Form Dp-146 - Non-Resident Personal Property Transfer Tax Return

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FORM
STATE OF NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
DP-146
NON-RESIDENT PERSONAL PROPERTY TRANSFER TAX RETURN
171
FOR DRA USE ONLY
PLEASE PRINT OR TYPE
ESTATE OF:
LAST NAME
FIRST NAME
MIDDLE INITIAL
DECEDENT'S SSN
DATE OF DEATH
STEP 1
NAME
ADDRESS
DOMICILE AT DATE OF DEATH:
STREET
CITY/TOWN
STATE
COUNTY
PROBATE NO.
SSN
FEIN
NAME OF EXECUTOR/ADMINISTRATOR:
LAST NAME
FIRST NAME
MIDDLE INITIAL
EXECUTOR/ADMINISTRATOR SSN OR FEIN
EXECUTOR/ADMINISTRATOR ADDRESS:
STREET
CITY/TOWN
STATE
ZIP CODE
STEP 2
Authorization is granted to the representative listed below to receive confidential tax information under RSA 21-J:14 and to act as the estate's
representative before the NH Department of Revenue Administration.
POWER
OF
NAME OF REPRESENTATIVE:
STREET
CITY/TOWN
STATE
ZIP CODE
(AREA CODE) TELEPHONE NO.
ATTORNEY
SIGNATURE OF EXECUTOR/ADMINISTRATOR: (THIS LINE MUST BE SIGNED TO GRANT A POWER OF ATTORNEY)
STEP 3
Did the decedent own any real estate in New Hampshire?
Yes
No
If yes, list location
TOWN/CITY
ANSWER
Does the decedent's gross estate total $650,000 or
more for 1999 or $675,000 or more for 2000?
Yes
No
If yes, a NH 706 Estate Tax Return must be filed.
QUESTIONS
(See instructions for other years gross amounts).
Is this an
Initial Return or
Amended Return?
STEP 4
PERSONAL PROPERTY LOCATED IN NEW HAMPSHIRE
A
B
C
D
PERSONAL
DESCRIPTION OF PERSONAL
LOCATION OF
OWNERSHIP
FAIR MARKET VALUE
PROPERTY
PROPERTY
PROPERTY
JOINT
INDIVIDUAL
OF PROPERTY
LOCATION
1
2
3
4
5
6
Total amount from supplemental (attached)
7
8
Total Value of Personal Property (sum of lines 1-7)
STEP 5
9 TOTAL TAXABLE ESTATE
. . . . . . . . . . . . . .
9
(Total of Line 8, Column D)
10 NH Non-Resident Personal Property Transfer Tax
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
(Line 9 x 2%)
TOTAL
11(a)
11 Credits and
(a) Estimated tax paid . . . . . . . . . . . . . . . . . . . . .
TAXABLE
11(b)
Payments:
(b) Tax paid with application for extension. . . .
ESTATE,
(c) Tax paid with original return . . . . . . . . . . . .
CREDITS
11(c)
(d) Other credits or payments
. .
(Attach explanation)
11(d)
AND
11 TOTAL CREDITS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
PAYMENTS
12 Balance of tax due
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
(Line 10 less Line 11)
13 Additions to tax:(a) Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13(a)
(b) Failure to pay . . . . . . . . . . . . . . . . . . . . . . . .
13(b)
(c) Failure to file. . . . . . . . . . . . . . . . . . . . . . . . .
13(c)
13 TOTAL ADDITIONS TO TAX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
STEP 6
14
14 Balance Due (Line
Make check payable to: State of New Hampshire. . . . . . . . . . . . . . . .
12 plus Line 13)
BALANCE DUE
15 Refund Due (Line
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
OR REFUND
11 less Line 10 adjusted by Line 13) . .
STEP 7
Under penalties of perjury, I declare that I have examined this return and to the best of my belief it is true, correct and complete. If
SIGNATURE
prepared by a person other than the taxpayer, this declaration is based on all information of which the preparer has knowledge.
FOR DRA USE ONLY
SIGNATURE OF EXECUTOR/ADMINISTRATOR
DATE
SIGNATURE OF PREPARER IF OTHER THAN EXECUTOR/ADMINISTRATOR
DATE
PREPARER'S TAX IDENTIFICATION NUMBER
NH DEPT OF REVENUE ADMINISTRATION
MAIL
DOCUMENT PROCESSING DIVISION
PREPARER'S ADDRESS
TO:
PO BOX 637
CONCORD NH 03302-0637
CITY/TOWN, STATE & ZIP CODE
DP-146
Rev. 11/00

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