Form TC & 565. STATE TAX COMMISSION (For Auditor’s Use) of mount a OF Received E Es] ABATEMENT F OR CLAIM 7 allowed : & | | REFUND ane | ee or credit . refund UTAH CREDIT q Indicate Below the Kind of Claim Filed [| [] _ File this claim with the State Tax Commission, 118 State City, Capitol, Salt Income Tax Filing Fee [4] Corporation Franchise Tax [] Motor Vehicle Registration , Lake a Cigarette Stamps Utah. Indicate CAUTION: STATE Use exact name on this line if not shown above. and address under which return or application was filed OF COUNTY OF The deponent, being duly sworn according to law, deposes and says that this statement taxpayer named, and that the facts given below with reference to said statement are true and is made on behalf complete. 1. Period involved: OS 2 Amount of tax or license fee paid or assessed 8. Correct amount of tax or license fee as computed by taxpayer or licensee : Amount claimed as refund or credit | | The deponent verily believes that this claim should be allowed for the following reasons (state in detail): From January 1, ae de ee ee ee ee ee ee ee Net Income as shown upon tax return Corrected net per income officer's report Difference in net Computation at ee a a , to...... 9 SOO december AS EE SOS DS OE OS 31, OOO we eR ape Ln Ded x thn doy Ne Aarne de Sook ) of the 1930. p..-. 175,134.69 examining 159,634.46 taxable income $15 3% 500. 23$465.01 Complete detail of changes made in net income is shown in examining officer P. Fred Pusey'’s report. (Attach letter size sheet if space is not sufficient.) Sioned...J- M. @ M. S. BROWNING COMPANY (Signature of officer administering RAs, EV a ry) Veith iti oath) VIOLA? SiH (Title) Cans £ ans Vit aed te : rep o . At} , } + toh Heh 7 PENALTY—Every person who with intent to evade any tax or other requirement shall supply any false or fraudulent shall be liable to penalties and imprisonment as provided by the Revised Statutes of Utah, 1938, as amended, information