Form Dp-145-Es - Estimate For New Hampshire Legacy & Succession Tax

FORM

DP-145-ES

ESTIMATE FOR NEW HAMPSHIRE LEGACY & SUCCESSION TAX

152

WHEN:

An estimate payment of the tax is due 9 months from date of death, even if the tax return is under

federal extension.

WHERE:

NH Department of Revenue Administration, PO Box 637, Concord, NH

03302-0637

IMPORTANT: Interest will be charged in accordance with RSA 21-J:28 if the required estimate is not filed timely.

NEED HELP:

Call NH Department of Revenue Administration, Estate and Legacy Bureau (603) 271-2580.

For hearing or speech impaired call TDD Access: Relay NH 1-800-735-2964.

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FORM

THE STATE OF NEW HAMPSHIRE

DP-145-ES

DEPARTMENT OF REVENUE ADMINISTRATION

152

PAYMENT VOUCHER

Due: Nine Months From

ESTIMATED LEGACY & SUCCESSION TAX

Date of Death

Please Type or Print

Estate of:

LAST NAME

FIRST NAME

MIDDLE INITIAL

Decedent's Social Securty No.

Date of Death

Domicile at date of death:

ADDRESS

CITY/TOWN

STATE

COUNTY

Probate Number

Name of Executor/Administrator:

LAST NAME

FIRST NAME

MIDDLE INITIAL

Executor/Administrator Social Security or FEI No.

Executor/Administrator:

ADDRESS

CITY/TOWN

STATE

ZIP CODE

For Office Use Only

RETURN THIS VOUCHER WITH CHECK OR MONEY ORDER PAYABLE TO: THE STATE OF NEW HAMPSHIRE

NH DEPT REVENUE ADMINISTRATION

Amount of Payment

$

MAIL

DOCUMENT PROCESSING DIVISION

TO:

PO BOX 637

CONCORD NH

03302-0637

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FORM

THE STATE OF NEW HAMPSHIRE

DP-145-ES

DEPARTMENT OF REVENUE ADMINISTRATION

152

PAYMENT VOUCHER

ESTIMATED LEGACY & SUCCESSION TAX

Due: Nine Months From

Date of Death

Please Type or Print

Estate of:

LAST NAME

FIRST NAME

MIDDLE INITIAL

Decedent's Social Security No.

Date of Death

Domicile at date of death:

ADDRESS

CITY/TOWN

STATE

COUNTY

Probate Number

Name of Executor/Administrator: LAST NAME

FIRST NAME

MIDDLE INITIAL

Executor/Administrator Social Security or FEI No.

Executor/Administrator:

ADDRESS

CITY/TOWN

STATE

ZIP CODE

For Office Use Only

RETURN THIS VOUCHER WITH CHECK OR MONEY ORDER PAYABLE TO: THE STATE OF NEW HAMPSHIRE

NH DEPT REVENUE ADMINISTRATION

Amount of Payment

$

DOCUMENT PROCESSING DIVISION

MAIL

PO BOX 637

TO:

CONCORD NH

03302-0637