Form Et-415 - Application For Deferred Payment Of Estate Tax
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3ET-415
New York State Department of Taxation and Finance
Application for Deferred Payment of Estate Tax
(2/11)
When the estate consists largely of an interest in a closely held business
For the estate of a decedent whose date of death is after May 25, 1990
Attach this completed form and supporting documents to Form ET-706, Form ET-115, or Form ET-115.1, and mail to the
address shown on that form.
Decedent’s last name
First name
Middle initial
Social security number (SSN)
Estate tax return due date
Date 2% interest rate begins Number of annual
Due date of first installment of tax plus interest
Date of death
installments elected
Are you electing to make installment payments on a deficiency? ......
Yes
No ........ If Yes, see instructions on back.
1 Value of decedent’s interest in a closely held business ..................................................
1.
2 Federal adjusted gross estate
(Form ET-706, Schedule A, line 22 minus the total from
.............................................
2.
federal Form 706 Part 5, lines 17, 18, and 19) (see instructions)
3 Percentage ratio
3.
%
......................
(see instructions; round the result to the fourth decimal place)
4 Net estate tax payable
(from Form ET-706, line 8, Form ET-115, line 23,
.................................................................................................
4.
or Form ET-115.1, line 8)
5 Maximum amount of estate tax that may be, or could have been, deferred
.............................................................................
5.
(multiply line 4 by the percent on line 3)
6 Amount of line 5 you elect to pay in installments
6.
............
(for deficiencies, see instructions)
7 Divide line 6 by the number of annual installments you elected above, not to exceed 10 ....
7.
8 Amount of tax not deferred, including the part of a deficiency attributable to
8.
installments already due
....................................................................
(see instructions)
9 Amount of estate tax paid to date, if any .........................................................................
9.
10 Amount due with this application, if any
. .................................. 10.
(subtract line 9 from line 8)
Make check or money order payable to Commissioner of Taxation and Finance and attach this application to Form ET-706, Form ET-115, or
Form ET-115.1
Executor’s last name
First name
MI
Signature of executor
Date
Firm’s name if preparer other than executor
Signature of preparer other than executor
Date
(or yours if self-employed)
Address of preparer
City
State
ZIP code
E-mail address of preparer
Firm’s employer identification number
Preparer’s PTIN or SSN
Preparer’s NYTPRIN
For Department use only
Application approved for $
. Payable in
annual installments of $
, plus interest.
Application denied for the following reason:
Signature of reviewer
Date
Instructions
General information
An executor of the estate must sign this form (see Executor
the portion of the New York State estate tax applicable to the value
information on Form ET-706-I, Instructions for Form ET-706)
of the decedent’s interest in a closely held business included in
and attach it to Form ET-706, New York State Estate Tax Return,
the gross estate. Also, you must mark the appropriate Yes box on
Form ET-115 or Form ET-115.1, New York State Estate Tax Report
page 1 of Form ET-706; Form ET-115 or Form ET-115.1, indicating
of Federal Audit Changes, to apply for an extension of time to pay
the estate intends to make the election.
(continued)
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