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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 beginning                    /                  and ending                /                    IL Attachment No. 22

Step 1: Provide the claimant’s information                                                 Step 2: 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
    Name of claimant                                                                             Name of deceased taxpayer
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.
Signature of claimant                                                Date

                                                                      Reset                       Print
IL-1310 (R-12/08)

                                                            Return only the top portion
                      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 crossing through the                                       copy of the decedent’s will is not acceptable as evidence
taxpayer’s name and writing “deceased” and the date of death above                                       that you are the decedent’s court-appointed personal
                                                                                                         representative.
the decedent’s name. Refer to “Filing a 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: Provide the 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 by the Illinois Income Tax Act. Disclosure of this information is REQUIRED. Failure
                                  to provide information could result in a penalty. This form has been approved by the Forms Management Center. IL-492-0061
IL-1310 (R-12/08)

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Computation of Penalties for Individuals

  • 1. Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes. Illinois Department of Revenue IL-1310 Statement of Person Claiming Refund Due a Deceased Taxpayer For calendar year or fiscal year beginning / and ending / IL Attachment No. 22 Step 1: Provide the claimant’s information Step 2: 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 Name of claimant Name of deceased taxpayer 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. Signature of claimant Date Reset Print IL-1310 (R-12/08) Return only the top portion 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 crossing through the copy of the decedent’s will is not acceptable as evidence taxpayer’s name and writing “deceased” and the date of death above that you are the decedent’s court-appointed personal representative. the decedent’s name. Refer to “Filing a 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: Provide the 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 by the Illinois Income Tax Act. Disclosure of this information is REQUIRED. Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center. IL-492-0061 IL-1310 (R-12/08)