For calendar year decedent was due a refund: 2 0 1 9 OR Fiscal year ending: M M Y Y 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the decedent’s name in the first field, ensuring you include the last name, first name, and middle initial.
3. Next, input the date of death in the specified format (MM DD YYYY). This is crucial for processing the claim accurately.
4. Fill in the decedent’s Social Security Number in the designated field to verify identity.
5. Provide your own name as the person claiming the refund, including last name, first name, and middle initial.
6. Enter your Social Security Number or ITIN to establish your identity as a claimant.
7. Complete your daytime phone number and home address details accurately for correspondence purposes.
8. Indicate your relationship to the decedent by checking one of the boxes provided. Ensure only one box is checked.
9. If applicable, complete Part 2 regarding any will or personal representative appointments based on your previous selections.
10. Finally, sign and date the form at Part 3 to certify that all information is true and correct before submitting it through our platform.

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