Form D-76p - Payment Voucher For Dc Estate Tax

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D-76P Payment Voucher
for DC Estate Tax
See instructions on back.
Detach at perforation and mail the voucher, with payment to the:
Office of Tax and Revenue, Audit Division, Estate Tax Unit, PO Box 556, Washington, DC 20044-0556.
Print
Clear Form
This is a FILL-IN format. Please do not handwrite any data on this form other than your signature.
Make check or money order payable to: DC Treasurer
OFFICIAL USE ONLY
Vendor ID#0002
Decedent’s Social Security Number (SSN)
Date of Death (MMDDYYYY)
Estate of (First name)
M.I.
(Last name)
Name of Personal Representative
Address of Personal Representative (number, street and suite/apartment number if applicable)
City
State
Zip Code +4
Revised 09/2016
Print
Clear Form
This is a FILL-IN format. Please do not handwrite any data on this form other than your signature.
Make check or money order payable to: DC Treasurer
OFFICIAL USE ONLY
Vendor ID#0002
Decedent’s Social Security Number (SSN)
Date of Death (MMDDYYYY)
Estate of (First name)
M.I.
(Last name)
Name of Personal Representative
Address of Personal Representative (number, street and suite/apartment number if applicable)
City
State
Zip Code +4
Revised 10/2016
Revised 09/2016

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