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ARIZONA FORM
Arizona Estate Tax Return
76
For estates of resident and nonresident decedents with date of death on or after January 1, 1980 but before January 1, 2005.

Complete and mail to: Estate Tax Unit, Arizona Department of Revenue, 1600 West Monroe, Room 520, Phoenix, AZ 85007-2650
For assistance, call (602) 716-7809 or toll-free from area codes 520 and 928, call (800) 352-4090, or
Visit our web site at www.azdor.gov
ESTATE OF (LAST NAME, FIRST NAME, MIDDLE INITIAL) DATE OF DEATH DECEDENT’S SOCIAL SECURITY NO.
M M D D Y Y Y Y
STREET ADDRESS, APARTMENT NUMBER PROBATE NUMBER - COUNTY

CITY, STATE, ZIP CODE ESTATE’S FEDERAL I.D. NUMBER

Computation of Tax for Estate of Arizona Resident Decedent
1 Credit for state death taxes from federal Form 706 ....................................................................................... 1 00
2 Estate or inheritance tax actually paid to other states .................................................. 2 00
3 Gross value of property in other states ......................................................................... 3 00
4 Value of gross estate from federal Form 706 ................................................................ 4 00
5 Divide line 3 by line 4 .................................................................................................... 5 %
6 Prorated credit: Multiply line 1 by line 5 ....................................................................... 6 00
7 Deduction allowable: Enter the smaller of line 2 or line 6 ............................................................................. 7 00
8 Estate tax payable to Arizona: Subtract line 7 from line 1............................................................................. 8 00
9 Prior tax payments: Attach a schedule of date(s) and amount(s) of payment(s) .......................................... 9 00
10 Balance of tax due or overpayment ............................................................................................................... 10 00
11 Penalty and interest ....................................................................................................................................... 11 00
12 Total due: Make check payable to Arizona Department of Revenue ........................................................... 12 00
13 Overpayment ................................................................................................................................................ 13 00

Computation of Tax for Estate of Nonresident Decedent
14 Credit for state death taxes from federal Form 706 ....................................................................................... 14 00
15 Gross value of property in Arizona: Attach a schedule of Arizona property or identify
on attached federal Form 706 ....................................................................................... 15 00
16 Value of gross estate from federal Form 706 ................................................................ 16 00
17 Divide line 15 by line 16 ................................................................................................ 17 %
18 Estate tax payable to Arizona: Multiply line 14 by line 17 ............................................................................. 18 00
19 Prior tax payments: Attach a schedule of date(s) and amount(s) of payment(s) .......................................... 19 00
20 Balance of tax due or overpayment ............................................................................................................... 20 00
21 Penalty and interest ....................................................................................................................................... 21 00
22 Total due: Make check payable to Arizona Department of Revenue ........................................................... 22 00
23 Overpayment ................................................................................................................................................ 23 00
Authorization
If you want the Department of Revenue to discuss matters relating to this estate tax return with the preparer of this return, complete line 24
below. By completing line 24, you are authorizing the department to release conﬁ dential information of the estate under A.R.S. §42-2003
to the appointee named below for matters relating to this estate tax return. This authorization will allow the preparer to receive conﬁ dential
information, to act as the estate’s representative before the Arizona Department of Revenue, and to make written or oral presentations on
behalf of the estate. The personal representative may revoke this authorization at any time. See the instructions for information about
how to revoke this authorization.
24 Name of Appointee State Address (number, street, room or suite no., city, state, zip code)

25 Installment Payment Election: Check the box if you elect to pay the taxes in installments. To make this
election, you must meet the requirements under A.R.S. §42-4004. You must attach documentation that
your federal election has been approved. You must also attach a proposed installment payment schedule. 25
26 Check the box if this is an amended return.................................................................................................... 26
Attachment
Attach a copy of Federal Estate Tax Return, Form 706.

ADOR 16-0035f (04) Rev 11/07

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 DECEDENT’S NAME AS SHOWN ON PAGE 1                                         DECEDENT’S SOCIAL SECURITY NO.

I declare under penalty of perjury that I have examined this return, including any accompanying schedules and statements, and to the 
best of my knowledge and belief, it is true, correct and complete.  If prepared by a person other than the personal representative, the 
declaration is based on all information of which preparer has any knowledge.

                                                              PREPARER (if other than personal representative)
                                                            If line 24 has been completed, check the applicable box.  I declare
                                                            that I am the:
                                                             Attorney
                                                             Certiﬁ ed Public Accountant
                   PERSONAL REPRESENTATIVE                   Enrolled Agent for the Personal Representative
TYPE OR PRINT NAME                      SOCIAL SECURITY NO. TYPE OR PRINT NAME                            PREPARER’S TIN

ADDRESS                                                     ADDRESS

CITY, STATE, ZIP                                            CITY, STATE, ZIP

TELEPHONE NO. WITH AREA CODE                                TELEPHONE NO. WITH AREA CODE

►        ►
    PERSONAL REPRESENTATIVE’S SIGNATURE DATE                    PREPARER’S SIGNATURE                      DATE

                                              Clear Form

ADOR 16-0035f (04) Rev 11/07               AZ Form 76 (2004) Rev 11/07                                                Page 2

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