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GARY F SMITH
166 Desmond Street
Rochester, NY 14615
$ $ 762.00
Account number (see instructions) C9D21B35-1107341 6 State 7 State identification no. 8 State income tax withheld
NY 800429876 7 $
Form 1099-K (Rev. 1-2022) (Keep for your records) www.irs.gov/Form1099K Department of the Treasury - Internal Revenue Service
2H8701 5.000