Form D-76a - Amended Dc Estate Tax Return
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1
2Government of the
AMENDED DC ESTATE TAX RETURN
District of Columbia
FORM D-76A
Date of death
Estate of: (Last Name, First Name, Middle Initial)
Location of Probate Court
Name of personal representative
SSN
SSN of decedent
Address of personal representative
Case number
Was the estate probated?
Telephone number of the personal representative
OFFICIAL USE
YES
NO
RESIDENT ESTATE
NON RESIDENT ESTATE
AMENDED - IRS AUDIT
AMENDED - DISCOVERY
Attach a copy of the IRS Audit.
of additional assets.
COLUMN 1
COLUMN 2
COLUMN 3
Originally Reported
Net Change (See Page 2)
Corrected Amount
$
$
$
1. Total Gross Estate
2. Total Allowable Deductions (From federal schedules)
3. Tentative Taxable Estate (Line 1 minus Line 2)
4. DC Estate Tax Due (From computation worksheet)
5. Penalty: 5% Per Month or Fraction Thereof (Maximum 25%)
6. Interest: (From
To
)
7. Total Tax, Penalty and Interest (Line 4 plus Lines 5 and 6)
8. Total Tax Penalty and Interest Previously Paid
(Line 10, Form D- 76)
9. Balance Due ( Line 7 minus Line 8)
10. Overpayment (Line 8 minus Line 7)
$
$
$
Under penalties of perjury, I (we) swear that I (we) have examined all assets and documents of this estate, including accompanying schedules and
statements, and to the best of my (our) knowledge, information and belief, all statements made herein are true, correct, and complete.
ATTORNEY’S NAME ____________________________________________
ATTORNEY’S ADDRESS
______________________________________________________________
______________________________________________
SIGNATURE OF PERSONAL REPRESENTATIVE
______________________________________________________________
ATTORNEY’S TELEPHONE NO. ___________________________________
DATE_________________________________________
Revised 09/13
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