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Illinois Department of Revenue
IL-1310
Statement of Person Claiming Refund Due a Deceased Taxpayer
For calendar year
or fiscal year ending
/
IL Attachment No. 22
Step 1:
Step 2:
Provide the claimant’s information
Provide the deceased taxpayer’s information
1
6
-
-
Claimant’s Social Security or Federal Employer’s Identification number
Deceased taxpayer’s Social Security number Date of death
2
7
Claimant’s name
Deceased taxpayer’s name
3
8
Street address
Street address (permanent residence or domicile at date of death)
( )
4
9
City, State, ZIP
Daytime phone number
City, State, ZIP
5
I am filing this statement as (check only one box)
Schedule A
a
surviving spouse claiming refund on behalf of deceased
Complete only if “Box a” or “Box c” is checked in Step 1, Line 5.
spouse’s separate tax return.
1
Did the deceased leave a will?
yes
no
(Complete Schedule A and attach proof of death.)
2 a
Has a personal representative been appointed? yes
no
b
deceased taxpayer’s personal representative.
b
If “no,” will one be appointed?
yes
no
(Attach a court certificate showing your appointment.)
If “yes” is checked for 2a or 2b, do not file this form.
c
other claimant for the estate of the deceased taxpayer.
The personal representative should file for the refund.
(Complete Schedule A and attach proof of death.)
3
Will you, as the claimant for the estate of the deceased
I hereby request the refund of taxes overpaid by, or on behalf of, the
taxpayer, disburse the refund according to the law of
deceased taxpayer and declare under penalties of perjury that I have
the state in which the deceased taxpayer maintained
examined this claim, and, to the best of my knowledge and belief, it is
a permanent residence?
yes
no
true, correct, and complete.
If “no,” do not file this form until you can submit proof of your appointment
as the deceased taxpayer’s personal representative or other evidence
showing that you are authorized under state law to receive payment.
S ignature of claimant
Date
*159701110*
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IL-1310 (R-12/11)
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General Information
Step-by-Step Instructions
What is the purpose of this form?
Step 1:
Provide the claimant’s information
This form allows a surviving spouse, a personal representative, or
Lines 1 through 4
– Follow the instructions on the form.
a claimant for the estate of the deceased taxpayer to claim a refund
on behalf of a deceased taxpayer.
Line 5
– Check the box that applies to you.
Box a – Check “Box a” if you are a surviving spouse claiming a
Who must complete this form?
refund on behalf of your deceased spouse’s separate
You must complete this form (and attach it to the decedent’s
tax return, and there is no court-appointed personal
Form IL-1040, Individual Income Tax Return) if you are claiming
representative for your deceased spouse.
a refund on behalf of a deceased taxpayer. However, if you are a
Complete Schedule A, and attach proof of death.
surviving spouse filing a joint return with your deceased spouse, do
not complete this form.
Box b – Check “Box b” if you are the executor, executrix,
administrator, or administratrix of the decedent’s estate, as
certified or appointed by the court.
If you are claiming a refund on behalf of a deceased
taxpayer, you must write “in care of” and your name and address
Attach a court certificate showing your appointment. A
on the decedent’s Form IL-1040 in addition to writing “deceased”
copy of the decedent’s will is not acceptable as evidence
and the date of death above the decedent’s name. See “Filing a
that you are the decedent’s court-appointed personal
representative.
decedent’s return” in the Form IL-1040 Step-by-Step Instructions for
more information.
Box c – Check “Box c” if you are not a surviving spouse or a
personal representative of the deceased.
What should be used as proof of death?
Complete Schedule A, and attach proof of death.
Proof of death may be a death certificate or may, if appropriate,
be the original or an authentic copy of a telegram or letter from the
Step 2:
Pr ovide th e deceased taxpayer’s information
Department of Defense notifying the next of kin of the taxpayer’s
death while in active service or a death certificate issued by an
Lines 6 through 9
– Follow the instructions on the form.
appropriate officer of the Department of Defense.
This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of
IL-1310 (R-12/11)
this information is required. Failure to provide information could result in a penalty.