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State
,
3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
TLS, have you
transmitted all R
text files for this
cycle update?
Date
Action
Revised proofs
requested
Date Signature
O.K. to print
INSTRUCTIONS TO PRINTERS
FORM 1310, PAGE 1 of 2
MARGINS: TOP
1
⁄
2
" CENTER SIDES PRINTS: HEAD to HEAD
PAPER: WHITE, WRITING, SUB. 20 INK: BLACK
FLAT SIZE: 216mm (8
1
⁄
2
") x 279mm (11")
PERFORATE: (NONE)
OMB No. 1545-0074
Statement of Person Claiming
Refund Due a Deceased Taxpayer
1310
Form
(Rev. November 2005)
Attachment
Sequence No.
87
Department of the Treasury
Internal Revenue Service
See instructions below and on back.
Tax year decedent was due a refund:
Calendar year
, or other tax year beginning
, , and ending
Decedent’s social security number
Name of decedent
Date of death
Name of person claiming refund
Home address (number and street). If you have a P.O. box, see instructions.
City, town or post office, state, and ZIP code. If you have a foreign address, see instructions.
Check the box that applies to you.
Check only one box.
Be sure to complete Part III below.
Surviving spouse requesting reissuance of a refund check (see instructions).
A
B
Court-appointed or certified personal representative (defined below). Attach a court certificate showing your appointment,
unless previously filed (see instructions).
Complete this part only if you checked the box on line C above.
Did the decedent leave a will?
1
2a
Has a court appointed a personal representative for the estate of the decedent?
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?
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
(Rev. 11-2005)
Part I
Part II
Cat. No. 11566B
Part III
Please
print
or
type
Person,
other
than A or B, claiming refund for the decedent’s estate (see instructions). Also, complete Part II.
C
Apt. no.
If you answered
“No”
to 2a, will one be appointed?
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.
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
If you answered
“Yes”
to 2a or 2b, the personal representative must file for the refund.
Yes No
b
Your social security number
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