Arizona Claim for Refund on Behalf of Deceased Taxpayer

Claim for Refund on Behalf of Deceased Taxpayer
Arizona Form 131
Arizona Form

131

FOR
CALENDAR YEAR

Claim for Refund on Behalf of Deceased Taxpayer
For Forms 140, 140A, 140EZ, 140NR, 140PY and 140X
Please print or type.

2023

	MONTH	 YEAR

 For calendar year decedent was due a refund: 2 0 2 3 OR  Fiscal year ending: M M Y Y
1 Decedent’s Name (last, first, middle initial)

2 Date of Death

4 Name of Person Claiming Refund (last, first, middle initial)

Daytime Phone (with area code)
94
Apt. No.

6 Home Address of Person Claiming Refund - number and street, rural route
7 City, Town or Post Office

State

66

3 Decedent’s Social Security Number
5 Claimant’s Social Security Number or ITIN
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

ZIP Code

8 Claimant’s Relationship to Decedent

81 PM

Check the box that applies to you. Check only one box.
Be sure to complete Part 3 below.
	 9a	 	Surviving spouse claiming a refund based on a joint return.
Part 1

	 9b	

	Court-appointed or certified personal representative.

	 9c	

	Person other than 9a or 9b claiming refund for the decedent’s estate.

80 RCVD

Include a court certificate (issued after death) showing your appointment.
See instructions and complete Part 2 below.

Part 2

Complete Part 2 only if you checked box 9c in Part 1.

	
YES	NO
	10a	 Did the decedent leave a will?....................................................................................................... 	 10a	 	 

	10b	 Has a personal representative been appointed for the estate of the decedent?........................... 	 10b	 	
	10c	 If you answered “No” on line 10b, will one be appointed?............................................................. 	 10c	
If you answered “Yes” to 10b or 10c, and you are not the personal representative (or executor
of the decedent’s will) do not file this form. The personal representative or executor
must file for the refund.
	11	

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?............................... 	 11	

		

If you answered “No” on line 11, a refund cannot be made until you submit a court certificate
showing your appointment as personal representative or until you submit other evidence that
you are entitled under state law to receive the refund.



	 

	 

Part 3
I request a refund of taxes overpaid by, or on behalf of, the decedent. Under penalties of perjury, I declare that the statements
made on this form have been examined by me and to the best of my knowledge, they are true, correct and complete.

	
	
	

	

Signature of Person Claiming Refund		

	

Date

Print Form
ADOR 10412 (23)