EFTA01222614.pdf

Statement of Person Claiming Foim 1310 (Rev. August 2014) Refund Due a Deceased Taxpayer OMB No. 1545-0074 Department of the Treasury 'Information about Form 1310 is available at www.irs.gov/form1310. Attachment Internal Revenue Service or. See instructions below and on back. Sequence No. at Tax year decedent was due a refund: Calendar year . or other tax year beginning . 20 . and ending . 20 Name of decedent Date of death Decedent's social security number Name of person claiming refund Your social security number Please print Or Home address (number and street). If you have a P.O. box. see instructions. Apt. no. type City. town or post office, state. and ZIP code. If you have a foreign address. see instructions. Part I Check the box that applies to you. Check only one box. Be sure to complete Part III below. A 0 Surviving spouse requesting reissuance of a refund check (see instructions). Court-appointed or certified personal representative (defined below). Attach a court certificate showing your appointment. unless previously filed (see instructions). C 0 Person, other than A or B. claiming refund for the decedent's estate (see instructions). Also, complete Part II. Part II Complete this part only if you checked the box on line C above. Yes No 1 Did the decedent leave a will? 2a Has a court appointed a personal representative for the estate of the decedent? b If you answered "No" to 2a, will one be appointed? If you answered "Yes" to 2a or 2b, the personal representative must file for the refund. 3 As the person claiming the refund for the decedent's estate, will you pay out the refund according to the laws of the state where the decedent was a legal resident') If you answered "No" to 3. a refund cannot be made until you submit a court certificate showing your appointment as personal representative or other evidence that you are entitled under state law to receive the refund. Part Ill Signature and verification. All filers must complete this part. I request a refund of taxes overpaid by or on behalf of the decedent. Under penalties of perjury. I declare that I have examined this claim. and to the best of my knowledge and belief, it is true. correct, and complete. Signature of person claiming refund ► Date ► Form 1310 tRev. 8-2014) EFTA01222614