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FORM NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
DP-145 LEGACY AND SUCCESSION TAX RETURN
151
DO NOT FILE THIS RETURN UNLESS THERE IS A TAXABLE LEGATEE(S)
FOR DRA USE ONLY
STEP 1 ESTATE OF: LAST NAME FIRST NAME MIDDLE INITIAL DECEDENT'S SSN DATE OF DEATH
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 FEI N
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
POWER OF estate's representative before the NH Department of Revenue Administration.
ATTORNEY NAME OF REPRESENTATIVE: STREET CITY/TOWN STATE ZIP CODE (AREA CODE) TELEPHONE NO.
SIGNATURE OF EXECUTOR/ADMINISTRATOR: (THIS LINE MUST BE SIGNED TO GRANT A POWER OF ATTORNEY)
STEP 3
YES NO
ANSWER A Does the decedent have a gross estate of $600,000 or more through 1997 or $625,000 or more through 1998, $650,000
QUESTIONS or more through 1999, $675,000 or more through 2000 and 2001? If yes, a NH-706 Estate Tax Return must be filed.....
A - G
B Were there in existence at the time of death any trusts that had been created by the decedent during his/her lifetime? If
yes, a copy of all such trust instruments must be attached to this return and a Form AU-101-C must be
completed.............................................................................................................................................................................
C Did the decedent, within 2 years of death, make any gifts or transfers having a total value greater than $1000? If yes,
please complete Form AU-101-B...........................................................................................................................................
D Was a disclaimer filed by any of the legatees? If yes, a copy of all such disclaimers must be attached to this
return....................................................................................................................................................................................
E Does this return amend a previously filed Legacy and Succession Tax Return?...............................................................
F Did you elect the alternate valuation? .................................................................................................................................
G Did the decedent own a safety deposit box at the time of death?......................................................................................
STEP 4 COMPLETE SCHEDULE A AND PAGE - 2- BEFORE COMPUTNG TAX
STEP 5 27 Taxable Portion of Rest & Residue (From Page 2, Line 26).............................. 27
TOTAL 28 Specific Bequests To Taxable Legatees (From Schedule A, Line 8)............... 28
TAX 29 Transfers To Taxable Legatees (From Schedule A, Line 16)........................... 29
30 TOTAL TAXABLE ESTATE.............................................................................. 30
31 NH Legacy and Succession Tax (Line 30 x 18%)..................................................................................... 31
STEP 6 32 Credits: (a) Estimated tax paid.............................................................. 32(a)
FIGURE (b) Tax paid with application for extension............................. 32(b)
CREDITS (c) Credits allowed under RSA 87:1....................................... 32(c)
INTEREST & (d) Other Credits or payments (Attach explanation)............... 32(d)
PENALTIES
32 TOTAL CREDITS....................................................................................................................................... 32
33 Balance of tax due (Line 31 less Line 32)................................................................................................. 33
34 Additions to tax: (a) Interest................................................................... 34(a)
(b) Failure to pay......................................................... 34(b)
(c) Failure to file.......................................................... 34(c)
34 TOTAL ADDITIONS TO TAX..................................................................................................................... 34
STEP 7 35 Balance Due (Line 33 plus Line 34) Make check payable to: State of New Hampshire.......................... 35
BALANCE DUE
OR 36 Refund Due (Line 32 less the sum of Line 31 and Line 34).................................................................... 36
REFUND THIS RETURN MUST BE ACCOMPANIED BY AN ACCOUNTING
STEP 8 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.
SIGNATURE If 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 AND ZIP CODE
DP-145
1 Rev. 11/00
