using the 2018 Tax Rate Schedules. Caution: If you wN have qualified dividends or a net capita( gain, or expect to exclude or deduct foreign earned Income or housing, see Worksheets 2-5 and 2-6 in Pub. 505 to figure the tax 6 Alternative minimum tax from Form 6261 or included on Form 1040A, line 28 6 Add lines 4 and 5. Add to this amount any other taxes you expect to include in the total on Form 1040. line 44 7 Credits (see instructions). Do not include any income tax withholding on this line 8 Subtract line 7 from line 6. If zero or less, enter 43- 9 Self employment tax (see instructions) 10 Other taxes (see instructions) 11a Add lines 8 through 10 b Eamed income credit, additional child tax credit, fuel tax credit, net premium tax credit, refundable American opportunity credit, and refundable credit from Form 8885 c Total 2018 estimated tax. Subtract line 11b from line 11a. If zero or less. enter .0. ► 12a Multiply line 11c by 90% (66 2/3% for farmers and fishermen) 12a Silir I b Required annual payment based on prior year's tax (see instructions) 12b c Required annual payment to avoid a penalty. Enter the smaller of line 12a or 12b Caution: Generally, if you do not prepay (through income tax withholding and estimated ax payments) at least the amount on fine 12c, you may owe a penalty for not paying enough estimated tax. To avoid a penalty, make sure your estimate on line f is Is as accurate as possible. Even if you pay the required annual payment, you may still owe tax when you file your return. If you prefer, you can pay the amount shown on line tic. For details, see chapter 2 of Pub. 505. 13 Income tax withheld and estimated to be withheld during 2018 (including income tax withholding on pensions, annuities, certain deferred income, etc.) 14a Subtract Me 13 from Me 12c ADJUSTED TO: 14a 643,400. Is the result zero or less? 0 Yes. Stop here. You are not required to make estimated tax payments. 0 No. Go to line 14b. b Subtract line 13 from Me 11c 1 2a 2b 2c 3 4 5 6 7 8 9 10 11a 11b 11c 12c 13 14b Is the result less than $1,000? 0 Yes. Stop here. You are not required to make estimated tax payments. 0 No. Go to line 15 to figure your required payment. 16 If the first payment you are required to make is due April 17. 2018. enter 1/4 of Me 14a (minus any 2017 overpayment that you are applying to this instalkeent) here, and on your estimated tax payment vouchers) if you are paying by check or money order 'When figuring your 2018 estimated taxes, and estimating your deductions, you might want to take into account that the standard deduction for all filing statuses has increased substantially and many itemized deductions have been eliminated or the deduction amount has been reduced. See the items under What's New. AMOUNT ALREADY PAID 15 Form 1040-ES (2018) 200,000. 710401 03-06.111 EFTA00792184
0 1040-ES Moat-Veva] of !Iv negate, LI- Internal RE/venue SevICO I 2018 Estimated Tax Payment 4 Voucher I 0 ,113 No 1545.0374 File only if you are making a p yment of estimated tax by check or money order. Mail this voucher with your check or m ney order payable to 'United States Treasury." Write your social security number a d '2018 Form 1040-ES' on your check or money order. Do not send cash. Enclose, bu do not staple or attach, your payment with this voucher. Your first name and initial ASTASIYA It mint payment, complete tor spouse Spouse's first name and initial Your last name S IROOCHENKO Calendar year - Due April 17, 2018 Amount of estimated tax you are paying by check or money order. i S 0. our social security number Spouses last name Spouses social security number Address number stree and a' t. no.) City, state, and ZIP code. (If a foreign address, enter city, also complete spaces below.) EW YORK, NY 10014 Foreign country name Foreign prownce/county Foreign postal code LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. CUT HERE MAIL TO: INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 710411 03-06.15 EFTA00792185
E r11942-CO 0 0,....., 01 the nocsArY I u. m.m."...s.u. payment n 2018 Voucher c Estimated Tax OV8 No 1545.0374 ile my if you are making a p /meat of estimated tax by check or money order. Mail this oucher with your check or m ney order payable to 'United States Treasury." Write ou social security number a d '2018 Form 1040-ES" on your chec or money order. Do of send cash. Enclose, bu do not staple or attach, your payment with this voucher. Calendar year- Due June 15, 2018 Amount of estimated tax you are paying by check or money order. $ 0. Print or type Your first name and initial ASTASIYA Your last name SIROOCHENKO Your social securit number If mint payment, comp wo e Spouse's first name and initial Spouses last name Spouses social security number Address number stree and a t. no. City, state, and ZIP code. (If a foreign address, enter city, also complete spaces below.) EW YORK, NY 10014 Foreign country name Foreign prownce/county Foreign postal code LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. CUT HERE MAIL TO: INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 210412 03-06.18 EFTA00792186
E I WW-C.0 o ovaarnoni a tho neesury I Li- wammvonwswvice payment •3 2018 Voucher 0 Estimated Tax CMS No 1SS41074 ile only it you are making a p yment of estimated tax by check or money order. Mail this oucher with your check or m ney order payable to 'United States Treasury.' Write our social security number a d '2018 Form 1040-ES- on your check or money order. Do not send cash. Enclose, bu do not staple or attach, your payment with this voucher. Calendar year- Due Sept. 17.2018 Amount of estimated by check or money order. tax you are paying s 0. i Print or type Your first name and initial ANASTASIYA Your last name SIROOCHENKO our social secunh number It mint payment, complete tor spouse Spouse's first name and initial Spouse's last name Spouses social security number Address number. street and a t no. i .sae, an co e. a °reign a ress, enter city, also complete spaces below.) NEW YORK, NY 10014 Foreign country name Foreign province/county Foreign postal code LHA For Privacy Act and Paperwork Reduction Act Notice, see I structions. CUT HERE MAIL TO: INTERNAL REVENUE SERVICE CENTER P.O. BOX 37007 HARTFORD, CT 06176-7007 71047I 03-06.15 EFTA00792187
E I WHJ-CO O Depanment al the Treasury I LI- wammomiu.semo. payment 4 . 2018 Voucher Estimated Tax CMS No istsdon ile only it you are making a p yment of estimated tax by check or money order. Mail this oucher with your check or m ney order payable to 'United States Treasury? Write our social security number a d '2018 Form 1040-ES' on your check or money order. Do not send cash. Enclose, bu do not staple or attach, your payment with this voucher. Calendar year- Due Jan. 15, 2019 Amount of estimated tax you are paying by check or money order. $ 443,400. I Print or type Your first name and initial ANASTASIYA Your last name SIROOCHENKO Your social security number it mint payment, comp e or spouse Spouse's first name and initial Spouse's last name Spouses social security number Address number street and a t. no. City, state, and ZIP code. (If a foreign address, enter city, also complete spaces below.) NEW YORK, NY 10014 Foreign country name Foreign province/county Foreign postal code LHA For Privacy Act and Paperwork Reduction Act Notice, see Instructions. CUT HERE MAIL TO: INTERNAL REVENUE SERVICE CENTER III. BOX 37007 HARTFORD, CT 06176-7007 4zr O 710422 03-06.15 EFTA00792188
E 1040 U.S. Individual Income Tax Return 6 120 1 71 For me V 1.0gc 31. 2017. Or ells, yam been 2017. en 01n9 20 See separate Instruction Your first name and initial ANASTASIYA Last name S IROOCHENKO Vote social apathy number If a joint return, spouse's first name and initial Last name SPatsWit Social Sacteity number home address (number and street). It you have a P.O. ox, see instructions. Apt no. A rem sure the $Stefe) above and on Me 6c are correct. City. town a post Office. Stab. and ZIP cos. It you have a foreign °cities. alS3 complete spaces below. NEW YORK, NY 10014 Presidential Mention twmpaign Chock here b you, or your spews It filing Jointly. want $310 go to mist nd Chcod g a box below Foreign country name Foreign province/state/county Foreign postal code will not change your tax re rotund. 0 You 0 spouse 00.13 No. 1545.0074 AS Use Only - Do not write or staple in this space Filing Status Check only one box. 1 l.X.l Single 2 0 Married filing jointly (even if onl one had income) 3 0 Married filing separately. Enter spouses SSN above and full name here. ► 6a LX.I Yourself. If someone can claim you as a dependent, do not check box 6a b 0 Spouse c Dependents: (firm name 4 I I Head of household (with qualifying person). If the qualifying person i a child but not your dependent, enter this child's name he e. 10, 5 0 Qualifying widow(er) (see instructions) Exemptions If more than four dependents, see instructions and Q check here pl. Last name 12) Omende st nr SOCIel SeOurity nuner DePeindent's tea:Instils to yOu Boxes checked on 6a and Eh No of children /0 Mb Sc h° vAtt ag 1 , h wee with you ILIMP(/ m hu odes not We with Runde you duo to divorce a separation leap insructieeel "NI d Total number of exemptions claimed Dependents on 6c not entered above Add numtors on lines._ above P"' Income Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld. If you did not get a W-2, see instructions. 7 Wages, salaries, tips, etc. Attach Form(s) W-2 8a Taxable interest Attach Schedule B it required b Tax-exempt interest. Do not include on line 8a 9a Ordinary dividends. Attach Schedule Bid required b Qualified dividends I Ob 10 11 12 13 Capital gain or (loss). Attach Schedule D U required. If not required, check here 14 Other gains or (losses). Attach Form 4797 15a IRA distnbutions 16a Pensions and annuities [5a I b Taxable amount 16a b Taxable amount 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 18 Farm income or (loss). Attach Schedule F 19 Unemployment compensation 20a Social security benefits p 20a j P b Taxable amount 21 Other income. List type and amount 22 Combine the amounts in the tar right column for lines 7 through 21. This is your total Income 23 Educator expenses CerNM business expenses of reservists. Manaming artists. and hasbaSISLIonnnsant 24 officleas Attach Fam 2106 or 2106-92 25 Health savings account deduction. Attach Form 8889 26 Moving expenses. Attach Form 3903 27 Deducdble part of self-employment tax. Attach Schedule SE 28 Self-employed SEP, SIMPLE, and qualified plans 29 Self-employed health insurance deduction 30 Penalty on early withdrawal of savings 31a Alimony paid b Recipient's SSN 32 IRA deduction 33 Student loan interest deduction 34 Tuition and fees. Attach Form 8917 35 Domestic production activities deduction. Attach Form 8903 36 Add lines 23 through 35 Taxable refunds, credits, or offsets of state and local income taxes Alimony received Business income or (loss). Attach Schedule C or C-EZ ► 7 8a 755. 9a 10 11 12 13 14 15b 16b 17 18 19 20b 21 22 1,645,828. ► 1,646,583. Adjusted Gross Income 23 24 25 26 27 28 29 30 31a 32 33 34 35 29,926. 710301 02-22.18 37 Subtract line 36 from line 22. This is your adjusted gross Income ► 36 37 29,926. 1,616,657. LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Pam 10400017) EFTA00792189
Earn 1040('0171 ANASTASIYA SIROOCHENKO Tax and 38 Amount from line 37 (adjusted gross income) Credits 39a Check 0 You were born before January2, 1953, 0 Blind. Total boxes DoclAtion . if: 0 Spouse was born before January 2, 1953, O Blind. J checked O. 39a • People wbo b It your spouse itemizes on a separate return or you were a dual-status alien, check here ► 39b chodt any box on line 3% or 40 39b OF who can be %%led DS a 41 Subtract line 40 from line 38 Satendant, see instrucbone. 42 43 44 45 • a °thaw 46 Excess advance premium tax credit repayment Attach Form 8962 Single or Mad% Ell0 9 47 Add lines 44, 45, and 46 Separately, $6.350 48 Foreign tax credit Attach Form 1116 if required Married MIN/ 49 Credit for child and dependent care expenses. Attach Form 2441 pinny e' Quamyho 50 Education credits from Form 8863, line 19 wdowlarl $1I2.730 . 51 Retirement savings contributions credit Attach Form 8880 Hood ot 52 Child tax credit Attach Schedule 8812, it required beufaltiold. $9.350 53 Residential energy credits. Attach Form 5695 54 Other credits from Form' a 0 3800 b 0 8801 c 55 Add lines 48 through 54. These are your total credits 56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- 38 Pao‘ 2 1,616,657. Itemized deductions (from Schedule A) or your standard deduction (see left margin) Exemptions. If line 38 is $156,900 or less, multiply $4,050 by the number on line 6d. Otherwise, see inst Taxable Income. Subtract line 42 from line 41.11 line 42 is more than line 41_,_ enter -0- Tax. Check if any from: a Form(s)Et814 b Form 4972 aL_I Alternative minimum tax. Attach Form 6251 ► 40 41 42 43 44 45 46 47 209,276. 1,407,381. 0. 1,407,381. 513,142. 513,142. 48 49 50 51 52 53 54 At 55 56 57 58 59 60a 60b 61 62 63 513,142. 57 Self-employment tax. Attach Schedule SE Other 58 Unreported social security and Medicare tax from Form: al= 4137 b 0 8919 Taxes 59 Additional tax on IRAs, other qualified retirement plans, et. Attach Form 5329 if required 60a Household employment taxes from Schedule H b First-time homebuyer credit repayment Attach Form 5405 it required 61 Health care: Individual responsibility (see instructions) PSI-year coverage 62 Taxes from: a M Form 8959 b M Form 8960 c 0 hut enter code(s) STATEMENT 2 63 Add lines 56 through 62. This is your total tax ► 59,851. 11,901. 584,894. Payments 64 Federal income tax withheld from Forms W-2 and 1099 65 2017 estimated tax payments and amount applied from 2016 return 66 a Earned income credit (EIC) b Nontaxable combat pay election 66b 67 Additional child tax credit Attach Schedule 8812 4 . 68 American opportunity credit from Form 8863, line 8 69 Net premium tax credit. Attach Form 8962 70 Amount paid with request for extension to file 71 Excess social security and tier 1 RRTA tax withheld - 72 Credit for federal tax on fuels. Attach Form 4136 73 Credits from Form: a 0 2439 b O gismo 08885 dp 74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments you hay* qua llyhg • aria% Schedule EIC 64 65 66a 47,000. 67 68 69 70 71 72 73 500,000. 74 75 76a STATEMENT 3 547,000. Refund 75 If line 74 is more than fine 63, subtract line 63 from line 74. This is the amount you overpaid d‘coit., 0. 76ab ii:Airillount of line 75 you want refunded to you. If Form 8888 is attached, check here urea Sae 011' c two 0 Ocean „,,,„g, p.driggl p. in 1 in" fl Ctir'n 77 Amount of line 75 you want applied to your 2018 estimated tax Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions Pio 79 l 700. You Owe 79 Estimated tax penalty (see instructions) Third Party Do you want to allow another person to discuss this return with the IRS (see instructions ? IV Yes Complete below. L_I No Designee F'12,7"10.DAVID WEISS Phtta kb. n r Personal Klaudicabon number (PI% Sign Unit! PrabiS Of [MU% I &CUMIN' I hiwparnotatisroman acconpanymg V.:Wm and altmtnis, and b Mimic, nybtosIttlptard Met Orin Pue.torrecl. and muettly hi at arm toms and swots ot ironImam' dirty Its En her. (*brew!, ol ;chow bhp dun tumuli is Malonall ntormilion of Muth ppm his nylon/Me Here you *Waive I Data Yaw OCCUPatiOn Darin,. phone motif Joint rokrra See Keep a copy Spouse's%future. I a phi velum. both must sir. Date tor yow record& 78 38,594. instructions. ART DEALER Spouse's Ocatpabon It the PS soot you an Identity Pro ad Pei I enter it here Churl Li it Sqlf-afrpletyad Print(TYPe wawa name Plepareir'S Slratta Paid Preparer DAVID WEISS Use Only tm's oar% leoDAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 719002 02-22.1$ FM'S (WOWS la.NEW YORK, NY 10016-4403 DAVID WEISS Date EFTA00792190
F.. 2210 Dopanmem M thaileaseey ememaineventaeSomice Underpayment of Estimated Tax by Individuals, Estates, and Trusts ► Go to www.irs.gov/Form2210 for instructions and the latest information. ► Attach to Form 1040, 1040A, 1040NR, 1040NR-EZ or 1041. OWNo.1545-0074 2017 Attachromt SOQuaMM116 Name(s) shown on tax r turn ANASTASIYA SIROOCHENKO Identifying number Do You Have To File Form 2210? Yes Complete Ines 1 through 7 below. Is line 7 less than $1.000? Don't file Form 2210. You dont owe a penalty. Yes lir No Complete lines 8 and 9 below. Is line 6 equal to or more than line 9? You don't owe a penalty. Don't file Form 2210 (but if box E n Part II applies, you must file page 1 of Form 2210). Yes No You may owe a penalty. Does any box in Part II below apply? You must file Form 2210. Does box B, C, or Din Part II apply? Don't file Form 2210. You aren't required to figure your penalty because the IRS will figure it and send you a bill for any unpaid amount. If you want to figure it, you may use Part Ill or Part IV as a worksheet and enter your penalty amount on your tax return, but don't file Form 2210. Yes ► You must figure your penalty. You aren't required to figure your penalty because the IRS will figure it and send you a bit for any unpaid amount. If you want to figure it. you may use Part III or Part W as a worksheet and enter your penalty amount on your tax retum, but file only page 1 of Form 2210. I Part I I R d A equire nnual Paymen t 1 Enter your 2017 tax alter credits from Form 1040, line 56 (see instructions it not tiling Form 1040) 2 Other taxes, including self-employment tax and, it applicable, Additional Medicare Tax and/or Net Investment Income Tax (see instructions) 3 Refundable credits, including the premium tax credit (see instructions) 4 Current year tax. Combine tines 1, 2, and 3. If less than $1,000. stop; you don't owe a penalty. Don'tfile Form 2210 5 Multiply line 4 by 90%(0.90) I 5 I 526,405. 6 Withholding taxes. Don't include estimated tax payments (see instructions) 7 Subtract line 6 from line 4. If less than $1,000, stop;you don't owe a penalty. Don'tfile Form 2210 8 Maximum required annual payment based on prior year's tax (see instructions) 9 Required annual payment. Enter the smaller of line 5 or line 8 Next Is line 9 more than line 6? No. You don't owe a penalty. Don't file Form 2210 unless box E below applies. M Yes You may owe a penalty, but don't file Form 2210 unless one or more boxes in Part II bebw applies. • If box B, C, or D applies, you must figure your penalty and file Form 2210. • If box A or E applies (but not B, C, or D) file only page 1 of Form 2210. You aren't required to figure your penalty; the IRS will figure it and send you a bill for any unpaid amount If you want to figure your penalty, you may use Part III or IV as a worksheet and enter your penalty on your tax return, but file only page 1 of Form 2210. 2 3 4 513,142. 71,752. 584,894. 6 7 8 9 584,894. 41,820. 41,820. I Part III Reasons for Filing. Check applicable boxes. If none apply, don't file Form 2210. A Li You request a waiver (see instructions) of your entire penalty. You must check this box and file page 1 of Form 2210, but you aren't required to figure your penalty. B 0 You request a waiver (see instructions) of part of your penalty. You must figure your penalty and waiver amount and file Form 2210. C 0 Your income varied during the year and your penalty is reduced or eliminated when figured using the annualized income installment method. You must figure the penalty using Schedule Al and file Form 2210. D 0 Your penalty is lower when figured by treating the federal income tax withheld from your income as paid on the dates it was actually withheld, instead of in equal amounts on the payment due dates. You must figure your penalty and file Form 2210. E 0 You filed or are filing a joint return for either 2016 or 2017, but not for both years, and line 8 above is smaller than line 5 above. You must file page 1 of Form 2210. but you aren't required to figure your penalty (unless box 8, C, or D applies). LJ1A For Paperwork Reduction Act Notice, see separate Instructions. Form 2210 (2017) 440008.V EFTA00792191
Form2210(2M7) ANASTASIYA SIROOCHENKO Regular Method (See the instructions if you are filing Form 1040NR or 1040NR.EZ.) Section A - Figure Your Underpayment Payment Due Dates (a) 4/15/17 (b) 6/15/17 (c) 9/15117 (d) 1/15/18 18 Required installments. If box C in Part II applies, enter the amounts from Schedule Al, the 25. Otherwise, enter 25% (0.25) of line 9, Form 2210, in each column 19 Estimated lax pad and tax Wanheld. For criumn (a) only. also go* the amount from line 19 on line 23. II line 19 Is papal to or more than line la for all payment periods, Stop IlOoX you 5511 oma a penalty. Don't file Form 2210 unless you checked a box In Part II Complete lines 20 through 26 of one column before going to line 20 of the next column. 20 Enter the amount, it any, from line 26 in the previous column 21 Add lines 19 and 20 22 Add the amotas on linos 24 and 25 In lho prasIC9S canna 23 Subtract line 22 from line 21. If zero or less, enter -0-. For column (a) only, enter the amount from line 19 24 If line 23 is zero, subtract line 21 from line 22. Otherwise, enter -0- 25 Underpayment. If line 18 is equal to or more than line 23, subtract line 23 from line 18. Then go to line 20 of the next column. Otherwise, go to line 26 ► 26 Overpayment. If line 23 is more than line 18, subtract line 18 from line 23. Then go to line 20 of the next column 18 10,455. 10,455. 10,455. 10,455. 19 47,000. 20 21 47,000. 22 10,455. 20,910. 31,365. 23 0 . 0 . 0 . 15,635. 24 10,455. 20,910. 25 10,455. 10,455. 10,455. 26 Page 3 ec ion B - Figure the Penalty (Use the Worksheet for Form 2210. Part IV. Section 8 Figure the Penalty in the instructions.) 27 Penalty. Enter the total penalty from line 14 of the Worksh et for Form 2210. Part IV. Section B - Figure the Penalty. Also include this amount on Form 1040, line 79; Form 1040A, line 51; Form 1040NR, line 76; Form 1040NR-EZ. line 26; or Form 1041, line 26. Don't file Form 2210 unless you checked a box In Part II ► Form 2210(2017) SEE ATTACHED WORKSHEET 27 700. 712411 01-05-18 EFTA00792192
UNDERPAYMENT OF ESTIMATED TAX WORKSHEET ANASTASIYA SIROOCHENKO (]cult; I* , MI Amount (C) kleiMed Balance Due a 3 0,e :E Ddi ' Peral.4Pote -0- 04/15/17 10,455. 10,455. 61 .000109589 70. 06/15/17 10,455. 20,910. 92 .000109589 211. 09/15/17 10,455. 31,365. 122 .000109589 419. 01/15/18 10,455. 41,820. 01/15/18 -47,000. -5,180. Penalty Due (Sum of Column F). 700. • Date of estimated lax payment, withholding credit date or installment due date. 7 125 11 W451.17 EFTA00792193
SCHEDULE A (Form 1040) Department 0 trio TreaSeY au., Inianal AMNIA $40440 `—', itemized Deductions Iii. Go to www.irs.gov/ScheduleA for instructions and the latest information. Illa Attach to Form 1040. Caution. II you no damson n not nt 'Miami (tomstor Nom on Form 4684 gee the metro lotions toe hno OMB N0. 1545-0074 2017 Arlachment hequreice No. a ., In harrieN) shown on aorm 1040 ANASTASIYA SIROOCHENKO eV social security runty Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions) SEE STATEMENT 6 1 3,836. Dental 2 Enter amount from Form 1040, line 38 I 211,616,657. Expenses 3 Multiply Erne 2 by 7.5% (0.075) 3 121,249. 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter 41 I 4 0 . Taxes You 5 State Paid a and fl local (check only one Income taxes, or l box): SEE STATEMENT 4 5 227,641. b 0 General sales taxes 6 Real estate taxes (see instructions) 6 7 Personal property taxes 7 8 Other taxes. List type and amount Illi. 8 9 Add lines 5 through 8 9 227,641. Interest io Home mortgage interest and points reported to you on Form 1098 10 You Paid 11 Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home. see instructions and show that person's name. Identifying no.. and address P Note: I , 11 Your mortgage 12 Points not reported to you on Form 1098. See instructions for special rules interest 12 deduction may 13 Mortgage insurance premiums (see instructions) 13 be limited (see 14 Investment interest. Attach Form 4952 if required. See instructions 14 instructions). 15 Add lines 10 through 14 115 Gifts to 16 Gifts by cash or check If you made any gift of $250 or more, see instructions 16 22,290. Charity 17 Other than by cash or check. If any gift of $250 or more, see instructions. If you made a You must attach Form 8283 if over 5500 1 17 STMT 5 gift and got a benefit for it, 18 Carryover from prior year 18 see instructions. 19 Add lines 16 through 18 19 22,290. Casualty and 20 Casualty or theft loss(es) other than net qualified disaster losses. Attach Form 4684 Theft Losses enter the amount from line 18 of that form. See instructions . . . . and 20 Job Expenses 21 Unreimbursed employee expenses - job travel, union dues. job education. etc. and Certain Attach Form 2106 or 2106EZ if required. See instructions. P Miscellaneous Deductions 21 22 Tax preparation fees 22 23 Other expenses • investment, safe deposit box, etc. List type and amount p. 23 24 Add lines 21 through 23 24 25 Enter amount from Form 1040, line 38 1261 26 Multiply line 25 by 2% (0.02) 26 27 Subtract line 26 from line 24. If line 26 Is more than line 24. enter 41 27 Other 28 Other • from list in instructions. List type and amount Ph. Miscellaneous Deductions 28 29 Is Total Form IMI 1040, line 38. over $156,900? No. Your deduction is not limited. Add the amounts in the far right column for lines 4 through 28. Also. enter this amount on Form 1040. line 40. STMT 7 29 209,276. Itemized M Yes. Your deduction may be limked. See the Itemized Deductions Deductions Worksheet in the instructions to figure the amount to enter. 30 If you elect to itemize deductions even though they are less than your standard deduction. check here P n LHA 7t9 Dl 02-22-113 For Paperwork Reduction Mt Notice, see the Instructions for Form 1040. Schedule A (Form 1040) 2017 EFTA00792194
SCHEDULE B (Form 1040A or 1040) Depattmenl 01 the Trinity Interne/ Revenue Service OM /lanais) shwa. on rata Interest and Ordinary Dividends IP. Attach to Form 1040A or 1040. ► Go to www.Irs.gov/ScheduleB for instructions and the latest information. OMB No 15454/ 2017 AMOIrron: SQeu.enco No ANASTASIYA SIROOCHENKO Part I Interest Note: If you received a Form 10991NT, Form 1099O1D, or substitute statement from a brokerage firm. list the firm's name as the payer and enter the total interest shown on that form. 1 List name of payer. If any interest is from a sellerfinanced mortgage and the buyer used the property as a personal residence, see the instructions and list this interest first. Also, show that buyer's social security number and address ► CHASE UNICREDIT BANK AUSTRIA AG 2 Add the amounts on line 1 3 Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 4 Subtract line 3 from line 2. Enter the result here and on Form 1040k or Form 1040, line 8a ► •.=•oc 'via 740. 15. 755. 3 4 755. Note: If line 4 is over $1,500, you must complete Part III. Amount Part II Ordinary Dividends Note: If you received a Form 1099DIV or substitute statement from a brokerage firm. list the firm's name as the payer and enter the ordinary dividends shown on that form. 5 List name of payer ill. 6 Add the amounts on line 5. Enter the total here and on Form 1040k or Form 1040. line 9a Note: If line 6 is over $1 500 you must complete Part III. Part III You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends: (b) had a foreign account: or (c) received a distribution from. or were a grantor of. or a transferor to. a foreign trust. Foreign 7a At any time during 2017, did you have a financial interest in or signature authority over a financial account (such Accounts as a bank account, securities account, or brokerage account) located in a foreign country? See instructions and If -Yes,' are you required to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR), Trusts to report that financial interest or signature authority? See FinCEN Form 114 and its instructions for filing requirements and exceptions to those requirements b If you are required to file FinCEN Form 114. enter the name of the foreign country where the financial account is located Nii• AUSTRIA 8 During 2017, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? Yes X No X 727501 11)-25.17 If you may have to file Form 3520. See instructions X LI-IA For Paperwork Reduction Act Notice, see your tax return Instructions. Schedule B (Form 1040A or 1040) 2017 EFTA00792195
SCHEDULE C (Form 1040) Department of IN Nino-, Internal Revenue Unica 1901 Name 01Pc011ebalCr Profit or Loss From Business (Sole Proprietorship) Ile. Go to vontirs.gov/ScheduleC for instructions and the latest information. GP. Attach to Form 1040, 1040NR, or 1041; partnerships generally must file Form 1065. OMR No 1545.0374 2017 Allachniont SeciiisoCil No 09 ANASTASIYA SIROOCHENKO A Principal business or profession, including product or service (see instructions) ART DEALER C Business name. If no separate business name, leave blank. SUBLIME ART LLC E Business address (including suite or room no.) ge. 244 FIFTH AVE #1590 Social BEmorcodeRommnuoiom ► 453920 DEnveiwcwastr) **_***7860 City, town or post office, state, and ZIP code NEW YORK, NY 10001 F Accounting method: (1) U Cash (2) Lyi Accrual (3) Lj Other (specify) le. G Did you 'Materially participate' in the operation of this business during 2017? If 'No; see instructions for limit on losses M Yes Q No Ii ff you started or acquired this business during 2017, check here I Did you make any payments in 2017 that would require you to file Form(s) 1099? (see instructions) 0 Yes DO No J If 'Yes; did you or will you file required Forms 1099? 0 Yes ILI No Part I I Income 1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on Form W-2 and the "Statutory employee' box on that form was checked 2 Returns and allowances 3 Subtract line 2 from line 1 4 Cost of goods sold (from line 42) 5 Gross profit. Subtract line 4 from line 3 6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) 7 Gross income. Add lines 5 and 6 iart l Expenses. Enter expenses for business use ofyour home only on line 30. 8 9 10 11 12 13 14 15 16 17 28 Total expenses before expenses for business use of home. Add fines 8 through 27a ► 29 Tentative profit or (loss). Subtract line 28 from line 7 30 Expenses for business use of your home. Do no report these expenses elsewhere. Attach Form 8829 unless using the simplified method (see instructions). Simplified method filers only: enter the total square footage of: (a) your home: and (b) the part of your home used for business: Use the Simplified Method Worksheet in the instructions to figure the amount to enter on line 30 31 Net profit or (loss). Subtract line 30 from line 29. • If a profit, enter on both Form 1040, line 12 (or Form 1040NR, line 13) and on Schedule SE, line 2. (If you checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3. • If a loss, you must go to line 32. 32 If you have a loss, check the box that describes your investment in this activity (see instructions). • If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and on Schedule SE, line 2. (If you checked the box on line 1, see the line 31 instructions). Estates and trusts, enter on Form 1041, line 3. • If you checked 32b, you mustattach Form 6198. Your loss may be limited. L.HA For Paperwork Reduction Act Notice, see the separate instructions. ► 1 2 3 4 5 6 7 3,230,000. 3,230,000. 1,285,000. 1,945,000. 1,945,000. Advertising 8 4,850. 18 Office expense Car and truck expenses 19 Pension and profit-sharing plans (see instructions) 9 20 Rent or lease (see instructions): Commissions and fees 10 225,000. a Vehicles, machinery, and equipment Contract labor (see instructions) , Depletion 11 b 21 Other business property Repairs and maintenance 12 Depreciation and section 179 22 Supplies (not included in Part III) expense deduction (not included in 23 Taxes and licenses Part III) (see instructions) 13 24 Travel, meals, and entertainment Employee benefit programs (other a Travel than on line 19) 14 b Deductible meals and Insurance (other than health) 15 1,159. entertainment (see instructions) Interest: 25 Utilities a Mortgage (paid to banks, etc.) 16a 26 Wages (less employment credits) D Other 16b 27 a Other expenses (from tine 48) Legal and professional services 17 12,000. b Reserved for future use 18 19 20a 20b 21 22 23 5,519. 24a 24b 25 26 27a 27b 28 29 48,958. 1,686. 299,172. 1,645,828. 30 _31 1,645,828. 32a ILI a math**. 32t, Some Inwestrnsot is not al Fisk Schedule C (Form 1040)2017 720001 to.2 I IT EFTA00792196
Schedule C (Form 1040)2017 ANASTASIYA SIROOCHENKO Part Ill I Cost of Goods Sold (see instructions) 33 Method(s) used to value closing inventory: a K Cost b Lower of cost or market c Other (attach explanation) age 2 34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory? If Yes:attach explanation Yes No 35 Inventory at beginning of year. If different from last years closing inventory, attach explanation 36 Purchases less cost of items withdrawn for personal use 37 Cost of labor. Do not include any amounts paid to yourself 38 Materials and supplies 39 Other costs 40 Add lines 35 through 39 41 Inventory at end of year 35 36 1,285,000. 37 38 39 40 1,285,000. 41 42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 ^,•> 42 1,285,000. Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the Instructions for line 13 to find out if you must file Form 4562. 43 44 When did you place your vehicle in service for business purposes? (month, day, year) le, / Of the total number of miles you drove your vehicle during 2017, enter the number of miles you used your vehicle for: a Business b Commuting c Other 45 Was your vehicle available for personal use during off-duty hours? Yes No 0 0 46 Do you (or your spouse) have another vehicle available for personal use? EI Yes No Nit 47 a Do you have evidence to support your deduction? Yes No b If Yes,' is the evidence written? Yes No Part V I Other Expenses. List below business expenses not included on lines 8-26 or line 30. PAYROLL PROCESSING FEES EXHIBITIONS FILING FEE 801. 860. 25. 48 Total other expenses. Enter here and on line 27a 48 1,686. 70002 I0-21.17 S hedule C (Form 1040) 2017 EFTA00792197
SCHEDULE SE (Form 1040) D000nnurni of :no Tioaray Intorno/ Renton SONIC. Self-Employment Tax 10 Go to www.irs.gov/ScheduleSE for instructions and the latest information. ► Attach to Form 1040 or Form 1040NR. OV43 No 1545.0074 2017 Attadvn401 Se<mince NO Name of person with self-employment income (as shown on Form 1040 or Form 1040NR) ANASTASIYA SIROOCHENKO Social security number of person with self-employment income ► Before you begin: To determine if you must file Schedule SE. see the instructions. May I Use Short Schedule SE or Must I Use Long Schedule SE? Note: Use this flowchart only if you must file Schedule SE. If unsure, see Who Must File Schedule SEM the instructions. Did you receive wages or tips in 2017? No I Yes 71, • Are you a minister, member of a religious order, or Christian Science practitioner who received IRS approval notto be taxed on earnings from these sources, but you owe self-employment tax on other eamings? ir No Are you using one of the optional methods to figure your net earnings (see instructions)? No Did you receive church employee i come (see instructions) reported on Form W-2 of $10828 r more? ir No You may use Short Schedule SE below Yes No Yes Was the total of your wages nd tips subject to social security or railroad retirement (tier 1) tax plus your net earnings from self-employment more than $127,200? Yes 10 Yes, t No Did you receive tips subject to social security or Medicare tax that you didn't report to our employer? Yes Yes t No Did you report any wages on Form 8919, Uncollected Social Security and Medicare Tax o Wages? 4 • You must use Long Schedule SE on page 2 Section A-Short Schedule SE. Caution: Read above to see if you can use Short Schedule SE. la Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K1 (Form 1065), box 14, code A b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F. line 4b. or listed on Schedule K1 (Form 1065), box 20, code Z 2 Net profit or (loss) from Schedule C, line 31: Schedule C.EZ. line 3: Schedule K1 (Form 1065), box 14, code A (other than farming); and Schedule K1 (Form 10658). box 9. code J1. Ministers and members of religious orders. see instructions for types of income to report on this line. See instructions for other income to report STMT 8 3 Combine lines la, 1 b, and 2 4 Multiply line 3 by 92.35% (0.9235). If less than $400, you dont owe selfemployment tax;don't file this schedule unless you have an amount on line 1 b ► Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line 1 b, see instructions 5 Self-employment tax. If the amount on line 4 is: • $127.200 or less, multiply line 4 by 15.3% (0.153). Enter the result here and on Form 1040, line 57, or Form 1040NR, line 55 • More than $127.200. multiply line 4 by 2.9% (0.029). Then, add $15,772.80 to the result. Enter the total here and on Form 1040, line 57, or Form 1040NR, line 55 6 Deduction for one-half of self-employment tax. line 5 by 50% (0.50). Enter Mu Form 1040 line 27, or Form 1040NR line 27 6 29,926. ltipty the result here and on la lb 2 3 1,645,828. 1,645,828. 4 1,519,922. 5 59,851. LHA For Paperwork Reduction Act Notice, see your tax return instructions. Schedule SE (Form 1040) 2017 724501 ID-20.17 EFTA00792198
DOES NOT APPLY For m 6251 Dope/1mm of :to Imago). Intorno/ Raven.. SONIC, (99) Alternative Minimum Tax - Individuals 0 Go to vnvw.irs.gov/Form6251 for instructions and the latest information. ► Attach to Form 1040 or Form 1040NR. Name(s) shown on Form 1040 or Form 1040NR ANASTASIYA SIROOCHENKO OMR 110 1545.0374 2017 ArtacWaot SanOno) no. 32 Your social security number Part I I Alternative Minimum Taxable Income 1 If filing Schedule A (Form 1040), enter the amount from Form 1040. line 41, and go to IMe 2. Otherwise, enter the amount from Form 1040, line 38, and go to line 7. (If less than zero. enter as a negative amount.) 2 Reserved for future use 3 Taxes from Schedule A (Form 1040). line 9 4 Enter the home mortgage interest adjustment. if any, from line 6 of the worksheet In the instructions for this line 5 Miscellaneous deductions from Schedule A (Form 1040), line 27 6 If Form 1040, line 38, is $156.900 or less, enter in. Otherwise, see instructions 7 Tax refund from Form 1040. line 10 or line 21 8 Investment interest expense (difference between regular tax and AMT) 9 Depletion (difference between regular tax and AMT) 10 Net operating loss deduction from Form 1040, line 21. Enter as a positive amount 11 Alternative tax net operating loss deduction 12 Interest from specified private activity bonds exempt from the regular tax 13 Qualified small business stock, see instructions 14 Exercise of incentive stock options (excess of MAT income over regular tax income) 15 Estates and trusts (amount from Schedule Kil (Form 1041), box 12, code A) 16 Electing large partnerships (amount from Schedule Kil (Form 10658). box 6) 17 Disposition of property (difference between AMT and regular tax gain or loss) 18 Depreciation on assets placed n service after 1986 (difference between regular tax and AMT) 19 Passive activities (difference between MIT and regular tax income or loss) 20 Loss limitations (difference between NAT and regular tax income or loss) 21 Circulation costs (difference between regular tax and MIT) 22 Longterm contracts (difference between AMT and regular tax income) 23 Mining costs (difference between regular tax and AMT) 24 Research and experimental costs (difference between regular tax and AMT) 25 Income from certain installment sales before January 1. 1987 26 Intangible drilling costs preference 27 Other adjustments, including incomebased related adjustments 28 Alternative minimum taxable Income. Combine lines 1 through 27. (If married filing separately and line 28 is more than $249.450. see instructions.) 1 1,407,381. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 227,641. -40,655. 28 1,594,367. part II I Alternative Minimum Tax (AMT) 29 Exemption. (If you were under age 24 at the end of 2017. see instructions.) IF your filing status is... AND line 28 is not over... THEN enter on line 29... Single or head of household $120.700 $54.300 Married filing jointly or qualifying wiclow(er) 160,900 84,500 Married filing separately 80,450 42,250 If line 28 is over the amount shown above for your filing status. see instructions 30 Satinet lino 29 horn lino 28. It moo) man WO. 90 10 lino 31. If van Or lea. enter .0. nofo and on linos 31.33. and 35. and go to lino 34 31 • If you are filing Form 2555 or 2555-EZ. see instructions for the amount to enter. • If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends on Form 1040. line 9b; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040) (as refigured for the MAT, if necessary), complete Part III on page 2 and enter the amount from line 64 here. • All others: If line 30 is $187,800 or less ($93,900 or less if maMed filing separately), multiply line 30 by 26% (0.26). Otherwise, multiply line 30 by 28% (0.28) and subtract $3.756 ($1.878 if married filing separately) from the result. 32 Alternative minimum tax foreign tax credit (see instructions) 33 Tentative minimum tax. Subtract line 32 from line 31 34 Add Form 1040. line 44 (minus any tax from Form 4972). and Form 1040, line 46. Subtract from the result any foreign tax credit from Form 1040, line 48. If you used Sch J to figure your tax on Form 1040, line 44, refigure that tax without using Schedule J before completing this line (see instructions) 35 AMT. Subtract fine 34 from fine 33. If zero or less, enter '0. Enter here and on Form 1040. line 45 29 0. 30 1,594,367. 31 442,667. 32 33 442,667. 34 35 513,142. 0. 719481 01-1 hie LHA For Paperwork Reduction Act Notice, see your tax return instructions. Form 6251 (2017) EFTA00792199
Form 6251 (2017) ANASTASIYA SIROOCHENKO Page 2 Part Tax Computation Using Maximum Capital Gains Rates Complete Part III only if you are required to do so by line 31 or by the Foreign Earned Income Tax Worksheet in the instructions. 36 Enter the amount from Form 6251, line 30. If you are filing Form 2555 or 255SEZ, enter the amount from line 3 of the worksheet in the instructions for line 31 36 37 Enter the amount from line 6 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040. line 44, or the amount from line 13 of the Schedule D Tax Worksheet in the instructions for Schedule D (Form 1040), whichever applies (as refigured for the AMT, if necessary) (see instructions). If you are filing Form 2555 or 2555•EZ, see instructions for the amount to enter 37 38 Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT, if necessary) (see instructions). If you are filing Form 2555 or 2555•EZ, see instructions for the amount to enter 38 39 If you did not complete a Schedule D Tax Worksheet for the regular tax or the AMT. enter the amount from line 37. Otherwise, add lines 37 and 38, and enter the smaller of that result or the amount from line 10 of the Schedule D Tax Worksheet (as refigured for the AMT, if necessary). If you are filing Form 2555 or 255.5.EZ. see instructions for the amount to enter 39 40 Enter the smaller of line 36 or line 39 40 41 Subtract line 40 from line 36 41 42 If line 41 is $187,800 or less ($93,900 or less if married filing separately), multiply line 41 by 26% (0.26). Otherwise. multiply line 41 by 28% (0.28) and subtract $3,756 ($1.878 if married filing separately) from the result Po 42 43 Enter: • $75.900 if maMed filing jointly or qualifying widow(er). • $37.950 if single or married filing separately, or 6 43 • $50.800 if head of household. 44 Enter the amount from line 7 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 14 of the Schedule D Tax Worksheet In the instructions for Schedule D (Form 1040), whichever applies (as figured for the regular tax). If you did not complete either worksheet for the regular tax, enter the amount from Form 1040, line 43; If or lessonter 0. If you are filing Form 2555 or 255.6EZ, see instructions for the amount to enter 44 45 Subtract line 44 from line 43. If zero or less, enter 0. 45 46 Enter the smaller of line 36 or line 37 46 47 Enter the smaller of line 45 or line 46. This amount is taxed 0% 47 48 Subtract !he 47 from line 46 48 49 Enter: • $418,400 if single • $235,350 if maMed filing separately 49 • $470,700 if married filing jointly or qualifying widower! • $444,550 if head of household 50 Enter the amount from line 45 50 51 Enter the amount from line 7 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040. line 44. or the amount from line 19 of the Schedule D Tax Worksheet, whichever applies (as figured for the regular tax). If you did not complete either worksheet for the regular tax, enter the amount from Form 1040, line 43: if zero or less, enter If you are filing Form 2555 or Form 2556EZ, see instructions for the amount to enter 51 52 Add line 50 and line 51 52 53 Subtract line 52 from line 49. If zero or less, enter 4} 53 54 Enter the smaller of line 48 or line 53 54 55 Multiply line 54 by 15% (0.15) ► 55 56 Add lines 47 and 54 56 If lines 56 and 36 are the same, skip lines 67 through 61 and go to line 62. Otherwise, go to line 67. 57 Subtract line 56 from line 46 57 58 Multiply line 57 by 20% (0.20) Os 58 If line 38 is zero or blank, skip lines 69 through 61 and go to line 62. Otherwise, go to line 69. 59 Add lines 41, 56, and 57 59 60 Subtract line 59 from line 36 60 61 Multiply line 60 by 25% (0.25) III. 61 62 Add lines 42. 55, 58, and 61 62 63 If line 36 is $187,800 or less ($93,900 or less if married filing separately), multiply line 36 by 26% (0.26). Otherwise, multiply line 36 by 28% (0.28) and subtract $3,756 ($1.878 if married filing separately) from the result 63 64 Enter the smaller of line 62 or line 63 here and on line 31. If you are filing Form 2555 or 255512, do not enter this amount on lie 31. Instead, enter it on line 4 of the worksheet in the instructions for line 31 64 119891 01.11.18 Form 6251 (2017) EFTA00792200
Form 8959 Department el tro Treesisy inleengii Revenue Service Additional Medicare Tax ► If any line does not apply to you, leave it blank. See separate instructions. ► Attach to Form 1040, 1040NR, 1040-PR, or 1040-SS. ► Go to www.irs.gov/Form8959 for instructions and the latest information. ome No. 1545.00M 2017 Artachmeni sequence Na. 71 Name(s) shown on return ANA S TAS I YA S I ROOCHENKO Part I Additional Medicare Tax on Medicare Wa g es Your 1 Medicare wages and tips from Form W2. box 5. If you have more than one Form W-2, enter the total of the amounts from box 5 1 2 Unreported tips from Form 4137, line 6 2 3 Wages from Form 8919, line 6 3 4 Add lines 1 through 3 4 5 Enter the following amount for your filing status: Married filing jointly $250,000 Married filing separately $125,000 Single, Head of household, or Qualifying widow** $200,000 5 6 Subtract line 5 from line 4. If zero or less. enter O- 6 7 Additional Medicare Tax on Medicare wages. Multiply line 6 by 0.9% (0.009). Enter here and go to Part II 7 Part II Additional Medicare Tax on Self-Employment Income 8 Self•employment income from Schedule SE (Form 1040), Section A, line 4, or Section B, line 6. If you had a loss, enter 0. (Form 1040•PR and Form 1040•SS filers, see instructions.) 8 1,519,922. 9 Enter the following amount for your filing status: Married filing jointly $250,000 Married filing separately $125,000 Single, Head of household, or Qualifying widow(er) $200,000 9 200,000. 10 Enter the amount from line 4 10 11 Subtract line 10 from line 9. If zero or less. enter .0- 11 200,000. 12 Subtract line 11 from line 8. If zero or less, enter .0- 12 1,319,922. 13 Additional Medicare Tax on self•employment income. Multiply line 12 by 0.9% (0.009). Ente here and go to Part III 13 11,879. Part Ill Additional Medicare Tax on Railroad Retirement Tax Act (RRTA) Compensation 14 Railroad retirement (ARTA) compensation and tips from Form(s) W2, box 14 (see instructions) 14 15 Enter the following amount for your fling status: Married filing jointly $250,000 Married filing separately $125,000 Single, Head of household, or Qualifying widow(er) $200,000 15 16 Subtract line 15 from line 14. If zero or less, enter O- 17 Additional Medicare Tax on railroad retirement (ARTA) compensation. Multiply line 16 by 16 0.9%10.009). Enter here and go to Part IV 17 Part IV Total Additional Medicare Tax 18 Add lines 7. 13. and 17. Also include this amount on Form 1040. line 62. (Form 1040NR. 1040PR. and 1040SS filers. see instructions) and go to Part V 18 11,879. Part V Withholding Reconciliation 19 Medicare tax withheld from Form W-2, box 6. If you have more than one Form W-2. enter the total of the amounts from box 6 20 Enter the amount from line 1 21 Multiply line 20 by 1.45% (0.0145). This Is your regular Medicare tax withholding on Medicare wages 22 Subtract line 21 from line 19. If zero or less, enter O. This is yourAdditional Medicare Tax withholding on Medicare wages 23 Additional Medicare Tax withholding on railroad retirement (RRTA) compensation from Form W-2, box 14 (see instructions) 24 Total Additional Medicare Tax withholding. Add lines 22 and 23. Also Include this amount with federal income tax withholding on Form 1040, line 64 (Form 1040NR. 1040PR. and 1040SS filers, see instructions) 19 20 21 22 23 24 723III 1243.1T LHA For Paperwork Reduction Act Notice, see your tax return Instructions. Form 8959 (2017) EFTA00792201
Form 8960 Department of Ina Treousy Internal Royal,. Service (9o) Name(s) shown on your tax return ANASTAS I YA SIROOCHENICO Part I Investment Income 1_1 Section 6013(g) election (see instructions) 0 Section 6013(h) election (see instructions) 0 Regulations section 1.1411.10(g) election (see Instructions) Net Investment Income Tax - Individuals, Estates, and Trusts ► Attach to your tax return. ► Go to www.irs.gov/Form8960 for instructions and the latest Information cue No. 1545.2227 2017 ANN:Omni s0000noo No. 72 Your social security number or EIN 1 Taxable interest (see instructions) 2 Ordinary dividends (see instructions) 3 Annuities (see instructions) 4a Rental real estate, royalties, partnerships, S corporations, trusts, etc. (see instructions) b Adjustment for net income or loss derived in the ordinary course of a nonsection 1411 trade or business (see instructions) c Combine lines 4a and 4b 6a Net gain or loss from disposition of property (see Instructions) b Net gain or loss from disposition of property that is not subject to net investment income tax (see instructions) c Adjustment from disposition of partnership interest or S corporation stock (see instructions) d Combine lines 5a through 5c 6 Adjustments to investment income for certain CFCs and PFICs (see instructions) 7 Other modifications to investment income (see instructions) 8 Total investment income. Combine lines 1,2,3.4c. 5d. 6. and 7 Part II Investment Expenses Allocable to Investment Income and Modifications 9a Investment interest expenses (see instructions) b State, local, and foreign income tax (see instructions) c Miscellaneous investment expenses (see instructions) d Add lines 9a. 9b, and 9c 10 Additional modifications (see instructions) 11 Total deductions and modifications. Add lines 9d and 10 Part III Tax Computation 12 Net investment income. Subtract Part II, line 11 from Part I, Ile 8. Individuals complete lines 13- 17. Estates and trusts complete lines 18a21. If zero or less, enter Individuals: 13 Modified adjusted gross income (see instructions) 1 13 1,616,657. 14 Threshold based on filing status (see instructions) 14 15 Subtract line 14 from line 13. If zero or less, enter '0 15 16 Enter the smaller of line 12 or line 15 17 Net investment income tax for individuals. Multiply fine 16 by 3.8% (.038).Enter here and Include on your tax return (see instructions) Estates and Trusts: 18a Net Investment income (line 12 above) 18a b Deductions for distributions of net investment income and deductions under section 642(c) (see instructions) c Undistributed net investment income. Subtract line 18b from 18a (see instructions). If zero or less, enter 0. 19a Adjusted gross income (see instructions) b Highest tax bracket for estates and trusts for the year (see instructions) e Subtract line 19b from line 19a. If zero or less, enter .0- 20 Enter the smaller of line 18c or line 19c 200,000. 1,416,657. A 1 2 3 755. 4c 5d 6 7 8 755. 9a 91) 9c 170. 9d 10 11 170. 170. 18b 18c 19a 19b 19c 21 Net investment income tax for estates and trusts. Multiply line 20 by 3.8% (.038). Enter here and Include on your tax return (see instructions) WA For Paperwork Reduction Mt Notice, see your tax return Instructions. Form 8960 (2017) 12 585. 16 585. 17 2 2 . 20 21 723121 12-22.17 EFTA00792202
Lines 9 and 10 - Application of Itemized Deduction Limitations on Deductions Properly Allocable to Investment Income Worksheet Part I - Application of Section 67 to Deductions Properly Allocable to Investment Income 1. Enter the amount of Miscellaneous Itemized Deductions properly allocable to investment income before any itemized deduction limitations (Description and Form 8960 line number where they'll be reported): Description Line Amount (a) (b) 2. Enter the total of all items listed in line 1 2. 3. Enter the amount of all Miscellaneous Itemized Deductions after the application of the section 67 limitation (Schedule A (Form 1040), line 27) 3. 4. Enter the lesser of the total reported on line 2 or line 3 4. Part II - Application of Section 67 Limitation to Specific Deductions (B) IF line 3 is less than line 2. THEN divide . line 3 by line 2 AND P H enter the amount in column (B). IF amounts reported (C) Multiply the 4 are equal, THEN in column (A) by the (A) li t!P ilit' on Part I. lines 2 and individual amoums enter 1.00 in column amount in column Reenter the amounts and descriptions from Part I, line 1. B (B). Description Line Amount (a) X = (b) X = i Individuals - Use the amounts in column (C) on Part Ill, line I, to determine the amount of these deductions that are TI P allowable after the application of the section 68 limitation. Estates or trusts - Enter the amounts in column (C) in the appropriate location on lines 9 and 10. Don't complete Parts III or IV of this worksheet. Keep for Your Records 123351 01-10-18 EFTA00792203
Lines 9 and 10 - Application of Itemized Deduction Limitations on Deductions Properly Allocable to Investment Income Worksheet - continued Keep for Your Records Part III - Application of Section 68 to deductions properly allocable to investment income (Individuals Only) 1. Enter the amount of Miscellaneous Itemized Deductions properly allocable to investment income from column (C) of Part II: Description Line Amount (a) (b) 2. Enter the amount of state, local, and foreign income taxes that are properly allocable to investment income 2. 170 . 3. Enter the amounts of other Itemized Deductions subject to the section 68 limitation and properly allocable to investment income before any itemized deduction limitations (Description and Form 8960 line number where they'll be reported): Description Line Amount (a) (b) 4. Enter the total deductions properly allocable to investment income subject to the section 68 limitation. Enter the sum of lines 1 through 3 4. 5. Enter the amount of total itemized deductions reported on Form 1040 5. 209,276. 6. Enter all other itemized deductions allowed but not subject to the section deduction limitation: (a) Investment Interest Expense (b) Casualty Losses (other than losses described in section 16.5(cX1)) (e) Medical Expenses (d) Gambling Losses (e) Total of lines 6(a) through 6(d) 8e. 7. Subtract tine 6e from line 5 7. & Enter the lesser of line 7 or line 4 8. TIP 170. 209,276. 170. This is the amount of itemized deductions that are properly allocable to investment income after the application of the sections 67 and 68 deduction limitations. Use Part IV of this worksheet to reconcile this amount to the Individual deduction amounts reported on Form 8960, lines 9 and 10. Part IV - Reconciliation of Schedule A Deductions to Form 8960, lines 9 and 10 (Individuals Only) (A) Reenter the amounts and descriptions from Part III, lines 1 3. Miscellaneous Itemized Deductions properly allocable to investment Income: Description Line Amount 1. (a) (b) 2. State, local, and foreign income taxes Itemized Deductions Subject to Section 68 included on Line 3 of Part III: 3. (a) (b) X 170. x X X (B) IF Part III, line 8 is less than Part III. line 4. THEN divide line 8 by line 4 AND enter the amount in column (B). IF the amounts reported on Part III, lines 4 and 8 are equal. THEN enter 1.00 in column (Ell. 1.0000 (C) Multiply the individual amounts in column (A) by the amount in column (B). Enter these amounts in the appropriate location on tines 9 and 10. 7 0 . nmual-lo.m EFTA00792204
For, 8960 Net Investment Income Tax - Individuals, Estates, and Trusts NEW YORK 2017 Name(s) ANA S TAS I YA S I ROOCH ENKO Part I Investment Income U section 6013(g) election Regulations section 1.1411.10(g) election Your EIN 1 Taxable interest (Form 1040, line 8a; or Form 1041, line 1) 2 Ordinary dividends (Form 1040. line 9a; or Form 1041, line 2a) 3 Annuities from nongualified plans 4a Rental real estate, royalties, partnerships, S corporations, trusts, etc. (Form 1040, line 17; or Form 1041, line 5) b Adjustment for net income or loss derived in the ordinary course of a ncri.section 1411 trade or business e Combine Ines 4a and 4b 5a Net gain or loss from disposition of property from Fenn 1040. combine lines 13 and 14; or from Form 1041. combine lines 4 and 7 b Net gain or loss from disposition of property that is not subject to net investment income tax c Adjustment from disposition of partnership interest or S corporation stock d Combine lines 5a through 5c 6 Changes in investment income for certain CFCs and PFICs 7 Other modifications to investment income 8 Total investment income. Combine lines 1. 2. 3. 4c. 5d. 6. and 7 A Part II State Income Tax Pro-ration for 2017 Income Tax Payments 9 State total income 10 State income tax payments for 2017 11 2017 state income tax payments attributable to investment income, line 8 divided by line 9 times line 10 Part III State Income Tax Pro-ration for 2016 Estimate Payments Made in 2017 12 State estimate payments for 2016 13 Percent of state income taxes attributable to investment income for 2016 14 2016 state estimate payments attributable to investment income. Line 12 times line 13 Part IV State Income Tax Pro-ration for Balance of Prior Years Tax Plus Extension Pa 4a 0. 1 755. 2 3 0. 4b 5a 0. 4c 0. Eb 5d 6 7 8 0. 755. y 9 10 11 1,616,657. 205,000. 12 13 14 96. ments Paid in 2017 15 Balance of prior years tax plus extension payments paid in 2017 16 Percent of state income taxes attributable to investment income for 2016 17 Balance of prior years tax and extension payments attributable to investment income. Line 15 times line 16 15 9,641. 16 .007631 17 74. Part V Reduction of State Tax Deduction 18 Reduction of state tax deduction 19 Percent of state income taxes attributable to investment income for 2016 20 Reduction of state tax deduction attributable to investment income. Line 18 times line 19 18 19 20 ) Part VI Total State Income Tax Payments Attributable to Investment Income 21 Combine lines 11. 14. 17 and 20. Carry to Form 8960. Line 9 Worksheet. Part III. line 2 21 170. Form 8960 (2017) 723,6i 04.0 7 EFTA00792205
ANASTASIYA SIROOCHENKO FORM 1040 PERSONAL EXEMPTION WORKSHEET STATEMENT 1 1. IS THE AMOUNT ON FORM 1040, LINE 38, MORE THAN THE AMOUNT SHOWN ON LINE 4 BELOW FOR YOUR FILING STATUS? NO. STOP. MULTIPLY $4,050 BY THE TOTAL NUMBER OF EXEMPTIONS CLAIMED ON FORM 1040, LINE 6D, AND ENTER THE RESULT ON LINE 42. YES. CONTINUE 2. MULTIPLY $4,050 BY THE TOTAL NUMBER OF EXEMPTIONS CLAIMED ON FORM 1040, LINE 6D 4,050. 3. ENTER THE AMOUNT FROM FORM 1040, LINE 38 1,616,657. 4. ENTER THE AMOUNT FOR YOUR FILING STATUS 261,500. SINGLE $261,500 MARRIED FILING JOINTLY OR WIDOW(ER) $313,800 MARRIED FILING SEPARATELY $156,900 HEAD OF HOUSEHOLD $287,650 5. SUBTRACT LINE 4 FROM LINE 3. IF THE RESULT IS MORE THAN $122,500 ($61,250 IF MARRIED FILING SEPARATELY), STOP. ENTER -0- ON LINE 42 1,355,157. 6. DIVIDE LINE 5 BY $2,500 ($1,250 IF MARRIED FILING SEPARATELY). IF THE RESULT IS NOT A WHOLE NUMBER, INCREASE IT TO THE NEXT HIGHER WHOLE NUMBER (FOR EXAMPLE, INCREASE 0.0004 TO 1) 7. MULTIPLY LINE 6 BY 2% (.02) AND ENTER THE RESULT AS A DECIMAL 8. MULTIPLY LINE 2 BY LINE 7 9. SUBTRACT LINE 8 FROM LINE 2. TOTAL TO FORM 1040, LINE 42. FORM 1040 OTHER TAXES STATEMENT 2 DESCRIPTION AMOUNT FROM FORM 8959 11,879. FROM FORM 8960 22. TOTAL TO FORM 1040, LINE 62 11,901. STATEMENT(S) 1, 2 EFTA00792206
ANASTASIYA SIROOCHENKO FORM 1040 CURRENT YEAR ESTIMATES AND STATEMENT 3 AMOUNT APPLIED FROM PREVIOUS YEAR DESCRIPTION AMOUNT 4TH QTR ESTIMATE PAYMENT 47,000. TOTAL TO FORM 1040, LINE 65 47,000. SCHEDULE A STATE AND LOCAL INCOME TAXES STATEMENT 4 DESCRIPTION AMOUNT OTHER STATE AND LOCAL INCOME TAXES NEW YORK 4TH QTR ESTIMATE PAYMENTS NEW YORK PRIOR YEAR BALANCE DUE AND EXTENSION PAYMENTS 13,000. 205,000. 9,641. TOTAL TO SCHEDULE A, LINE 5 227,641. SCHEDULE A CASH CONTRIBUTIONS STATEMENT 5 DESCRIPTION AMOUNT AMOUNT AMOUNT 100% LIMIT 50% LIMIT 30% LIMIT BYRD HOFFMAN WATER MILL FOUNDATION 22,000. DRAWING CENTER 250. VARIOUS ORGANIZED CHARITIES 40. SUBTOTALS 22,290. TOTAL TO SCHEDULE A, LINE 16 22,290. SCHEDULE A MEDICAL AND DENTAL EXPENSES STATEMENT 6 DESCRIPTION AMOUNT MEDICAL INSURANCE PREMIUMS PAID 3,836. TOTAL TO SCHEDULE A, LINE 1 3,836. STATEMENT(S) 3, 4, 5, 6 EFTA00792207
ANASTASIYA SIROOCHENKO SCHEDULE A ITEMIZED DEDUCTIONS WORKSHEET STATEMENT 7 1. ENTER THE TOTAL OF THE AMOUNTS FROM SCHEDULE A, LINES 4, 9, 15, 19, 20, 27, AND 28. 2. ENTER THE TOTAL OF THE AMOUNTS FROM SCHEDULE A, LINES 4, 14, AND 20, PLUS ANY GAMBLING AND CASUALTY OR THEFT LOSSES INCLUDED ON LINE 28 AND ANY QUALIFIED CONTRIBUTIONS INCLUDED ON LINE 16. 3. IS THE AMOUNT ON LINE 2 LESS THAN THE AMOUNT ON LINE 1? IF NO, YOUR DEDUCTION IS NOT LIMITED. ENTER THE AMOUNT FROM LINE 1 ABOVE ON SCHEDULE A, LINE 29. IF YES, SUBTRACT LINE 2 FROM LINE 1. 4. MULTIPLY LINE 3 BY 80% (.80). 199,945. 5. ENTER THE AMOUNT FROM FORM 1040, LINE 38. 1,616,657. 6. ENTER $313,800 IF MARRIED FILING JOINTLY OR QUALIFYING WIDOW(ER); $287,650 IF HEAD OF HOUSEHOLD; $261,500 IF SINGLE; OR $156,900 IF MARRIED FILING SEPARATELY. 261,500. 7. IS THE AMOUNT ON LINE 6 LESS THAN THE AMOUNT ON LINE 5? IF NO, YOUR DEDUCTION IS NOT LIMITED. ENTER THE AMOUNT FROM LINE 1 ABOVE ON SCHEDULE A, LINE 29. IF YES, SUBTRACT LINE 6 FROM LINE 5. 1,355,157. 8. MULTIPLY LINE 7 BY 3% (.03). 40,655. 9. ENTER THE SMALLER OF LINE 4 OR LINE 8. 249,931. 0. 249,931. 40,655. 10. TOTAL ITEMIZED DEDUCTIONS. SUBTRACT LINE 9 FROM LINE 1. ENTER THE RESULT HERE AND ON SCHEDULE A, LINE 29. 209,276. SCHEDULE SE NON-FARM INCOME STATEMENT 8 DESCRIPTION AMOUNT ART DEALER 1,645,828. TOTAL TO SCHEDULE SE, LINE 2 1,645,828. STATEMENT(S) 7, 8 EFTA00792208
DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 (212) 695-5771 OCTOBER 4, 2018 ANASTASIYA SIROOCHENKO DEAR ANASTASIYA: ENCLOSED ARE YOUR 2017 NEW YORK INCOME TAX RETURN AND 2018 ESTIMATED TAX VOUCHERS. THIS RETURN HAS QUALIFIED FOR ELECTRONIC FILING. AFTER YOU HAVE REVIEWED YOUR RETURN FOR COMPLETENESS AND ACCURACY, PLEASE SIGN, DATE AND RETURN FORM TR-579-IT TO OUR OFFICE BY MAIL, E-MAIL ([email protected]), OR FAX (212-695-5772). WE WILL THEN TRANSMIT YOUR RETURN ELECTRONICALLY TO THE NY TAX DEPT, AND NO FURTHER ACTION IS REQUIRED. DO NOT MAIL THE PAPER COPY OF THE RETURN TO THE NY TAX DEPT. RETURN FORM TR-579-IT TO US AS SOON AS POSSIBLE (BY OCTOBER 15, 2018). YOUR OVERPAYMENT IN THE AMOUNT OF $11,180 HAS BEEN APPLIED TO YOUR STATE DECLARATION OF ESTIMATED TAX. NO PAYMENT IS REQUIRED. NEW YORK ESTIMATED TAX VOUCHERS: SEPARATELY MAIL VOUCHER 1 OF THE DECLARATION OF ESTIMATED TAX. NO PAYMENT IS REQUIRED. ADDITIONAL ESTIMATED TAX PAYMENTS WILL ALSO BE DUE. PAYMENTS SHOULD BE MAILED TO THE FOLLOWING ADDRESS ON OR BEFORE THE DATES INDICATED. MAIL TO - NYS ESTIMATED INCOME TAX PROCESSING CENTER P.O. BOX 4122 BINGHAMTON, NY 13902-4122 FOR YOUR REFERENCE WE HAVE LISTED ALL ESTIMATED TAX PAYMENTS AND THEIR ORIGINAL DUE DATES BELOW. VOUCHER NO. 1 BY 04/17/18 NO PAYMENT REQUIRED VOUCHER NO. 2 BY 06/15/18 NO PAYMENT REQUIRED VOUCHER NO. 3 BY 09/17/18 NO PAYMENT REQUIRED EFTA00792209
VOUCHER NO. 4 BY 01/15/19 $137,320 YOUR COPY OF THE RETURN IS ENCLOSED FOR YOUR FILES. WE SUGGEST THAT YOU RETAIN THIS COPY INDEFINITELY. VERY TRULY YOURS, DAVID WEISS Q' Q EFTA00792210
2017 TAX RETURN FILING INSTRUCTIONS NEW YORK INCOME TAX RETURN FOR THE YEAR ENDING DECEMBER 31, 2017 Prepared for IMISSill Prepared by DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 Amount of tax Total tax $ 208,879 Less: payments and credits $ 220,404 Plus: interest and penalties $ 345 OVERPAYMENT $ 11,180 Overpayment Miscellaneous Donations 0 Credited to your estimated tax $ 11,180 Refunded to you $ 0 Make check payable to NOT APPLICABLE Mail tax return and check (if applicable) to THIS RETURN HAS QUALIFIED FOR ELECTRONIC FILING. AFTER YOU HAVE REVIEWED YOUR RETURN FOR COMPLETENESS AND ACCURACY, PLEASE SIGN, DATE AND RETURN FORM TR-579- IT TO OUR OFFICE. WE WILL THEN SUBMIT YOUR ELECTRONIC RETURN TO THE NY TAX DEPT. Return must be mailed on or before RETURN FORM TR -579- IT TO US BY OCTOBER 15, 2018. Special Instructions DO NOT MAIL THE PAPER COPY OF THE RETURN TO THE NY TAX DEPT. 700051 04-01.17 EFTA00792211
2018 ESTIMATED TAX FILING INSTRUCTIONS NEW YORK ESTIMATED TAX FOR THE YEAR ENDING DECEMBER 31, 2018 Prepared for 111101111 Prepared by DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 Amount of tax Total Estimated Tax Less credit from prior year Less amount already paid on 2018 estimate Balance due $ Payable in full or In installments as follows: 208,500 11,180 60,000 137,320 Installment Amount Due Date No.1 $ 0 APRIL 17, 2018 No.2 $ 0 JUNE 15, 2018 No.3 $ 0 SEPTEMBER 17, 2018 No.4 $ 137,320 JANUARY 15, 2019 Make check payable to NEW YORK STATE INCOME TAX Mail voucher and check (if applicable) to NYS ESTIMATED INCOME TAX PROCESSING CENTER P.O. BOX 4122 BINGHAMTON, NY 13902-4122 Special Instructions MAIL EACH VOUCHER ON OR BEFORE THE DATE INDICATED ABOVE. ENCLOSE YOUR CHECK FOR THE SPECIFIED AMOUNT, PAYABLE TO NEW YORK STATE INCOME TAX. INCLUDE YOUR SOCIAL SECURITY NUMBER AND THE WORDS "2018 FORM IT-2105" ON YOUR CHECK. 700011 04-01-17 EFTA00792212
/I -NEW YORK STATE 2017th Department of Taxation and Finance New York State E-File Signature Authorization for Tax Year 2017 For Forms IT-201, IT-201-X, IT-203, IT-203-X, IT-214, NYC-208, and NYC-210 Electronic return originator (ERO): Do not mai this form to the Tax Department. Keep it for your records. Taxpayers name: ANASTASIYA SIROOCHENKO Purpose Form TR579•IT must be completed to authorize an ERO to efile a personal income tax return and to transmit bank account information for the electronic funds withdrawal. General Instructions Taxpayers must complete Part B before the ERO transmits the taxpayer's electronically filed Form IT•201, ResWent Income Tax Return, IT.201•X, Amended Resident Income Tax Return, IT-203, NomesWent and Part-Year Resident Income Tax Return, IT.203.X, Amended Nonresident and Part-Year Resident income Tax Return, IT-214. Oak?) for Real Property Tax Credit, INNC•208, Claim for New York City Enhanced Real Property Tax Credit, or NYC210, Claim for New York City School Tax Credit. For returns filed jointly, both spouses must complete and sign Form TR579•IT. Spouse's name: Oointly filed return ony) 788351 12.29-17 EROs must complete Part C prior to transmitting electronically filed income tax returns (Forms 11%201, 11%2014(.17.203, IT•203.X.IT•214, NYC•208, and NY0210). Both the paid preparer and the ERO are required to sign Part C. However, if an individual performs as both the paid preparer and the ERO, he or she is only required to sign as the paid preparer. It is not necessary to include the ERO signature in this case. Please note that an alternative signature can be used as described in Publication 58. Information for Income Tax Return Preparers. Go to our website at www.tax.ny.gov to view this document. Do not mail Form TR-579-IT to the Tax Department. EROs must keep this form for three years and present it to the Tax Department upon request. This form is not required for electronically filed Form I1370, Application for Automatic Six-Month Extension of Time to File for Individuals. See Form TR879.1•IT, New York State Taxpayer Authorization for Electronic Funds Withdrawal for Tax Year 2017 Form IT-370 and Tax Year 20%8 Form IT-2105. Part A - Tax return information Federal adjusted gross income (from applicable line) Refund 1 2 3 Amount you owe 4 Financial institution routing number 5 Financial institution account number 6 Account type: D Personal checking D Personal savings Business checking Business savings Si 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 any accompanying schedules, attachments, and statements, and certify that my electronic return is true. correct, and complete. The ERO has my consent to send my 2017 New York State electronic return to New York State through the Internal Revenue Service (IRS). In addition, by using a computer system and software to prepare and transmit my form electronically, I consent to the disclosure to New York State of all information pertaining to the transmission of my tax form electronically. I understand that by executing this Form TR-579-IT, I am authorizing the ERO to sign and file this return on my behalf and agree that the ERO's submission of my personal income tax return to the IRS. together with this authorization, will serve as the electronic signature for the return and any authorized payment transaction. If I am paying my New York State personal income taxes due by electronic funds withdrawal, I certify that the account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account indicated on my 2017 electronic return, and authorized the financial institution to withdraw the amount from that account As New York does not support International ACM Transactions (IAT), I attest the source for these funds is within the United States. I understand and agree that I may revoke this authorization for payment only by contacting the Tax Department no later than five (5) business days prior to the payment date. Taxpayers signature: Date: Spouse's signature: (jointly filed return only) Date: Part C Declaration of electronic return originator (ERO) and paid preparer Under penalty of perjury, I declare that the information contained in this 2017 New York State electronic personal income tax returns the information furnished to me by the taxpayer. If the taxpayer furnished me a completed paper 2017 New York State retum signed by a paid preparer, I declare that the information contained in the taxpayer's 2017 New York State electronic return is identical to that contained in the paper copy of the return. If I am the paid preparer, under penalty of perjury I declare that I have examined this 2017 New York State electronic personal income tax retum, and, to the best of my knowledge and belief, the return is true, correct, and complete. I have based this declaration on all information available to me. ERO's signature: Print name: Paid preparer's signature: DAVID WEISS Print name: DAVID WEISS Date: Date: TR-579-IT (12/17) 1019 EFTA00792213
758341 10.27.17 17-2105-1 (2018)1Pagt 1 Estimated tax worksheet (see instructions) 1 Enter amount otNew York acpsted Toss income (NYAGE you expeci In 2018 2 Enter either your standard deduction or estimated itemized deduction 3 Subtract line 2 from line 1 4 Dependent exemptions (multiply91,000 by number of dependents) 5 Estimated NYS taxable income (subtract line 4 from line 3) 6 NYS tax on lines amount (see instructions) 7 NYC resident tax on line 5 amount (see Instructions) 8 NYC household credit and NYC accumulation distribution credit 9 Subtract line 8 from line 7 10 NYC tax on ordinary income portion of lump-sum distribution 11 Add lines 9 and 10 12 NYC unincorporated business tax credit 12a NYC general corporation tax credit 12b Add lines 12 and 12a 13 Subtract line 12b from line 11 14 Enter household aedit nonresidents and part-year residents also enter child and dependent care credit and earned income credit me Nerruereenee 15 Subtract line 14 from line 6 (see instructions) 16 Other taxes (see Instructions) 17 Add lines 15 and 16 (in NYC column: add Enos 13 and 16) 18 Resident credit and other nonrefundable credits (see instructions) 19 Total estimated NYS and NYC income tax (New 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% (1675)) (b) nonresident earnings tax (from Form Y-203) (c) total (add lines 22a and 22b) 23 Totals (New York State column, line 21: New York City column, line 21; Yonkers column, line 22c; Estimated MCTMT worksheet, In. 5) 24 Multiply line 23 by 90% (.90)(66 2/3% (.6667) for farmers and fishermen) 25 Enter your 2017 tax (see instructions) 26 Enter the lesser of line 24 or 25. This is your required annual payment (see Penalty for underpayment of estimated ta4. 27 Estimate of income tax to be withheld, estimated income tax paid with Form IT-2663 and/or IT-2664, and estimated tax paid on your behalf by a partnership or corporation 28 Balance (subtract line 27 from line 26). If any amount on this line, columns A, B, a C, is $300 or more, or if any amount is shown in column D, fill out and file the payment voucher along with your payment If each amount on this line (columns A, 6, and C only) is less than $300, no payment is required at this time. If you are applying an overpayment from 2017 to 2018, see How to complete the payment voucher Computation of Installments: If the first installment Is paid: April 17. 2018 June 15.2018 September 17. 2018 January 15.2019 A New York State 1. 2. 3. 4. 5. 6. B- New York City I C - Yonkers I D - MCTMT 7 8 9 10 11 12 12a 12b 13 14. 15. 16. 17. 18. 19. 20. 21. 228. 22b. 22c. 23. 24 25 26 27 28 ADJ TO 110% 155360 51840 5720 OVERPAYMENT APPLIED 1019 ESTIMATE PAID TO DATE Enter In the appropriate spaces on the voucher (less any 2017 overpayment you are applying to this Installment): 25% (.25) of line 28 50% (.50) of line 28 75% (.75) of line 28 amount on line 28 9880 1300 45000 15000 EFTA00792214
2018 768012 10.27.17 Department of Taxation and Finance Tips for Estimated Tax Did you know? You can pay your estimated tax electronically on our website with a debit from your checking or savings account. Visit us on the Web at www.tax.ny.gov to pay your estimated tax electronically. For assistance. see Form IT-21054, Instructions for Form IT-2105, Estimated Tax Payment Voucher lorIndNlduals. To help us match your New York State estimated tax account to your New York State income tax return. and to avoid a delay in processing your return, please note the following: • Social security number (SSN)Aaxpayer identification OD) number - Make sure that the entire SSN used on your vouchers agrees with the number on your social security card and the number used on your New York State income tax return. If you use a taxpayer ID number, this number must agree with the number used on your New York State income tax return. Failure to do so may result in monies not being properly credited to your account. • Name • Make sure that your name is spelled correctly. You should enter your first name, middle initial, then last name in the spaces provided (for example, John O. Smith). Your name must agree with the name on your New York State income tax return. • Foreign addresses - Enter the information in the following order: city. province or state, and then country (all in the City, village, or post office box). Follow the country's practice for entering the postal code. Do not abbreviate the country name. • Married taxpayers - Each married taxpayer should establish a separate estimated tax account. If you and your spouse each maintain an estimated tax account and file a joint New York State income tax return, we will credit the balances of both accounts to your joint income tax return. • All filers must be sure to separately enter the amounts for New York State. New York City. Yonkers, and MCTMT: then enter the total n the Total payment box. Note: If there is no amount to be entered for one or more Ines. leave them Manic. Do not staple or clip the check or money order to the voucher. Please detach any check stubs before mailing. Need help? Visit our website at www.tany.gov • get information and manage your taxes online • check for new online services and features Telephone assistance Automated income tax refund status: (518) ill fr 457-5 n Personal Income Tax Information Center: (518) 457.5181 To order forms and publications: (518) 457-5431 Text Telephone (TTY) Hotline (for persons with hearing and speech disabilities using a TTY): If you have access to a TTY, contact us at (518) 485-5082. If you do not own a TTY. check with independent living centers or community action programs to find out where machines are available for public use. Persons with disabilities: In compliance with the Americans with Disabilities Act. we will ensure that our lobbies, offices. meeting rooms, and other facilities are accessible to persons with disabilities. If you have questions about special accommodations for persons with disabilities, call the information center. NEW Department of Taxation and Finance YORK sun Estimated Tax Payment Voucher for Individuals New York State • New York City • Yonkers • MCTMT Detach (cut) here OP Calendar-year filer due dates: April 17.2018; June 15, 2018; September 17, 2018; and January 15, 2019. Enter applicable amount(s) and total payment In the boxes to the right. Print the Last tour CigitS of your SSN or taxpayer ID number and 201817-2105 on your payment. Make payable to MIS Income Tax. Mail voucher and payment to: NYS Estimated Income Tax, Processinci Center. PQ Box 4122. Sinctiamton NY 13902-4122. u or payer I num er *****9816 Enter condition your 2-character special code if applicable (see! axpayer s Its name an mi ini ia ANASTASIYA axpayer s as name SIROOCHENKO •al mg a ess nu er an s ree or ox; see ins ruc tons a en num er NEW YORK e NY • c e 10014 axpayer s e-mai a 'ress IT-2105 Estimated tax amounts str) Now York Stale 0 00 New York CRY 0 00 Yonkots 00 KICTIA7 0 00 Total payment 0 00 STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792215
768012 10.27.17 Department of Taxation and Finance Tips for Estimated Tax Did you know? You can pay your estimated tax electronically on our website with a debit from your checking or savings account. Visit us on the Web at www.tax.ny.gov to pay your estimated tax electronically. For assistance. see Form IT-21054, Instructions for Form IT-2105, Estimated Tax Payment Voucher lorIndlvkluals. To help us match your New York State estimated tax account to your New York State income tax return. and to avoid a delay in processing your return, please note the following: • Social security number (SSN)Aaxpayer identification OD) number - Make sure that the entire SSN used on your vouchers agrees with the number on your social security card and the number used on your New York State income tax return. If you use a taxpayer ID number, this number must agree with the number used on your New York State income tax return. Failure to do so may result in monies not being properly credited to your account. • Name - Make sure that your name is spelled correctly. You should enter your first name, middle initial, then last name in the spaces provided (for example, John O. Smith). Your name must agree with the name on your New York State income tax return. • Foreign addresses - Enter the information in the following order: city. province or state, and then country (all in the City, village, or post office box). Follow the country's practice for entering the postal code. Do not abbreviate the country name. • Married taxpayers - Each married taxpayer should establish a separate estimated tax account. If you and your spouse each maintain an estimated tax account and file a joint New York State income tax return, we will credit the balances of both accounts to your joint income tax return. • All filers must be sure to separately enter the amounts for New York State. New York City. Yonkers, and MCTMT: then enter the total n the Total payment box. Note: If there is no amount to be entered for one or more Ines, leave them Manic. Do not staple or clip the check or money order to the voucher. Please detach any check stubs before mailing. Need help? Visit our website at www.tany.gov • get information and manage your taxes online • check for new online services and features Telephone assistance Automated income tax refund status: Personal Income Tax Information Center. To order forms and publications: A (518) 457-5149 (518) 457.5181 (518) 457-5431 Text Telephone (TTY) Hotline (for persons with hearing and speech disabilities using a TTY): If you have access to a TTY. contact us at (518) 485-5082. If you do not own a TTY. check with independent eviler' living centers or community action programs to find out where machines are available for public use. Persons with disabilities: In compliance with the Americans with Disabilities Act. we will ensure that our lobbies, offices, meeting rooms, and other facilities are accessible to persons with disabilities. If you have questions about special accommodations for persons with disabilities, call the information center. 2018 NEW Department of Taxation and Finance YORK STATE Estimated Tax Payment Voucher for Individuals New York State • New York City • Yonkers • MCTMT el Detach (cut) here OP Calendar-year filer due dates: April 17.2018; June 15, 2018; September 17, 2018; and January 15, 2019. Enter applicable amount(s) and total payment In the boxes to the dolt. Print the test tour digits of your SSN or taxpayer ID number and 201817-22105 on your payment. Make payable to PFIS Income Tax. Mail voucher and payment to: NYS Estimated Income Tax, Processing Center. PQ Box 4122. Binghamton NY 13902-4122. pull SSN or taxpayer iu number *****9816 Enter your 2-character special condition code if applicable (see/ taxpayer s hrst name and middle initial ANASTASIYA iaxpayer s last name SIROOCHENKO Mailing address (number and street or PC box; see instruchons) Apartment number NEW YORK state NY ZIP code 10014 taxpayer s e-mail address IT-2105 Estimated tax amounts str) Now York Stale 0 00 New YQIk City 0 00 Yonkots 00 KICTIM 00 Total payment 0 00 STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792216
er NEW YORK STATE 2018 - Tips for Estimated Tax Department of Taxation and Finance 768012 10.27.17 Did you know? You can pay your estimated tax electronically on our website with a debit from your checking or savings account. Visit us on the Web at www.tax.ny.gov to pay your estimated tax electronically. For assistance. see Form IT-21054, Instructions for Form IT-2105, Estimated Tax Payment Voucher forIndNlduels. To help us match your New York State estimated tax account to your New York State income tax return. and to avoid a delay in processing your return, please note the following: • Social security number (SSN)Aaxpayer Identification OD) number - Make sure that the entire SSN used on your vouchers agrees with the number on your social security card and the number used on your New York State income tax return. If you use a taxpayer ID number, this number must agree with the number used on your New York State income tax return. Failure to do so may result in monies not being properly credited to your account. • Name - Make sure that your name is spelled correctly. You should enter your first name, middle initial, then last name in the spaces provided (for example, John O. Smith). Your name must agree with the name on your New York State income tax return. • Foreign addresses - Enter the information in the following order: city. province or state, and then country (all in the City, village, or post office box). Follow the country's practice for entering the postal code. Do not abbreviate the country name. • Married taxpayers - Each married taxpayer should establish a separate estimated tax account. If you and your spouse each maintain an estimated tax account and file a joint New York State income tax return, we will credit the balances of both accounts to your joint income tax return. • All filers must be sure to separately enter the amounts for New York State, New York City. Yonkers, and MCTMT: then enter the total n the Total payment box. Note: If there is no amount to be entered for one or more Ines, leave them blank. Do not staple or clip the check or money order to the voucher. Please detach any check stubs before mailing. Need help? Visit our website at www.taK.ny.gov • get information and manage your taxes online • check for new online services and features Telephone assistance Automated income tax refund status: Personal Income Tax Information Center: To order forms and publications: (518) 457-5149 (518) 457.5181 (518) 457-5431 Text Telephone (TTY) Hotline (for persons with heating and speech disabilities using a TTY): If you have access to a TTY, contact us at (518) 485-5O82. If you do not own a TTY. check with independent eviler' living centers or community action programs to find out where machines are available for public use. Persons with disabilities: In compliance with the Americans with Disabilities Act. we will ensure that our lobbies, offices. meeting rooms, and other facilities are accessible to persons with disabilities. If you have questions about special accommodations for persons with disabilities, call the information center. 2018 NEW Department of Taxation and Finance YORK STATE Estimated Tax Payment Voucher for Individuals New York State • New York City • Yonkers • MCTMT 1 Detach (cut) here Calendar-year filer due dates: April 17, 2018; June 15, 2018; September 17, 2018; and January 16, 2019. Enter applicable amount(s) and total payment In the boxes to the fight. Print the Last tour CigitS of your SSN or taxpayer ID number and 20181T-2105 on your payment. Make payable to WS Income Tax. Mail voucher and payment to: NYS Estimated Income Tax, Processinci Center. PQ Box 4122, Sinohamton NY 13902-4122. rug SSN or taxpayer lu number *****9816 Enter your 2-character special condition code if applicable (see! i axpayer s hrst name and middle initial ANASTASIYA i axpayer s last name SIROOCHENKO mean address number and street or PC box; see instructions) Apartment number vi age, or pos o e NEW YORK state NY ZIP code 10014 laxpayer s e-mail aadress IT-2105 Estimated tax amounts str) now York Stale 0 00 New YOIk CRY 0 00 Yonkots 00 KICTIM 00 Total payment 0 00 STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792217
2018 768042 10.27.17 Department of Taxation and Finance Tips for Estimated Tax Did you know? You can pay your estimated tax electronically on our website with a debit from your checking or savings account. Visit us on the Web at www.tax.ny.gov to pay your estimated tax electronically. For assistance. see Form IT-21054, Instructions for Form IT-2105, Estimated Tax Payment Voucher lorIndlvkluals. To help us match your New York State estimated tax account to your New York State income tax return. and to avoid a delay in processing your return, please note the following: • Social security number (SSNytaxpayer Identification SD) number - Make sure that the entire SSN used on your vouchers agrees with the number on your social security card and the number used on your New York State income tax return. If you use a taxpayer ID number, this number must agree with the number used on your New York State income tax return. Failure to do so may result in monies not being properly credited to your account. • Name - Make sure that your name is spelled correctly. You should enter your first name, middle initial, then last name in the spaces provided (for example, John O. Smith). Your name must agree with the name on your New York State income tax return. • Foreign addresses - Enter the information in the following order: city. province or state, and then country (all in the City, village, or post office box). Follow the country's practice for entering the postal code. Do not abbreviate the country name. • Married taxpayers - Each married taxpayer should establish a separate estimated tax account. If you and your spouse each maintain an estimated tax account and file a joint New York State income tax return, we will credit the balances of both accounts to your joint income tax return. • All filers must be sure to separately enter the amounts for New York State. New York City. Yonkers, and MCTMT: then enter the total in the Total payment box. Note: If there is no amount to be entered for one or more Ines, leave them blank. Do not staple or clip the check or money order to the voucher. Please detach any check stubs before mailing. Need help? Visit our website at www.tany.gov • get information and manage your taxes online • check for new oriole services and features Telephone assistance Automated income tax refund status: (518) 457-5149 Personal Income Tax Information Center. (518) 457.5181 To order forms and publications: (518) 457-5431 Text Telephone (TTY) Hotline (for persons with hearing and speech disabilities using a TTY): If you have access to a TTY, contact us at (518) 485.5082. If you do not own a TTY. check with independent living centers or community action programs to find out where machines are available for public use. Persons with disabilities: In compliance with the Americans with Disabilities Act. we will ensure that our lobbies, offices, meeting rooms, and other facilities are accessible to persons with disabilities. If you have questions about special accommodations for persons with disabilities, call the information center. NEW Department of Taxation and Finance YORK STATE Estimated Tax Payment Voucher for Individuals New York State • New York City • Yonkers • MCTMT 1 Detach (cut) here OP Calendar-year filer due dates: April 17, 2018; June 15, 2018; September 17, 2018; and January 15, 2019. Enter applicable amounts aria rota payment in me coxes to me nom. wintry* Last Tour Inas or your bei or re 2018 IT-2105 on your payment. Make payable to WS Income Tax. Mail voucher and paytnen Processinci Center. PQ Box 4122, Binghamton NY 13902-4122. pull SSN or taxpayer lu number *****9816 Enter your 2-character special condition code it applicable (see/ taxpayers hrst name and middle initial ANASTASIYA iaxpayer s last name SIROOCHENKO PC box; see instruchons) Apartment number , , NEW YORK state NY ZIP code 10014 taxpayers e-mail address IT-2105 Estimated tax amounts payer ID number and to: NYS Estimated Income Tax, DONS Cents st') 100480. 00 New York Stale New YQIk City 36840. 00 Yonkots 00 KICTIK 00 Total payment 137320. 00 STOP: Pay this electronically on our website 0601181019 *****9816 9 EFTA00792218
2017 NEW YORK STATE Department of Taxation and Finance Resident Income Tax Return New York State • New York City • Yonkers • MCTMT For the full year January 1, 2017, through December 31, 2017, or fiscal year beginning and ending 76S:101 1t 17,17 1T-201 ror neip completing your return, see me insuucoons, ronn I I •ZIPI. I. Your tirai name Mi Y011 last name (ter a pail return, enter epcuee's mime on line be Your date Ol WM (mmdaPPIY/ 'tax Mail Mart number ANASTAS IYA S IROOCHENKO 07301987 I Spouse's first name MI Spouse's lae1 name Spouse's date Of DIM pendapral Spouse's Social Saari), number Mailing address (see instructions. page 13/Muni:sand Mater or PO be I 'velment number New York Statecounty of residence 288 WEST 4TH ST NY City. village. a pail oltce Stare MP cock, Country pt not u kW elates/ School ninny name NEW YORK NY 10014 MANHATTAN Taxpayer's permanent home address (nee instructions. page 13)(nwnber end seal or rural route) AMU rant nombie School district code norrike r 369 City. Wimp. Or pint °MOO Stale ZIP code Tanliyin One 01 Oail arnataiM $2219, 5MM/idea/I OnMeaani I i ef l Em al__LI__I tiMMI A Filing status (mark an X In ono box): O El Single @ Married filing joint return LJ (enter spouse's social security number above) m Married filing separate return LJ (enter spouse's social security number above) 0 D Head of household kith qualifying person) D Qualifying widow(er) with dependent child B Did you Itemize your deductions on your 2017 federal income tax return? Yes ID No D C Can you be claimed as a dependent on anothe taxpayer's fede al return? Yes K No El r rr 1 H Dependent exemption inforrna ion (see Page 15) First name MI Last name Relationship Social security number Date of bitt (mmddyy)Y) 1 D1 Did you have a fnancial account located in a foreign country? (see page 14) D2 Yonkers residents and Yonkers part-year residents only: (1 ) Did you receive a property tax relief credit? (see page 14) Yes ri No K (2) Enter the amount .00 Yes El No K D3 Wore you requred to report, under M. 110-343, Div. C, §801(d)(2). any nonqualified deferred compensation on your 2017 federal return? (seepage 14) Yes K No El E (1) Did you or your spouse maintain living quarters in NYC during 2017? (see page 14) Yes K No K (2) Enter the number of days spent in NYC in 2017 (any part of a day spent in NYC is considered a day)... F NYC residents and NYC part-year residents only (seepage 14): (1) Number of months you lived in NYC In 2017 365 X12 (2) Number of months your spouse lived in NYC in 2017 G Enter your 2-character special condition code(s) If applicable (see page 14) If more than 7 dependents. mark an X in the box. 1111121111141161 0 ill For office use only NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM EFTA00792219
Page 2 of 4 IT-201 (2017) Yost social security number 768002 lirt7-17 Federal income and adjustments (see page 15) 1 Wages, salaries, tips, etc. 2 Taxable interest income 3 Ordinary dividends 4 Taxable refunds, credits, or offsets of state and local income taxes (also enter on Ma 25) 5 Alimony received 6 Business income or loss (submit a copy of federal Schedule Cot C-EZ, Form 1040) 7 Capital gain or loss (if required, submit a copy of federal Schedule D, Form 1040) 8 Other gains or losses (submit a copy of federal Form 4797) 9 Taxable amount of IRA distributions. If received as a beneficiary, mark an X in the box 10 Taxable amount of pensions and annuities. If received as a beneficiary. mark an X in the box 11 Rental real estate, royalties, partnerships, S corporations, trusts, etc. (submit copy of federal Schedule E, Form 1040) 12 Rental real estate included in line 11 13 Farm income or loss (submit a copy of federal Schedule F, Form 1040) 14 Unemployment compensation 15 Taxable amount of social security benefits (also enter on line 27) 16 Other income two pegs 15) I identifY: 17 Add lines 1 through 11 and 13 through 16 18 Total federal adjustments to income gee page 15) Ild6VINfr SE TAX DEDUCTION Whole dollars only 1 .00 _ 2 755.00 _ 3 .00 _ 4 .00 _ 5 .00 _ 6 1645828.00 7 .00 8 .00 9 .00 10 .00 11 .00 121 .00 19 Federal adjusted gross Income (subtract line 18 from line 17) New York additions (see Pogo 10 20 Interest income on state and local bonds and obligations (but not those of NYS or its local governments) 21 Public employee 414(h) retirement contributions from your 4lage statements (sea Page 16) 22 New York's 529 college savings program distributions 23 Other (Form IT-225, line 9) 24 Add lines 19 through 23 New York subtractions (see page 17) 25 Taxable rotunda credits, or offsets al state are loco/ income taxes prom lino 4) 25 .00 26 Penton of NYS and tocol governments and two Waal government (see page IT) 26 .00 27 Taxable amount of social security benefits (from line 15) 27 .00 28 Interest income on U.S. government bonds 28 .00 29 Pension and annuity income exclusion (see page 18) 29 .00 30 New York's 529 college savings program deduction/eamings 30 .00 31 Other (Form 1T-225, line 18) 31 .00 32 Add lines 25 through 31 33 New York adjusted gross Income (subtract line 32 from fine 24) (Standard deduction or itemized deduction (see page 20) 34 Enter your standard deduction (table on page 20) or your itemized deduction (from Form IT-201-D) Mark an X in the appropriate box: Standard al Itemized 35 Subtract line 34 from line 33 Of line 34 is more than line 33, leave blank) 36 Dependent exemptions (enter the number of dependents listed in Item H; see page 20) 37 Taxable Income (subtract line 36 from line 35) 1 1111 o III 13 .00 14 .00 15 .00 16 .00 17 1646583.00 18 29926.00 19 1616657.00 20 .00 21 .00 22 .00 23 .00 24 1616657.00 32 33 .00 1616657.00 34 11145.00 35 1605512.00 36 000.00 37 1605512.00 NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM EFTA00792220
Nameis) as shown on page I ANASTASIYA SIROOCHENKO Tax computation, credits, and other taxes 38 Taxable Income (from line 37 on page 2) 38 1605512.00 39 NYS tax on line 38 amount (see page 21) 39 141606.00 40 NYS household credit (page 21, table 1, 2, or 3) 40 .00 41 Resident credit (see page 22) 41 .00 42 Other NYS nonrefundable credits (FonralT-201-ATT, line 7) 42 .00 43 Add lines 40, 41, and 42 43 .00 44 Subtract line 43 from line 39 Of tine 43 is more than line 39, leave blank) 44 141606.00 45 Net other NYS taxes (Form 1T-201-ATT. line 30) 45 00 46 Total New York State taxes (add lines 44 and 45) 46 141606.00 768003 11.17.17 IT-201 (2017) Page 3 of 4 New York City and Yonkers taxes, credits, and surcharges, and MCTMT 47 NYC resident tax on line 38 amount (see page 22) 47 62105 oo 48 NYC household credit (Page 22, table 4, 5, or 6) 48 .00 49 Subtract line 48 from line 47 49! line 48 is more than line 47, leave blank) 49 62105 .00 50 Panyear NYC resident tax (Form IT-360.1) 50 .00 51 Other NYC taxes (Form IT-201-AM line 34) 51 .00 52 Add lines 49, 50, and 51 52 62105 .00 53 NYC nonrefundable credits (Form IT-201-ATT, fine 10) 53 15004 .00 54 Subtract line 53 from line 52 (if Una 531s more than fine 52, leave blank) 54 47101 .00 Ma MCTMT net earnings base Islet 1519922 .00 54b MCTMT Mb 5168 .00 55 Yonkers resident income tax surcharge (see page 25) 66 .00 56 Yonkers nonresident earnings tax (Form V-203) 56 .00 57 Part-year Yonkers resident income tax surcharge (Form IT-360.1) 67 .00 58 Total New York City and Yonkers taxes / surcharges and MCTMT (add lines 54 and 54b through 57) 59 Sales or use tax (see page 26: do not leave line 59 blank ) 04'pr Voluntary contributions (see page 27) 60a Return a Gift to Wildlife 60a .00 60b Missing/Exploited Children Fund 60b .00 60c Breast Cancer Research Fund 60c .00 60d Alzheimer's Fund 60d .00 60e Olympic Fund ($2 a $4; see page 27) 60e .00 601 Prostate and Testicular Cancer Research and Education Fund 601 .00 60g 9/11 Memorial 60g .00 60h Volunteer Firefighting & EMS Recruitment Fund 60h .00 601 Teen Health Education 60i .00 60) Veterans Remembrance 60) .00 60k Homeless Veterans 60k .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 taxes, MCTMT, and voluntary contributions (add fines 46, 58, 59, and 60) 201003171019 oic See instructions on pages 22 through 25 to compute New York City and Yonkers taxes, credits, and surcharges, and MCTMT. 52269.00 sat 59 6_ 01 Ono .00 61 193875.00 NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM EFTA00792221
Page 4 of 4 IT-201 (2017) 768001 11-17-N. 62 Enter amount from line 61 Payments and refundable credits (see pages 28 through 31) 62 1938750o 63 Empire State child credit 63 .00 64 NYS/NYC child and dependent care credit 64 .00 65 NYS earned income credit (BC) 65 .00 66 NYS noncustodial parent EIC 66 .00 67 Real property tax credit 67 .00 68 College tuition credit 68 400 .00 69 NYC school tax credit (fixed amount) (also complete F on page 1) 69 .00 69a NYC school tax credit (rate reduction amount) 69a 00 70 NYC earned income credit 70 .00 70a NYC enhanced real property tax credit 70a 00 71 Other refundable credits( OIM IT-201-ATT, line 18) 71 .00 72 Total New York State tax withheld 72 00 73 Total New York City tax withheld 73 DO 74 Total Yonkers tax withheld 74 00 76 Total estimated tax payments and amount paid with Form IT•370 75 205000 .00 76 Total payments (add lines 63 through 75) Your refund, amount you owe, and account information (see pages 31 through 34) 77 Amount overpaid Of line 76 is more then line 62, subtract line 62 from line 76) 78 79 79a 80 81 82 83 Amount of line 77 to be refunded (— I direct deposit to checking or Mark one refund choice: savings account mu in Ina 83) Amount of line 77 that you want applied to your 2018 estimated tax (see instructions) Amount of line 77 that you want as a NYS 529 account deposit (submit Form I7-195) Amount you owe (if line 761s less than Me 62, subtract line 76 from line 62). To pay by electronic funds withdrawal, mark an X in the box K and in lines 83 and 84. If you pay by check or money order you must complete Form IT201N and mail it with your return Estimated tax penalty °mind° this amount in line 80 or reduce the overpayment on line 77; see page 32) Other penalties and interest (see page 32) Account information for direct deposit or electronic funds withdra val (see page 33). If the funds for your pnment (or refund) would co K me from (or go to) an account outside the U.S., mark an X in this K box (see pg. 33) paper I__I check If applicable, complete Form(s) IT-2 and/or IT-1099-R and submit them with your return (see page 12). Do not send federal Form W-2 with your return. 76 I 205400.00 LESS LN 81 rt I 11180oo 78 00 11180 .00 Refund? Direct deposit is the easiest, fastest way to get your refund. See page 32 for payment options. 80 00 79 7921 .00 81 345 .00 82 .00 See page 35 for the proper assembly of your return. 8:3a Account type: Personal checking - or - Personal savings - or - D Business checking - or - Business savings 83b Routing number 84 Electronic funds withdrawal (see page 33) 83c Account number Date Amount .00 Third-party designee? (see Instr.) Yesird No ri EmS: • Paid preparer must complete/ Mane. 51010.1r. DAVID WEI SS Print designee's name DAVID WEI Designee's phone number may NYIPRIN Personal identification number (PIN) 13349 /metope. 03 Preparers prow nom DAVID WEISS FM'S MM. Or yours. al 80-ertoroysiin DAVID WEISS CPA, PLLC mews 183 MADISON AVE SUITE 803 Preparers PIIN a ESN 1 1111 III 11 III • Taxpayer(s) must sign here • VOW signature Your ocCupellOn ART DEALER Spouse's signature and OCcupalion ht Pint NUM DON Daytime phone melte dons for where to mall your return. NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM EFTA00792222
NEW YORK STATE 2017 See the instructions for completing Form 11.201ATT in the instructions for Form 11.201. Submit this form with your Form IT-201. Department of Taxation and Finance Other Tax Credits and Taxes Attachment to Form IT-2O1 s 1T-201LATT Name(s) as 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 instructions) Part 1 - O her New York State, New York City, and Yonkers ax credits Section A - New York State nonrefundable, non-carryover credits used 1 Accumulation distribution credit (submit computation) 2 Other nonrefundable, noncanyover credits Code Amount .00I El Code Total other nonrefundable. noncarryover credits (addlines 2a and 2b) Amount .00 Section B - New York State nonrefundable, carryover credits used 3 Longterm care insurance credit 4 Investment credit 5 Solar energy system equipment credit 6 Other nonrefundable. carryover credits Code Amount ea ee se ed se 61 69 .00 .00 .00 .00 .00 .00 .00 Code Amount 6h .00 61 .00 S .00 ek .00 61 .00 6m .00 6n .00 Total other nonrefundable. carryover credits (add lines 6a through 6n) 7 Total New York State nonrefundable credits used (add lines 1 through 6: enter here and on Form (T-20 f, line 42) Section C - New York City nonrefundable, non-carryover credits used 8 New York City resident UST credit 8a New York City resident GCT credit 9 New York City accumulation distribution credit (submit computation) 9a Partyear resident nonrefundable NYC child and dependent care credit 10 Total other New York City nonrefundable credits used (add lines 8.8a. 9. and 9a: enter here and onForm 17t201, fine 53) Yes No El O Whole dollen only 1 .00 21 .00 3 .00 4 .00 5 .00 61 .00l 7 .00 8 15004.00 8a .00 9 .00 9a .00 10 15004.00 Section D - New York State, New York City, Yonkers, and MCTMT refundable credits 11 Farmers' school tax credit 12 Other refundable credits Code 12a 12b 12c 12d 12e 12f Total other refundable credits (add lines 12a through 120 13 Add lines 11 and 12 Code Amount 12g .00 - 12h .00 12i .00 .00 12k .00 121 .00 11111111111i11111 111111111111 (continued on page 2) 11 00 12 13 .00 .00 EFTA00792223
IT-201-ATT (2017) (page 2) Part 1, Section D - New York State, New York City, Yonkers, and MCTMT refundable credits (continued) 14 Entor amount from line 13 on page 1 15 New York State claim of right credit 16 New York City claim of right credit 17 Yonkers claim of right credit 17a MCTMT (metropolitan commuter transportation mobility tax) claim of right credit 18 Total New York State, New York City, Yonkers, and MCTMT other refundable credits (add lines 14 through 17a; enter here and onForm 1T-201, One 71) Part 2 - Other New York State taxes (submit all applicable forms) If you are subject to other New York State taxes, complete Part 2. 19 New York State tax on capital gain portion of lump•sum distributions (Form IT-230) 20 Other New York State taxes Code Amount 20a 20b 20c 20d 20e 201 .00 .00 .00 .00 .00 .00 1_0a 20h 201 a 20k 201 Code Total other New York State taxes (add lines 20a th ough 200 Amount .00 14 15 .00 16 .00 17 .00 7a .00 18 .00 19 .00 .00 .00 .00 .00 .00 .00 21 Add lines 19 and 20 22 See instructions for line 22 23 Enter amount from Form IT-201, line 39 24 26 20 1 .00 I 21 .00 22 23 .00 .00 Subtract line 23 from line 22 C line 23 is more than line 22, leave blank) Subtract line 24 from line 21 (f line 24 is more than line 21. leave blank) 26 New York State separate tax on lump.sum distributions (Form IT-230) 24 25 .00 .00 26 .00 27 Resident credit against separate tax on lumpsum distributions 127 I 28 Subtract line 27 from line 26 .00 29 This line intentionally left blank 30 Net other New York State taxes (add lines 25 and 28: enter here and onForm IT-201, line 45) Part 3 - Other New York City taxes (submit all applicable forms) 31 This line intentionally left blank 32 New York City resident separate tax on lumpsum distributions (Form IT-230) 33 New York City tax on capital gain portion of lump.sum distributions (Form IT-230) 34 Total other New York City taxes (add lines 32 and 33; enter here and onForm IT-201, line 51) 241002171019 III 11 III 28 1 .001 29 30 .00 31 32 33 .00 .00 34 .00 NO HANDWRITTEN ENTRIES ON THIS FORM 41 A 7t ft? EFTA00792224
NEW YORK STATE 2017 21]Ml• OD :la 12. Department of Taxation and Finance Resident Itemized Deduction Schedule IT-201-D Submit this form with Form IT-201. See instructions for completing Form 11.201O in the instructions for Form IT•201. 11.201 Name(s) as shown on your Form ANASTASIYA Yaw social secur number SIROOCHENKO 1 Medical and dental expenses (federal Schedule A, line 4) 2 Taxes you paid (federal Schedule A, line 9) 3 Interest you paid (federal Schedule A, line 15) 4 Gifts to charity (federal Schedule A, line 19) 5 Casualty and theft losses (federal Schedule A, line 20) 6 Job expenses/miscellaneous deductions (federal Schedule A, line 27) 7 Other miscellaneous deductions (federal Schedule A, line 28) 8 Enter amount from federal Schedule A, line 29 TATEMENT 1 9 State. local. and foreign income taxes (or general sales tax, If applicab and ether subtraction adjustments (see Instructions) 10 Subtract line 9 from line 8 11 Addition adjustments (see instructions) 12 Add lines 10 and 11 13 Itemized deduction adjustment (see instructions) 14 Subtract line 13 frcrn line 12 STATEMENT 2 15 College tuition itemized deduction (see Form 1T-272) 16 New York State itemized deduction (add lines 14 and 15; enter on Pamir-201, line 34) 201005171019 Whole dollars only 1 .00 2 227641.00 3 .00 4 22290.00 5 .00 6 .00 7 .00 8 209276.00 9 190604.00 10 18672.00 11 4500 oo 12 23172.00 13 12027 oo 14 11145.00 15 .00 16 11145.00 NO HANDWRITTEN ENTRIES ON THIS FORM EFTA00792225
All others: Add lines 5, 6. and 7 (partners. see instructions) 9 Enter your taxable income from: Full-year NYC resident individuals - Form IT-201, line 37 Part-yea. NYC resident Individuals - Forte 11%360.1. line 47 Full-year NYC resident estates or trusts - Form 11%205, line 5 Part-year NYC resident trusts - Form IT•205•A, line 10. col. (b) 10 If line 9 above is: — $42,000 or less, enter 1.000 (100%) — more than $42.000, but less than $142,000, complete Worksheet B (on page 2) — $142,000 or more, enter .230 (23%) 11 Multiply line 8 by line 10. New York City resident Individuals - Continue on line 12 below. NYC part-year resident individuals: Stop: enter line 11 amount on Form IT-360.1, line 54. Estates and trusts: Stop: 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 IT-201-ATT. line 8 NEW YORK STATE 2017 Submit Form IT-219 with your return. Form IT-201. Form IT-203. or Form IT-205. Department of Taxation and Finance Credit for New York City Unincorporated Business Tax Name(s) as shown on retum ANASTASIYA SIROOCHENKO Part 1 - Partner (see instructions) 768)11 II•f18 I T ▪ 2 1 9 Taxpayer identification number SSN or EIN) Name of partnership (as shown on Form NYC-204) Partnership year end (tom Fain NYC.204) Partnership ON 1 Enter the amount from Form NYG.204, line 23 (see instr.) 1 .00 2 Enter the amount from Form NYC-204, line 20 (see Instr.) 2 .00 3 Add lines 1 and 2 31 .00 4 Enter your percentage of total distributive shares from Form NYO204, Schedule C, column I. Enter amount as a decimal and round to the fourth decimal place (1or examPle. 17.5% =.1750) 4 5 Multiply line 3 by line 4 (if more than one business, see instructions) 5 .00 Part 2 - Individual A 6 Resident individual: Enter the amount from Form NYC-202, line 21, or Form NYC-2025. line 8 (see Instr.) Part-year resident Individual: Enter the amount from Worksheet A, line 5 (on page 2) 65233.00 Part 3 - Beneficiary's share of unincorporated business taxes(soe Instructions) 7 Beneficiary - Enter your share of New York City unincorporated business taxes imposed on the estate or trust (see instructions) Name of estate or trust Employer identification number 7 .00 Part 4 - Computation of credit 8 Fiduciaries: Enter the amount from Schedule A, Fiduciary line, column D (on page 2; see instr.) Lel 41 1605512.00 219001171019 III IIII III 1 II IIII III! I III I III II III 65233.00 10 .230 11 15004.00 12 62105.00 13 .00 14 .00 15 62105.00 16 15004.00 EFTA00792226
IT-219 (2017) (Page 2) 768212 11.13-17 1 2 3 4 5 Worksheet A Enter the amount from Form INC-202, line 21, Form NYC-202EIN, line 21, or Form NYC•202S, line 8 Individuals: Enter the amount from Form IT560.1, line 6, column B Trusts: Enter the amount from Form IT-205A, Schedule 4, line 16, column C 1 .00 (see instructions) 2 .00 Individuals: Enter the amount from Form IT-360.1,11e 6, column A Trusts: Enter the amount from Form IT-205A, Schedule 4, line 16, column A (see instructions) 3 .00 Divide line 2 by line 3 and round the result to the fourth decimal place 4 Multiply line 1 by line 4. This is the pait•year resident tax imposed on the unincorporated business. Estates and trusts: Include this amount (below) in Schedule A. Totals line, column D. All others: Transfer this amount to line 6 on page 1 5 .00 Worksheet B 1 Base percentage 100% 1 1.000 2 Enter your taxable income from page 1, line 9 2 .00 3 Base amount $42500.00 4 5 6 7 Subtract line 3 from line 2 4 .00 Divide line 4 by $100,000 and rand to the third decimal place Multiply line 5 by .770 Subtract line 6 from Ilne 1. Transfer this decimal amount to page 1. line 10 7 Schedule A (for estates and trusts only) Fiduciary's and beneficiary's share of New York City unincorporated business tax A Name and address of beneficiary B Beneficiary's identifying number C Allocation percentage D Beneficiary's eligible unincorporated business taxes Totals 100% .00 .00 .00 .00 Fiduciary .00 III III III 11 III EFTA00792227
NEW YORK STATE 2017 Department of Taxation and Finance Claim for College Tuition Credit or Itemized Deduction Full-year New York State residents only Submit your completed Form IT-272 with Form IT201. See Form IT2724, Instructions for Form IT-272. Your name as shown on return (first name first) Your social securit number ANASTASIYA SIROOCHENRO Spouse's name (first name first) Spouse's social security number Note: If you are married and filing separate New York State returns, you must also enter your spouse's name and social security number. IMI!)! I 0-02.17 11-272 1 Are you claimed as a dependent on another taxpayer's New York State tax return for this tax year? El Yes D No W • If Yes, stop; you do not qualify for the college tuition credit or the college tuition itemized deduction. • If No, continue with question 2. 2 Were you (and your spouse if filing a Joint return) a New York State resident for all of this tax yea? • If Yes, continue with Part 1 below. • If No, stop; you do not qualify for the college tuition credit. However, you may qualify for the college tuition itemized deduction. For more information, see the instructions for Form 11203. Yes II No n Part 1 - In the spaces provided below, complete lines A through H for up to three eligible students for whom you paid qualified college tuition expenses. (If you are claiming expenses for more than three eligible students, see instructions.) A Eligible students name 1- Student 1 2- Student 2 3- Student 3 ANASTAS I YA S IRO Eligible students social security B number (SSN) *****9816 Is the student claimed as a dependent C on your NYS return? (see instructions) Yes Fi No M Yes F-I No In Yes Fl No Fl D EIN of college or university (see Instr.) 135598093 E Name of coll or univ ' (see Instr.) TRUSTEES OF COL Were expenses for undergraduate F tuition? (see instructions) Yes IT' No n Yes Fl No In Yes El No n Amount of qualified college tuition G expenses (see instructions) 39018.00 .00 .00 H Enter the lesser of line G or 10.000 10000.00 .00 .00 3 Total qualified college tuition expenses (Add line H, columns f, 2, and 3; include amounts from any additional sheets. Complete Part 2or Part 3 on page 2.) 272001171019 o III fb 3 10000.00 NO HANDWRITTEN ENTRIES ON THIS FORM EFTA00792228
IT•272 (2017) (page 2 of 2) 76E+097 10.02.17 Part 2 - Complete Part 2 if your total qualified college tuition expenses on line 3 are less than $5,000. 4 Credit limitation ($200) 6 Enter the lesser of line 3 or line 4. This is your college tuition credit • If you did not itemize your deductions on your federal return, enter the line 5 amount on Form IT.201. line 68. • If you itemized your deductions on your federal return, continue with Part 4. Part 3 - Complete Part 3 if your total qualified college tuition expenses on line 3 are $6,000 or more. 6 Enter the amount from line 3 7 Multiply line 6 by 4% (.04). This is yourcollege tuition credit • If you did not Itemize your deductions on your federal return, enter the line 7 amount on Form IT•201, line 68. • If you itemized your deductions on your federal return, continue with Part 4. Part 4 - College tuition itemized deduction election 4 200.00 5 .00 6 10000 00 7 400 oo If you itemized your deductions on your federal return, you may elect to claim the college tuition Itemized deduction instead of the college tuition credit. To compute your college tuition itemized deduction, complete Worksheet 1 in the instructions for this form. To determine if you will receive a greater tax benefit from the itemized deduction or credit. complete Worksheet 2 in the instructions for this form. 8 Mark an X in this box only if you elect to claim the college tuition Itemized deduction • If you marked an X in the box at line 8. enter the amount from Worksheet 1. line 5 On the instructions for this form), on your itemized deduction schedule. Do not enter the college tuition credit from line 5 or 7 above on Form I7201. You are entitled to claim either the deduction or the credit, but not both. • If you did not mark an X in the box at line 8 and you elect to claim the college tuition credit instead of the college tuition itemized deduction, enter the line 5 or line 7 amount on Form IT201, line 68. 8 Important: If you are claiming the college tuition credit or the college tuition itemized deduction, you must submit Form 11272 with your return. 272002171019 NO HANDWRITTEN ENTRIES ON THIS FORM EFTA00792229
NEW Department of Taxation and Finance YORK STATE By In wicluals and Fiduciaries 2017 New York State • New York City • Yonkers • MCTMT 1 pName(s) as shown on return ANASTASIYA SIROOCHENKO art 1 - All tilers must complete this part(seainsaucaons, Form IT-2105.9.1. for assistance) 768051 114)9.17 Underpayment of Estimated Tax IT-2105.9 Identification number (SSN or EIN) 1 Total tax from your 2017 return before withholding and estimated tax payments (caution. see instructions) 2 Empire State child credit (from Form IT-201, fine 63) 3 NYS/NYC child and dependent care credit (from Form IT-201, fine 64) 4 NY State earned income credit (EIC) (from Form IT-201, line 65) 5 NY State noncustodial parent EIC (from Form IT-201, fine 66) 6 Real property tax credit (from Form IT-201, fine 67) 7 College tuition credit (from Form IT-201, line 68) 7a Total amount of any check(s) received from the Tax Department for any school or property tax credits (see instructions) 8 NY City school tax credit (from Form ir.2or. Woe 69 end filo. or Form 17-203.11nOS 60 Ond 6041) 9 NY City earned income credit (from Form IT-201, line 70) 9a NY City enhanced real property tax credit (from Form IT-201, fine 70a) 10 Other refundable credits (worn Rom :T.201. Kno 71: Form17400.11110 41; Or FCfm17-205. 33) 11 Add lines 2 through 10 12 Current year tax (subtract line 11 from line 1) 13 Multiply line 12 by 90% (So) 14 Income taxes withheld (Mom Form M201.18148 72. 73. and 74: Form 1T.203.11nos 62.63. and 64: or FormFT-205.11mo 31.35. and 36) 15 Subtract line 14 from line 12. If the result is less than $300, do not complete the rest of this form (see instructions) 16 Enter your 2016 tax (caution: see Instructions) 17 Enter the smaller of line 13 or line 16 Part 2 - Short method for computing the penalty - Complete lines 18 through 24 if you paid withholding tax and/or paid four equal estimated tax instalments (on the due dates), or if you made no payments of estimated tax. Otherwise, you must complete Part 3 - Regular method. 18 Enter the amount from line 14 above 18 .00 19 Enter the total amount of estimated tax payments you made (see instructions) 19 .00 20 Add lines 18 and 19 20 .00 21 Total underpayment for yea'. Subtract line 20 from line 17 (if zero or less, you do not owe the penalty) 21 .00 22 Multiply line 21 by .04985 and enter the result 22 .00 23 If the amount on line 21 was paid on or after April 15. 2018. enter 0. If the amount on line 21 was paid before April 15, 2018, make the following computation to find the amount to enter on this line: Amount on line 21 x number of days paid beforeApt 15, 2018 x .00020 = 23 00 24 Penalty. Subtract line 23 from line 22 241 U11 2 3 4 5 8 7 .00 .00 .00 .00 .00 400.00 7e .00 .00 .00 .00 .00 8 9 ga 10 13 174128 oo 19 3 8 7 5.00 11 4 0 0.00 12 19 3 4 7 5.00 14 .00 19 3 4 7 5.00 16 118 5 9.00 17 11859.00 Enter here and on Form IT-201, line 81: Form fT•203, line 71: or Form 11%205, line 42. Part 3 - Regular method - Schedule A - Computing your underpayment (Schedule B Is on page 2) Payment due dates A 4/15/17 8 6/15/17 C 9/15/17 D 1/15/18 26 Required installments. Enter V4 of line 17 in each column. Rya, mod the annuallied Income Installment method. see Instructions.) 26 Estimated tax paid and tax withheld (see instructions) 25 29 6 5.00 2 9 6 5.00 29 6 5.00 296 4.00 26 .00 .00 .00 20 5000.00 Complete lines 27 through 29, one column at a time, starting In column A. 27 Overpayment or underpayment from prior period 27 - 2965.00 -5930.00 - 8 8 9 5.00 28 If line 27 is an overpayment, add lines 26 and 27; it line 27 is an underpayment, subtract line 27 from line 26 (see Instr.) 29 Underpayment (subtract line 28 from line 25) or overpayment (subtract line 25 from line 28; see instructions) 28 .00 - 2965.00 -5930.00 196105.00 29 - 2 9 6 5.00 - 59 3 0.00 - 8 8 9 5.00 193141.00 HI111111iiiiiiiiiii 11111 III EFTA00792230
IT-2105.9 (2017) (page 2) 768052 10-24-17 Part 3 - Regular method - Schedule 8 - Computing the penalty Payment due dates A 4/15/17 B 6/15/17 C 9/15/17 D 1/15/18 30 Amount of underpayment (from Me 29) First Installment (April 15 - June 15, 2017) 31 April 15 • June 15 = (61 365) x 7.5% = .01253 - Or - April 15 l* 365)x 7.5%= • 32 Multiply line 30. column A by line 31 30 31 32 2965.00 37 oc. Second Installment (June 15 - September 15, 20 7) 33 June 15 • September 15 = (92 365) x 7.5% = .01890 June 15. =( 365) x 7.5% = 34 Multiply line 30. column 8 by line 33 33 34 5930.0o 112 8895.00 Third installment (September 15, 2017 • January 15, 2018) 35 September 15. January 15 = (122 + 365) x 7.5% = .02506 ti -a- September 15. I 365) x 7.54t a 36 Multiply line 30. column C by line 35 Fourth Installment (January 15 - April 15, 2018) 37 January 15 • April 15 = (90* 365) x 7.5% = .01848 January 15 • *365)x 7.5% = • 35 36 1963:i .00 37 38 Multiply line 30, column D by line 37 39 Penalty. Add lines 32. 34, 36, and 38. Enter here and on Form IT•201, line 81: SEE ATTACHED UNDERPAYMENT WKSHT Form IT•203, Me 71: or Form IT-205. line 42 39 .00 345.00 059002171019 Submit this form with your New York State return. 38 EFTA00792231
UNDERPAYMENT OF ESTIMATED TAX WORKSHEET NY \air.e(s:, ANASTASIYA SIROOCHENKO ci,AL• I,H -Date (B) Amount (C) kfluMed Balance Due i 3aa-.e0.:e Dal ' Poraft'iRate -0- 04/15/17 2,965. 2,965. 61 .000205479 37. 06/15/17 2,965. 5,930. 92 .000205479 112. 09/15/17 2,965. 8,895. 107 .000205479 196. 12/31/17 205,000. -196,105. 01/15/18 2,964. -193,141. Penalty Due (Sum of Column F). 345. • Date of estimated tax payment. withholding credit date or installment due date. 71?ill 04.01.17 EFTA00792232
ANASTASIYA SIROOCHENKO NY IT-201 WORKSHEET 2 - SUBTRACTION ADJUSTMENT LIMITATION STATEMENT 1 1. ENTER AMOUNT FROM FEDERAL ITEMIZED DEDUCTION WORKSHEET, LINE 9 2. ENTER AMOUNT FROM FEDERAL ITEMIZED DEDUCTION WORKSHEET, LINE 3 3. DIVIDE LINE 1 BY LINE 2 AND CARRY THE RESULT TO FOUR DECIMAL PLACES 4. AMOUNT OF STATE, LOCAL AND FOREIGN INCOME TAXES FROM FEDERAL SCHEDULE A, LINES 5 AND 8 5. AMOUNT OF SUBTRACTION ADJUSTMENTS (FROM ITEMIZED DEDUCTIONS) THAT ARE INCLUDED IN TOTAL FEDERAL ITEMIZED DEDUCTIONS FROM FEDERAL SCHEDULE A, LINE 29, BEFORE ANY FEDERAL DISALLOWANCE 6. ADD LINE 4 AND LINE 5 7. MULTIPLY LINE 6 BY LINE 3 8. SUBTRACT LINE 7 FROM LINE 6 9. ENTER ANY OTHER SUBTRACTION ADJUSTMENTS TO ITEMIZED DEDUCTIONS 10. ENTER THE AMOUNT FROM WORKSHEET 1, LINE 5 (SEE BELOW) 11. ADD LINES 8, 9, 10. ENTER THE TOTAL ON FORM IT-201-D, LINE 9 40,655 249,931 0.1627 227,641 0 227,641 37,037 190,604 0 190,604 WORKSHEET 1 LONG-TERM CARE ADJUSTMENT 1. AMOUNT OF LONG-TERM CARE PREMIUMS INCLUDED ON FEDERAL SCHEDULE A, LINE 1 2. AMOUNT FROM FEDERAL SCHEDULE A, LINE 1 3. DIVIDE LINE 1 BY LINE 2 AND CARRY THE RESULT TO FOUR DECIMAL PLACES 4. AMOUNT FROM FEDERAL SCHEDULE A, LINE 4 5. MULTIPLY LINE 4 BY LINE 3 0 STATEMENT(S) 1 EFTA00792233
ANASTASIYA SIROOCHENKO NY IT-201-D ITEMIZED DEDUCTION WORKSHEET - ADDITION ADJUSTMENTS STATEMENT 2 DESCRIPTION AMOUNT 2015 NYC TAXES PAID IN 2017 4,500. TOTAL TO FORM IT-201-D, LINE 11 4,500. STATEMENT(S) 2 EFTA00792234
DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 (212) 695-5771 OCTOBER 4, 2018 ANASTASIYA SIROOCHENKO DEAR ANASTASIYA: ENCLOSED ARE YOUR 2017 NEW YORK CITY U.B.T. RETURN AND 2018 ESTIMATED TAX VOUCHERS. THIS RETURN HAS QUALIFIED FOR ELECTRONIC FILING. AFTER YOU HAVE REVIEWED YOUR RETURN FOR COMPLETENESS AND ACCURACY, PLEASE SIGN, DATE AND RETURN FORM NYC 579-UBTI TO OUR OFFICE BY MAIL, E-MAIL ([email protected]), OR FAX (212-695-5772). WE WILL THEN TRANSMIT YOUR RETURN ELECTRONICALLY TO THE NYC DOF, AND NO FURTHER ACTION IS REQUIRED. DO NOT MAIL THE PAPER COPY OF THE RETURN TO THE NYC DOF. IF AFTER THREE WEEKS YOU HAVE NOT RECEIVED YOUR REFUND, YOU MAY CONTACT THE NYC DOF AT . RETURN FORM NYC 579-UBTI TO US AS SOON AS POSSIBLE (BY OCTOBER 15, 2018). NO PAYMENT IS REQUIRED AS YOU ARE TO RECEIVE A REFUND IN THE AMOUNT OF $2,802. NEW YORK CITY U.B.T. ESTIMATED TAX VOUCHERS: SIGN AND SEPARATELY MAIL THE DECLARATION OF ESTIMATED TAX FORM AS SOON AS POSSIBLE. ENCLOSE YOUR CHECK FOR $65,240, PAYABLE TO NYC DEPARTMENT OF FINANCE. INCLUDE YOUR SOCIAL SECURITY NUMBER ON YOUR CHECK. MAIL TO - NYC DEPARTMENT OF FINANCE UNINCORPORATED BUSINESS TAX P.O. BOX 3923 NEW YORK, NY 10008-3923 FOR AND YOUR REFERENCE WE HAVE LISTED ALL ESTIMATED THEIR ORIGINAL DUE DATES BELOW. TAX PAYMENTS VOUCHER NO. 1 BY 04/17/18 NO PAYMENT REQUIRED VOUCHER NO. 2 BY 06/15/18 NO PAYMENT REQUIRED VOUCHER NO. 3 BY 09/17/18 $65,240 VOUCHER NO. 4 BY 01/15/19 NO PAYMENT REQUIRED YOUR COPY OF THE RETURN IS ENCLOSED FOR YOUR FILES. WE EFTA00792235
SUGGEST THAT YOU RETAIN THIS COPY INDEFINITELY. EFTA00792236
2017 TAX RETURN FILING INSTRUCTIONS NEW YORK CITY U.B.T. RETURN FOR THE YEAR ENDING DECEMBER 31, 2017 Prepared for ANASTASIYA SIROOCHENKO Prepared by DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 Amount of tax Total tax $ 65 233 Less: payments and credits $ 70,000 Plus: interest and penalties $ 1,965 OVERPAYMENT $ 2 , 8 0 2 Overpayment Miscellaneous Donations $ 1 0 Credited to your estimated tax $ 0 Refunded to you 2,802 Make check payable to NOT APPLICABLE Mail tax return and check (if applicable) to THIS RETURN HAS QUALIFIED FOR ELECTRONIC FILING. AFTER YOU HAVE REVIEWED YOUR RETURN FOR COMPLETENESS AND ACCURACY, PLEASE SIGN, DATE AND RETURN FORM NYC 579-UBTI TO OUR OFFICE. WE WILL THEN SUBMIT YOUR ELECTRONIC RETURN TO THE NYC DOF. Return must be mailed on or before RETURN FORM NYC 579-UBTI TO US BY OCTOBER 15, 2018. Special Instructions DO NOT MAIL THE PAPER COPY OF THE RETURN TO THE NYC DOF. IF AFTER THREE WEEKS YOU HAVE NOT RECEIVED YOUR REFUND, YOU MAY CONTACT THE NYC DOF AT . 700351 04-01.17 EFTA00792237
2018 ESTIMATED TAX FILING INSTRUCTIONS NEW YORK CITY U.B.T. ESTIMATED TAX FOR THE YEAR ENDING DECEMBER 31, 2018 Prepared for ANASTASIYA SIRO HENK Prepared by DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 Amount of tax Total Estimated Tax S 65,240 Less credit from prior year S - 0 Less amount already paid on 2018 estimate S 0 Balance due S 65,240 Payable in full or In Installments as follows: Installment Amount Due Date No.1 $ 0 APRIL 17, 2018 No.2 $ 0 JUNE 15, 2018 No.3 $ 65,240 SEPTEMBER 17, 2018 No.4 $ 0 JANUARY 15, 2019 Make check payable to NYC DEPARTMENT OF FINANCE Mail voucher andcheck(ff applicable)to NYC DEPARTMENT OF FINANCE UNINCORPORATED BUSINESS TAX P.O. BOX 3923 NEW YORK, NY 10008-3923 Special Instructions SIGN AND MAIL EACH VOUCHER ON OR BEFORE THE DATE INDICATED ABOVE. ENCLOSE YOUR CHECK FOR THE SPECIFIED AMOUNT, PAYABLE 1 NYC DEPARTMENT OF FINANCE. INCLUDE YOUR SOCIAL SECURITY NUMBER ON YOUR CHECK. 700021 044)I.1T EFTA00792238
NYC - 5UBTI C‘,:ercItit , 11;mt DECLARATION OF ESTIMATED UNINCORPORATED BUSINESS TAX (FOR INDIVIDUALS, ESTATES AND TRUSTS) For CALENDAR YEAR 2018 beginning and ending 2018 First name and oltial ANASTASIYA Laet name Nome Cbant, — SIROOCHENKO SOCIAL SECURITY NUMBER Sassiness name SUBLIME ART LLC BUENTESS CODE NUMBER AS PEE Et-IJE,tAl ESTATES ANO TRUSTS ONLY, ENTER EMPLOYER IDENTIFICATION NUMBER Baniness address (number and fleet, MINKS 244 FIFTH AVENUE #1590 Charge - City and Mate NEW YORK, NY ZIP Cot% 10001 Country In nOT US) Sassiness Telephone Number Taxpayer's Email Address A Payment 1. Estimate of 2018 tax Amount included with form • Make payable to: NYC Department of finance A. 2. Amount to be paid with this declaration (Payable to: NYC DEPARTMENT OF FINANCE) 2. ayrisan n 65240. 0. Signature of taxpayer 1Ir Data To receive proper credit, you must enter your correct Social Security Number or Employer Identification Number on your declaration and remittance. DETACH ON DOTTED LINE & MAIL UPPER PORTION. RETAIN LOWER PORTION FOR YOUR RECORDS 05 11. ESTIMATED TAX WORKSHEET • KEEP THIS PORTION FOR YOUR RECORDS • 1. Net income from business expected in 2018 (see instructions) 1. 2. 3. 4. Tax • enter 4% of line 3(see Instructions) 4, 5a. Business Tax Credit (00 ) (Check applicable box below and enter credit amount) Tax on line 4 is $3,400 or less. Your credit is the entire amount of tax on line 4. Tax on line 4 is $5,400 or over. No credit is allowed. Enter "0". Tax on line 4 is over $3,400 but less than S5,400, use formula for credit amount: Tax on line 4 X ( $5,400 minus tax on line 4) 5a. $2,000 sb, Other credits (see instructions) 5b. 6c. Total credits (add lines 5a and 5b) 5c. 6. Estimated 2018 Unincorporated Business Tax pine 4 less line 5c) Enter here, on line lb, and on line 1 of declaration above 7a. 2017 Unincorporated Business Tax 7a. 65233. 7b. Estimate of 2018 tax from line 6 ... 7b. COMPUTATION OF INSTALLMENT - ) Caeca proper box below and enter amount hdicated. Faecal year taxpayerssee Instructions. 8. II this declaration X April 17, 2018, enter 1/4 of line 7b Sept. 17, 2018, enter 1/2 of line 7b 2. Exemption (see instructions) 3. Line 1 less line 2 (estimated taxable business income) ADJBSTED TO 6. Is due on: — — June 15, 2018, enter 113 of line 7b Jan. 15, 2019, enter amount of line 7b 8. 9. Enter amount of overpayment on 2017 return which you e ected to have applied as a credit against 2018 estimated tax 9. 10. Amount to be paid with this declaration pine 8 less line 9) (Payable to: NYC DEPARTMENT OF FINANCE) 10. Make remittance payable to the order of: NYC DEPARTMENT OF FINANCE Payment must be made in U.S. dollars, drawn on a U.S. bank. 794571 II -15.17 65240. 65240. 0. MAILING INSTRUCTIONS MAIL YOUR DECLARATION FORM TO: WC DEPARTMENT OF FINANCE UNINCORPORATED BUSINESS TAX P.O. BOX 3923 NEW YORK, NY 10008.3923 NYC-51.18T1 2018 EFTA00792239
NYC - 5UBTI 0,:ercItit ,11;mt DECLARATION OF ESTIMATED UNINCORPORATED BUSINESS TAX (FOR INDIVIDUALS, ESTATES AND TRUSTS) For CALENDAR YEAR 2018 beginning and ending 2018 Fig ABM an, Initial I AV 0.-Vn9 Fiale Change — SOCIAL SECURITY NUMBER Business name BUSNESS CODE NUMBER AS PER FEDER/a HE TLHN SWIM'S address (number and street) Mitres* Caange — City and Sae ZIP coos I Cckinv? In n0 VS/ ESTATES ANO TRUSTS ONLY. ENTER EMPLOYER IDENTIFICATION NUMBER Business Telephone Runt. Taxpayer's Email Address aymonAmour' 1. Estimate of 2018 tax 2. Amount to be paid with this declaration (Payable to: NYC DEPARTMENT OF FINANCE) 1. 2. Signature of Caspar,/ Trio Date To receive proper credit, you must enter your correct Social Security Number or Employer Identification Number on your declaration and remittance. DETACH ON DOTTED LINE & MAIL UPPER PORTION. RETAIN LOWER PORTION FOR YOUR RECORDS 05 794672 11.15.17 EFTA00792240
NYC - 5UBTI C‘,:ercItit ,11;mt. DECLARATION OF ESTIMATED UNINCORPORATED BUSINESS TAX (FOR INDIVIDUALS, ESTATES AND TRUSTS) For CALENDAR YEAR 2018 beginning and ending 2018 Frbt ABM OM initial ANASTASIYA Last mole SIROOCHENKO Casot, — SOCIAL SECURITY NUMBER TRIMNESS CODE NUMBER AS PER EWEHAI HE TURN Esolness name SUBLIME ART LLC Business OCIdlOSS (numb°, aria StiaGil AddrOSS 244 FIFTH AVENUE #1590 Chang. Clly and Mate NEW YORK, NY ZIP Code 10001 Cony la not V$/ ESTATES PRO RIVETS ONLY. ENTER EMPLOYER IDENTIFICATION NUMBER Eanatess Telephone Numbs' Taxpayer's Entell AddieSS A Payment 1. Estimate of 2018 tax Amount included with form • Make payable to: NYC Department of Runts A. 2. Amount to be paid with this declaration (Payable to: NYC DEPARTMENT OF FINANCE) 1. 2. PaYmen 65240. 65240. 65240. Signature of taxpayer TRIO Data To receive proper credit, you must enter your correct Social Security Number or Employer Identification Number on your declaration and remittance. DETACH ON DOTTED LINE & MAIL UPPER PORTION. RETAIN LOWER PORTION FOR YOUR RECORDS 05 794672 11.16.17 EFTA00792241
NYC - 5UBTI 0,:ercItit ,11;mt DECLARATION OF ESTIMATED UNINCORPORATED BUSINESS TAX (FOR INDIVIDUALS, ESTATES AND TRUSTS) For CALENDAR YEAR 2018 beginning and ending 2018 Fig ABM an, Initial I AV 0.-Vn9 Fiale Change — SOCIAL SECURITY NUMBER Business name BUSNESS CODE NUMBER AS PER FEDER/a HE TLHN SWIM'S address (number and street) Mitres* Caange — City and Sae ZIP coos I Cckinv? In n0 VS/ ESTATES ANO TRUSTS ONLY. ENTER EMPLOYER IDENTIFICATION NUMBER Business Telephone Runt. Taxpayer's Email Address aymonAmour' 1. Estimate of 2018 tax 2. Amount to be paid with this declaration (Payable to: NYC DEPARTMENT OF FINANCE) 1. 2. Signature of Caspar,/ Trio Date To receive proper credit, you must enter your correct Social Security Number or Employer Identification Number on your declaration and remittance. DETACH ON DOTTED LINE & MAIL UPPER PORTION. RETAIN LOWER PORTION FOR YOUR RECORDS 05 794672 11.15.17 EFTA00792242
Estates and Trusts using an EIN as their primary identifier must use Form NYC-202E IN NYC - 202 Dow:mm(4 Fence UNINCORPORATED BUSINESS TAX RETURN f0rt INDIVIDUALS AND SINGLE-MEMBER LLCs For CALENDAR YEAR 2017 beginning First name and withal Last name ANASTASIYA SIROOCHENKO In Care Of Cnanca Business name SUBLIME ART LLC Business address (number and street) Address Change — 244 FIFTH AVENUE #1590 City and State NEW YORK, NY Business Telephone Number ZIP Code 10001 Country lit nOlUS) Bak beams Mein n NYC Crusdalrd 0UM butimg ended in AYC(rindetY) and ending 2017 TAXPAYER'S EMAIL ADDRESS SOCIAL SECURITY NUMBER BUSINESS CODE NUMBER FROM FEDERAL SCHEDULE C: Amended (earn It the purpose of the amended ream is to report a Heard a state carom chock Ma appmxime box: MS change Date or Anal NT$ change Determination Final return r Caned eparatons Attach copy of your entire federal Form 1030 and statement snowing ditexisition or Easiness propene. Engaged in a fully morrot unincorpormal business away Engaged in a partially exempt unincomoratal business activity Clam any an inn <Name ladaral tax benefits(sm instructions) Enter 2-chaea Weed ~Moe code. Ir retelicanbtese retractions) SCHEDULE A Computation of Tax BEGIN WITH SCHEDULE B ON PAGE 3. COAIPLEIE AU. OTHER SCHEDULES. TRANSFER APPLICABLE AMOUNTS TO SCHEDULE A A. Payment I Amount being paid electronically with this return A. 1. Business income (from page 3, Schedule B, line 27) 1. 2. Business allocation percentage from Schedule C, line 5. (If not allocating, enter 100%) 2. 100 . 00 % 3. If line 2 is less than 100%. enter income or loss on NYC real property(see instructions) 3. 4. Balance (line 1 less Ina 3) 4. 5. Multiply line 4 by the business allocation percentage on line 2 6. Amount from line 3 (NYC real property income and gain not subject to allocation) (see Instructions) 6. 7. Investment income (from page 3. Schedule B. line 26) 7. 8. Investment allocation percentage (from page 4, Schedule D, line 2) 8. 9. Multiply line 7 by the investment allocation percentage from kne 8 (see Instructions) 9. 10. Total before NOL deduction (sum of Ines 5. 6 and 9 or line 1 and line 9) (see instructions for Una 2) 10. 11. Deduct: NYC net operating loss deduction (from Form NYC-NOLDUBTI, line 7) (see instructions) 11. 12. Balance before allowance for taxpayer's services (line 10 less line 11) 12. 13. Less: allowance for taxpayer's services • do not enter more than 20% of line 12 oe110,000, whichever is less (see instructions) 13. 14. Balance before exemption (line 12 less line 13) 14. 15. Less: exemption • 55,000 (taxpayer operating more than one business or short period taxpayer, see Instructions) 16. t6. Taxable income gine 14 less line 15)(see instructions) 16. t7. Tax before business tax credit (4% of amount on line 16) 17. 18. Less: business tax credit (select the applicable credit condition from the Business Tax Credit Computation schedule on the bottom of page 2 and enter amount) (see instructions) 18. t9. UNINCORPORATED BUSINESS TM (line 17 less line 18) (see Instructions) 19. Payment FIT1NOnt 1645828. 5. 1645828. 1645828. 1645828. 1645828. 10000. 1635828. 5000. 1630828. 65233. 65233. 714521 I I-22.• IT THIS RETURN MUST BE SIGNED. (SEE PAGE 5 FOR SIGNATURE BOX AND MAILING INSTRUCTIONS.) r;,., 2K " 05 602117435 EFTA00792243
Form NYC-202 2017 Pa e 2 Name ANASTASIYA SIROOCHENKO SSN 20a. Credits from Form NYC,114.5 (attach form) (see instructions) 20a. 20b. Credits from Form NYC•114.6 (attach form) (see instructions) 20b. 20c. Credits from Form NYC•114.8 (attach tarn) (see instructions) 20o. 20d. Credits from Form NYC•114.10 (attach form) (see instructions) 20d. 20e. Credits from Form NYC•114.12 (attach form) (see instructions) 20e. 21. Net tax after credits (line 19 less sum of lines 20a through 20e) 21. 22. Payment of estimated Unincorporated Business Tax, including carryover credit from preceding year and payment with extension, NYOEC 22. 23. If line 21 is larger than line 22. enter balance due 23. 24. If line 21 is smaller than line 22. enter overpayment 24. 25a. Interest (see instructions) 25b. Additional charges (see instructions) 25c. Penalty for underpayment of estimated tax (attach form NY0221) 26. Total of lines 25a, 25b and 25c 27. Net overpayment (line 24 less line 26) (see instructions) 28. Amount of line 27 to be: (a) Refunded • Direct deposit • fail out ifne 28c OR (b) Credited to 2018 Estimated Tax on Form NYCZUBT 2k. Routing Account Number Number 29. Total remittance due (see instructions) 30. NYC rent deducted on federal tax return or NYC rent from Schedule C 31. Gross receipts or sales from federal return 25a. 2511. 25a. — 1—C 26. 27. 28a. 28b. X Paper check . ACCOUNT TYPE &wines 29. 30. 31. 65233. 70000. 4767. 1965. 2802. 2802. 0. 3230000. Business Tax Credit Computation 1. If the amount on page 1. line 17, is S3.400 or less, your credit on line 18 is the entire amount of tax on line 17. (NO TAX WILL BE DUE.) 2. If the amount on page 1. line 17, Is 55.400 or over, no credit is allowed. Enter `0' on line 18. 3. If the amount on page 1, line 17, is over $3,400 but less than $5,400, your crodit is computed by the following formula: amount on pg. 1, line 17 X ( $5,400 minus tax on line 17)= $2,000 your credit Prepayments of Estimated Tax Computation PREPAYMENTS CLAIMED ON SCHEDULE A, LINE 22 DATE AMOUNT A. Payment with declaration, Form NYC•5UBTI (1) B. Payment with Notice of Estimated Tax Due (2) C. Payment with Notice of Estimated Tax Due (3) D. Payment with Notice of Estimated Tax Due (4) E. Payment with extension, Form NYOEXT F. Overpayment credited from preceding year G. TOTAL of A. B. C. D. E. F (enter on Schedule A. line 22) 01-16-18 70000. 70000. 60221705 794.522 11.72.17 05 EFTA00792244
Form NYC-202 2017 Page 3 Name ANASTASIYA SIROOCHENKO SSN SCHEDULE B Computation of Total Income Part 1 Items of business income, gain, loss or deduction 1- Net profit (or loss) from business, farming or professions as reported for federal tax purposes from federal Schedule C, GEZ or F (Form 1040) (see instructions) 2. If entering income from more than one federal Schedule C. C•EZ or F (Form 1040), check this box Enter the number of Schedules C, C•EZ or F attached: ► 3. Gain (or loss) from sale of business personal property or business real property (math ted0/01 Si:Moduli 0 a FO/m4797) 3. 4. Net amount of rental or royalty income from business personal property or business real property (attach federal Schedule E) (see instructions) 5- Other business income (or loss) (attach schedule) (see instructions) 6. Total federal income (or loss) (combine lines 1 through 5) 7. Subtract net income or gain (or add net loss) from rental, sale or exchange of real property situated outside New York City, if included in line 3 or 4 above (attach schedule) (see instructions) 8. Total income before New York City modifications (combine lines 6 and 7) 1. 2. 4. 5. 6. 7. 8. Part 2 I New York City modifications (see instructions for Schedule B. part 2) ADDITIONS 9. All income taxes and Unincorporated Business Taxes 10a. Relocation credits 10b. Expenses related to exempt income 10c. Depreciation adjustments (attach Form NYC-399 and/or NYC-399Z) 10d. Real estate additions (see instructions) 11. Other additions (attach schedule) (see Instructions) 12. Total additions (add lines 9 through 11) SUBTRACTIONS 13. All income tax and Unincorporated Business Tax refunds (included in part 1) 13. 14. Wages and salaries subject to federal jobs credit (see instructions) 14. 15. Depreciation adjustment (attach Form NYC-399 and/or NYC-399Z) 15. 16. Exempt income included in part 1 (attach schedule) Art 16. 17. 50% of dividends(see instructions) 17. 18. Real estate subtractions (see instructions) 18. 19. Other subtractions (attach schedule) (see instructions) 19. 20. Total subtractions (add lines 13 through 19) I 20. 21. NYC modifications (combine lines 12 and 20) 21. 22. Total income (combine lines 8 and 21) 22. 1645828. 23. Less: Charitable contributions (not to exceed 5% of line 22)(see Instructions) 23. 24. Balance (line 22 less line 23) 24. 1645828. 25. Investment income • (complete lines a through g below) (see Instructions) (a) Dividends from stocks held for investment 25a. (b) Interest from investment capital (include nonexempt governmental obligations) (Itemise on rider) 25b. (c) Net capital gain (loss) from sales or exchanges of secuMies held for investment 25c. (d) Income from assets included on line 3 of Schedule D 25d. (e) Add lines 25a through 25d inclusive 25e. (I) Deductions directly or indirectly attrbutable to investment Income 251. (g) Interest on bank accounts included in income reported on line 25d 25g. 26. Investment income (line 25e less line 250 (enter on page 1, Sch. A. line 7) 26. 27. BUSINESS INCOME (line 24 less line 26) (enter here and transfer amount to pg 1, Sch. A, line 1) 27. 1645828. 9. 10a. 10b. 10c. 10d. 11. 12. 1645828. 1645828. 1645828. 60231705 794531 11.72-17 05 EFTA00792245
Form NYC-202 2017 Page 4 Name ANASTASIYA SIROOCHENKO SSN ALLOCATION OF BUSINESS INCOME Taxpayers who carry on business both inside and outside New York City should complete Schedule C. Parts 1.2 and 3 (below). Taxpayers who do not carry on business both inside and outside New York City should omit Schedule C. Parts 1 and 2 (below), enter 100% on Pat 3 line 5 and enter 100% on Schedule A line 2. SCHEDULE CJ Complete this schedule It business is carried on both inside and outside New York City p art 1 List location of each place of business INSIDE New York office, public warehouse, contractor, converter. etc. . City, nature of activities at each loca ion (manufacturing, sales office. executive and number of employees, their wages salaries and duties at each location. Complete Address Rent Nature of Activities No ry Frnoioyeas Wages, Salaries, Etc. Duties I I I I Total Part 2 List location of each place of business UU I bilk New York City, nature of actwitle at each location (manutactunng. sales office. executive office. public warehouse, contractor. converter. etc). and number of employees. their wages, salaries and duties at each location. Complete Address Rent Nature of Activities Employees Wages, Salaries, Etc. Duties I I I I Total Part 3 I Formula Basis Allocation of Income DESCRIPTION OF ITEMS USED AS FACTORS COLUMN A - NEW YORK CITY COLUMN B - EVERYWHERE COLUMN C 1 Amapa vas 07 The real and langi0si owional Vegans of the buslnan hies WW) a. Business real property owned Ia. b. Business real property rented from others wort x 61 lb. e. Business tangible personal property owned 1c. d. Busnesstrgiticpusomi Prowlyrinlid from Wien bent x Id. e. Total of lines 1a • 1d le. f. Multiply Column C of line 1e by 3.5 If. 2a. pntn ip;oes dnuta;111)"4774".. "‘"1"9"4";."""" 2a. 2b. Multiply Column C of line 2a by 3.5 2b. at.net J2. Owing ew tiva y 3a. PERCENTAGE IN NEW YORK CITY (COLUMN A DIVIDED BY COLUMN B) 3b. Multiply Column C of line 3a by 93 SD. Weighted Factor Allocation 4a. Add Column C. lines 1f, 2b and 3b 41. Olvkle Ina la by 100 It no tatters we mISSIng• ntbSIng. CMOS Wle 4a by point rota ot tr. weights of the tactoa 4D. present Enter as pacentage Round to the nearest one honcirecnfi 01a percentage point Business Allocation Percentage 5. Enter percentage from line 4b. Transfer to page 1, Schedule A. line 2. See instructions 6. IS ANY PLACE OF BUSINESS LISTED IN PARTS 1 AND 2 LOCATED IN YOUR HOME? 7. DID YOU CLAIM A DEDUCTION FOR EXPENSES OF AN OFFICE IN YOUR HOME? 40. YES YES 5. aS NO NO SCHEDULE D I Investment Capital and Allocation and Cash Election DESCRIPTION OF INVESTMENT No of Lees cr Amount of Seaman C Average Liabilities Valso pp Atyllanable to Investment Capital Net E Avenge value bolos C minis Whine ED F Issuer's 4.47XatIon Porcentage Win Camden to NYC (Caprivi E x column Fl L'S I ESASlag SW h71.711, • NSF RIDERIF NUMMI,. I. Tools (Including ItewiS Co WOO • Igs 2. Investment allocation percentage 3. Cash . (TO beet win as Imes:yawl capita, " you mast include non IN* hoe 4. Investment capital. Total of tines 1E line 1G divided by line I lb and 3E 1E, round to the nearest one hundredth of a percentage point) we illt• 60241705 ATTACH FEDERAL SCHEDULE C, SCHEDULE C-EZ OR SCHEDULE F, FORM 1040 TO THIS RETURN 794532 II 22.17 05 EFTA00792246
Form NYC-202 2017 Page 5 Name ANASTASIYA SIROOCHENKO SSN SCHEDULE E If you are taking a Net Operating Loss Deduction this year, please attach Form NYC-NOLD-UBTI SCHEDULE F The following Information must be entered for this return to be complete. 1. Nature of business or profession: ART DEALER 2. New York State Sales Tax ID Number: 3. Did you file a New York City Unincorporated Business Tax Return for the following years: 2016: X YES — — NO 2016: X YES NO If 'NO,' state reason: 4. 6. 6. Enter home address: 288 WEST 4TH ST NEW YORK NY ZIP Code: 10014 If business terminated during the current taxable year, state date terminated. (mmddly) (Attach a statement showing disposition of business property.) Has the Internal Revenue Service or the New York State Department of Taxation and Finance Increased or decreased any taxable Income (loss) reported in any tax period, or are you currently being audited?. YES X NO If 'YES", by whom? Internal Revenue Service State period(s): Beg.: End.: --ammmr— New York State Department of Taxation and Finance State period(s): Beg.: End.: 7. Has Form NYC•115 (Report of FederaVState Change in Taxable Income) been filed? --ammmr— Only applicable for years prior to 1/1/15. For years beginning on or after 1/1/15, file an amended return. (see instructions) YES X NO 8. Did you calculate a depreciation deduction by the application of the federal Accelerated Cost Recovery System (ACES)? YES X NO 9. Were you a participant in a 'Safe Harbor Leasing" transaction during the period covered by this return? YES X NO 10. Does this taxpayer pay rent greater than $200,000 for any premises in NYC in the borough of Manhattan south of 96th Street for the purpose of carrying on any trade, business, profession, vocation or commercial activity? YES X NO 11. If 'YES', were all required Commercial Rent Tax Returns filed? YES NO Please enter Employer Identification Number or Social Security Number which was used on the Commercial Rent Tax Return: CERTIFICATION I hereby 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(' saes StanNeworrw PT'S PREPARER'S USE MiLY -> ',gonna w .a DAVID sagnalurro win*, name WE I S S Chock It self. employee Date DAVID WEISS CPA, PLLC 183 MADISON AVE SUITE 803 NEW YORK, NY 10016-4403 A Firm's name (or yours, if self-employed) A Address A ZIP Code Frn S (11(113/41Inalliunn Aunt If MAILING INSTRUCTIONS H Attach copy of federal Form 1040, Schedule C, Schedule C-EZ or Schedule F. If this is a final retum, attach an entire copy of federal Form 1040. Make remittance payable to the order of NYC DEPARTMENT OF FINANCE. Payment must be made in U.S. dollars and drawn on a U.S. bank. To receive proper credit, you must enter your correct Social Security Number on your tax return and remittance. The due date for the calendar year 2017 retum is on or before April 7, 20 8. For fiscal years beginning in 2017, file on or before the 15th day of the fourth month following the close of the fiscal year. ALL RETURNS EXCEPT REFUND RETURNS NYC DEPARTMENT OF FINANCE UNINCORPORATED BUSINESS TAX P.O. BOX 5564 BINGHAMTON, NY 13902-5564 REMITTANCES PAY ONLINE WITH FORM NYC-200V AT NYC.GOV/ESERVICES OR Mall Payment and Form NYC-200V ONLY to: NYC DEPARTMENT OF FINANCE M . BOX 3933 NEW YORK, NY 10008-3933 RETURNS CLAIMING REFUNDS 'NC DEPARTMENT OF FINANCE UNINCORPORATED BUSINESS TAX P.O. BOX 5563 BINGHAMTON, NY 13902-5563 60251705 MOM II-22-17 06 EFTA00792247
NYC - 221 litclr.9fill:"1111111:t UNDERPAYMENT OF ESTIMATED UNINCORPORATED BUSINESS TAX ATTACH TO YOUR TAX RETURN For CALENDAR YEAR 2017 or FISCAL YEAR beginning Print or Type • Name , and ending 2017 ANASTASIYA SIROOCHENKO SOCIAL SECURITY NUMBER OR PARTNERSHIPS. ESTATES AAO TRUSTS ONLY ENTER EMPLOYER IDENTIFICATION NUMBER Computation of Underpayment 1. 2017 tax (from NYC•202 or NYG2028N, Schedule A, line 19; NY0204, Schedule A. line 21; or NYC -2025. Schedule A, line 8) 1. 2. Credits (from NY0202 or NYO202EIN. Schedule A, lines 20a, 20b, 20c, 20d and 20e or NYC204, Schedule A, lines 22a. 22b, 22c. 22d and 22e) 2. 3. Line 1 less line 2 At . & 4. 90% of line 3 4. 65233. 65233. 58710. Enter quarterly due dates of installments a— 1- FIRST 2- SECOND 3- THIRD 4 FOURTH I 06-15-17 I 04-18-17 I 09-15-17 I 01-15-18 5. Divide amount of line 4 by the number of installments required for the year. Enter the resutt in the appropriate columns • • • 5. 6. Amount paid or credited for each period 6. 7. Overpayment of previous installment 7. 8. Total of lines 6 and 7 8. 9. Overpayment (line 8 less line 5) 9. 10. Underpayment pine 5 less line 8) 10. 14678. 14678 . 14678. 14676. 70000. 70000. 55324. 14678. 14678 . 14678. -> COMPUTATION CONTINUES ON PAGE 2 Exceptions that Avoid the Underpayment Penalty total cumulative amount paid or credited from the beginning of the taxable year through the installment dates that correspond to the 15th day of the 4th. 6th and 9th months of the taxable year and the 15th day of the first month of the succeeding taxable year AEXCEPTION I. . Rib( Rigs to (2010 i 4 5440 .1 1 .6 ?sr oRARTER 2- SECOND QUARTER 3. THIRD QUARTER 4 I-01)4TH QUARTER 0. 0. 0. 70000. 25% or 2016 tax 1360. 50% of 2016 fax 2720. 75% 01 2016 tax 4080. 100% 012016 tax 5440. • EXCEPTION 2 - Tax on prior year's facts and law using 2017 rates (attach computation) • EXCEPTION 3 - Tax on annualized 2017 income (attach computation) • EXCEPTION 4 - Tax on 2017 income over short periods (attach computation) • EXCEPTION 5 - Tax on recurring seasonal 2017 income (attach computation) Enter 25% 01 tax Enter 5016 at tax Enter 7596 o tat Enter 100% Ot tar. Enter 22.50% at fax Enter 4596 ot tax Enter 67.50% 0. tax Enter 9(06 of tax Enter Ma ca tax Enter 90)6 of tax EXCEPTION MET 60511705 n4etti 11.1617 NO NO NO N/A NYC-021711 05 EFTA00792248
Form NYC-221 - 2017 Page 2 COMPUTATION OF PENALTY t- FIRST 2- SECOND 1 06 - 15 - 17 3- THIRD 4- FOURTH 04 - 18 - 17 09 - 15 - 17 01 - 15 - 18 11. Enter the date of payment a the 15th day of the 4th month after the close of the taxable year, whichever is earlier 12. Number of days from due date of instalment to the date shown on line 11 13. mem:mita dayson lane 12 ars 4/152017 and bean 7/1/2012 13. 14. Number of days on line 12 after 6/30/2017 and before 10/1/2017 14. 15. Number of days on line 12 after 9/30/2017 and before 1/1/2018 15. 16. Number of days on line 12 after12/31/2017 and before 4/1/2018 16. 17. Number of days on line 12 after 3/31/2018 and before 7/1/2018 17. 18. Number of days on line 12 after 8/30/2018 and before 10/1/2018 18. 19. Number of days on line 12 after 9/30/2018 and before 1/1/2019 19. 20. Monts of days on line 12 afar 1231/2015 and WOO 3/15/7019 11. 12. 20. 21. Number of days on line 13 x 8% x amount on line 10 365 21. 22. Number of days on line 14 x 8% x amount on line 10 365 23. Number of days on line 15 x 8% x amount on line 10 365 22. 23 24. Number of days on line 16 x •% x amount on line 10 365 24 SEE UNDER PAYMENT OF ES TIMATED TAX WORKSHEE 25. Number of days on line 17 x x amount co line 10 365 25. 26. Number of days on line 18 x x amount co line 10 365 26. 27. Number of days on line 19 x •% x amount on line 10 365 27. 28. Number of days on line 20 x •% x amount on line 10 365 28. 29. Add lines 21 through 28 29. 30. To complete this line, refer to the instructions for line 30 30 196. 592. 1177. 31. Add the amounts on line 29 (or line 30, if applicable) for quarters through 4. Enter total and transfer amount to Form NYC-202 or NYC-202EIN, Schedule A, line 25c or Farm NYC-204, Schedule A, line 27c (see instructions for line 30) 31. 60521705 1965. 'For information regarding interest rates, call 311. If calling from outside of the five NYC boroughs, please call 212-NEW-YORK (212-639-9675). You may also consult the Department of Finance website at nyc.gov/finance 794482 I 1- 1 r 05 EFTA00792249
UNDERPAYMENT OF ESTIMATED TAX WORKSHEET NYC I ANASTASIYA SIROOCHENKO d f - e iff ff (B) Amount (C) Adjusted Balance Due a 3 0,e :E Da I Penalty Rate -0- 04/15/17 14678. 14678. 61 .000219178 196. 06/15/17 14678. 29356. 92 .000219178 592. 09/15/17 14678. 44034. 122 .000219178 1177. 01/15/18 14676. 58710. 01/15/18 70000. 11290. Penalty Due (Sum of Column F). 1965. • Date of estimated lax payment, withholding credit date or installment due date. 7 125 11 EFTA00792250
NYC F nr07 NYC Dwm _44 579-UBTI NEW YORK CITY DEPARTMENT OF FINANCE 2017 Signature Authorization for E-Filed Unincorporated Business Tax Return for Individuals ELECTRONIC RETURN ORIGINATORS (ER0): DO NOT MAIL THIS FORM TO THE DEPARTMENT OF FINANCE. KEEP THIS FOR YOUR RECORDS. FIRST NAME AND INITIAL ANASTASIYA LAST NAME SIROOCHENKO ER EMAIL ADDRESS: TYPE OF FORM: NYOSUBTI — NYC•EXT NYC202S • X WC-202 Financial Institution Information - must be included if electronic payment is authorized AMOUNT OF AUTHORIZED DEBIT: FINANCIAL INSTITUTION ROUTING NUMBER: FINANCIAL INSTITUTION ACCOUNT NUMBER: Part A - Declaration and authorization of Taxpayer for Forms NYC-202, NYC-202S, NYC-EXT or NYC-5UBT1 Under penalty Unincorporated knowledge and electronically Internal Revenue Business Tax New York City designated financial Business Tax X lauthorize as my _ As the of perµury, I declare that I am the taxpayer and that I have examined the information on its 2017 New York City electronically Business Tax return. including any accompanying schedules, attachments and statements or other report, and to the belief, the electronically filed document is true, correct and complete. The ERO has my consent to send the 2017 New filed Unincorporated Business Tax return or other report checked above to the New York City Department of Finance through Service. I authorize the ERO to enter my PIN as my signature on the 2017 New York City electronically filed Unincorporated return or other report, as indicated above or I will enter my PIN as my signature on the document indicated above. If I am Unincorporated Business Tax owed by electronic funds withdrawal. I authorize the New York City Department of Finance agents to initiate an electronic funds withdrawal from the financial institution account indicated on the Unincorporated return or other report, and I authorize the financial institution to debit the amount from that account. DAVID WEISS CPA, PLLC to enter my PIN: 49816 filed best of my York City the paying the and its above. tiff) HAM NAME signature on the 2017 Unincorporated Bus:less Tax retum or other report, as indicated above taxpayer I will enter my PIN as my signature on the 2017Mnincorporated Business Tax return or other report, as indicated —* It Signature of Taxpayer Official title Date Part B - Declaration of electronic return originator (ERO) and paid preparer Under penalty of perjury, I declare that the information unincorporated business tax return or other report with a completed 2017 New York City paper unincorporated information contained in the taxpayer's 2017 New contained in the paper return. If I am the paid preparer, filed unincorporated business tax return or other based this declaration on all information available ERO EFIN/PIN: Enter your six•cligit EFIN followed DAVID WEISS CPA, PLLC contained in the above named taxpayers 2017 New York City electronically filed checked above Ls the information furnished to me by the taxpayer. If the taxpayer furnished business tax return or other report signed by a paid preparer. I declare that York City electronically fled unincorporated business tax return or report is identical under penalty of perjury I declare that I have examined this 2017 New York City report, and, to the best of my knowledge and belief, the return is true, correct, and complete. to me. by your five digit PIN: 13769913349 me the to that electronically I have DAVID WEISS CPA, PLLC ERO's Signature Print Name Date DAVID WEISS Paid Preparer's Signature Print Name Date PURPOSE - A completed Form NYC679•UBTI provides documentation that an ERO has been authorized to electronically file the Unincorporated Business Tax return or other report. The taxpayer may designate the ERO to electronically sign the return or other report by entering the taxpayer's personal identification number (PIN). The form also authorizes payment of tax due on an electronically submitted return or report by an automatic clearing house (ACH) debit from a designated checking or savings account of the taxpayer. You cannot revoke this authorization. GENERAL INSTRUCTIONS Part A - Part A must be completed by the taxpayer before the ERO transmits the electronically filed Form NYC•202 (Unincorporated Business Tax Return for Individuals and Single Member LI_C's); NYC•202S (Unincorporated Business Tax Return for Individuals); NYC•EXT (Application for &Month Extension to File Business Income Tax Return); or NYC6UBTI (Declaration of Estimated Unincorporated Business Tax for Individuals, Estates and Trusts). EROs/paid preparers must complete Part B prior to transmitting electronically filed unincorporated business tax returns or reports (Forms NYC•202. NYC•202S, NYC•EXT or NYC6UBTI). Both the paid preparer and the ERO are required to sign Part B. However, if an individual performs as both the paid preparer and the ERO, he or she is only required to sign as the paid preparer. It is not necessary to include the ERO signature in this case. Do not mail Form NYC-579•UBTI to the Department of Finance. The EROs/paid preparers must keep the completed Form NYC•579•LIB11 for three years from the due date of the return or report or the date the return or report was filed, whichever is later, and must present It to the Department of Finance upon request. 794911 11-15-17 NYCsnr-mm 2017 06 EFTA00792251












