IT-EP (12-19)                                 State of New Jersey                                                                       For Division Use Only
Transfer Inheritance Tax                      Division of Taxation
PO Box 249                            Inheritance and Estate Tax
Trenton, NJ 08695-0249                Payment on Account (Estimated Payment)

Decedent’s Name                                                                         Decedent’s S.S. No.                                     /    / 
                            (Last)    (First)                                   (Middle)
                                                                                                                                      Testate       Intestate  
Date of Death (mm/dd/yy)         /  / County of Residence 

                         Name                                                           Daytime Phone (                                           ) 
Mailing Address to send 
all correspondence       Street 

                         City                                                           State                                           ZIP Code 
                                      Payment on Account (Estimated Payment)
The amount remitted with this form is a payment on account (estimated payment) to be applied as indicated below.
(Please check one box only.)

(Code 67)        1a.          Inheritance Tax Only................................................................................    $                 . 

(Code 68)        1b.          Estate Tax Only ....................................................................................... $                 . 

                 1c.          Combined Inheritance and Estate Taxes to be applied as follows: .........                               $                 . 

                         Inheritance Tax Payment .........................    $          . 

                         Estate Tax Payment ................................. $          . 

                 2.      Total Amount Remitted with this Form .......................................................                 $                 . 

Payments on account may be made at any time to avoid further accrual of interest on the amount so paid. All applications for the refund 
of an overpayment must be made in writing within the three year statutory period in accordance with and in the manner set forth in 
N.J.A.C. 18:26-3A.11, N.J.A.C. 18:26-3B.10 (Estate Tax), and N.J.A.C. 18:26-10.10 (Inheritance Tax).
Make checks payable to “NJ Inheritance Tax”, PO Box 249, Trenton, NJ 08695-0249.