Form D-76a - Amended Estate Tax Return
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1
2GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF TAX AND REVENUE
D-76A
AMENDED ESTATE TAX RETURN
FORM D-76A
FORM FOR ESTATES OF INDIVIDUALS DYING ON OR AFTER 1/1/2003.
ESTATE OF: (Last Name, First Name, Middle Initial)
DATE OF DEATH
LOCATION OF PROBATE COURT
NAME AND SSN OF PERSONAL REPRESENTATIVE
ADDRESSS OF PERSONAL REPRESENTATIVE
SSN OF DECEDENT
WAS THE ESTATE PROBATED?
TELEPHONE NO. OF PERSONAL
OFFICIAL USE
o YES
o NO
REPRESENTATIVE
y RESIDENT ESTATE
y NON RESIDENT ESTATE
COLUMN 1
COLUMN 2
COLUMN 3
As Previously Reported
Net Change (See Page 2)
Corrected
Amount
1. Total Gross Estate
$
$
$
2. Total Allowable Deductions (From federal schedules)
3. Tentative Taxable Estate
4a. Gross Value of Property Located Outside the
District of Columbia
4b. Allowable Deductions Relating to Property Located
Outside the District of Columbia
4c. Net Value of Property Located Outside the District
Columbia (Line 4a minus Line 4b)
5. District of Columbia Taxable Estate ( Line 3 minus Line
4c)
6. District of Columbia Estate Tax Due (see computation worksheet)
7. Penalty: 5% Per Month or Fraction Thereof (Maximum 25%)
8. Interest: (From
To
)
9. Total Tax, Penalty and Interest (Line 6 plus Lines 7 & 8)
10. Total Tax Penalty and Interest Previously Paid (Line 12, Form D- 76)
11. Balance Due ( Line 9 minus Line 10)
12. Overpayment (Line 10 minus Line 9)
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
November 2003
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