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Georgia Free Printable  for 2024 Georgia Deceased Taxpayer Refund Check Claim

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Deceased Taxpayer Refund Check Claim
Form GA-5347

PRINT CLEAR Form GA-5347 (Rev. 08/16/18) Georgia Department of Revenue Deceased Taxpayer Refund Check Claim Form Section 1 Complete the information below. Name of Decedent Decedent’s Social Security Number Date of Death Name of Claimant Claimant’s Social Security Number Tax Year of Refund Check Address of Claimant Relationship to Decedent: Section 2  Administrator/Executor  Brother/Sister  Surviving Spouse  Parent  Other Check the ONE box that applies to you after reviewing the instructions. Be sure to sign Section 4. Line A □ Surviving spouse requesting reissuance of a refund check. Attach original check & copy of death certificate. Line B □ Court-appointed personal representative. Attach original check, copy of death certificate, & court document showing appointment. Line C □ Person, other than A or B, claiming refund less than $1,000 for decedent’s estate. Attach original check, copy of death certificate, & complete Section 3. Section 3  Complete only if you checked Line C in Section 2. I am an heir of the decedent and meet the qualifications in the affidavit below. I am claiming this refund, which is less than $1,000, for the decedent’s estate and have completed the affidavit and had it notarized. I truthfully signed the affidavit and do not need to file to probate or be appointed a personal representative to claim this refund of taxes. Claimant’s Affidavit. For collection of personal property in the form of a tax refund check (to be used by heirs of deceased taxpayers). State of Georgia, __________________________ County Name of County I, ___________________________, being duly sworn, affirm that this affidavit is made for the purpose of requesting reissuance of a tax Full Legal Name refund check in the amount of $____________ originally issued to __________________________, who died on ___________________. Amount Decedent’s Full Legal Name Date on Death Certificate I further certify under oath the following (Initial after each statement): 1. 2. The refund check issued in the decedent’s name is for less than $1,000. The court has not appointed a personal representative for the estate of the decedent, and no application/petition for the appointment of a personal representative is pending in any jurisdiction. 3. I am an heir of the decedent and there are no other heirs of the same or closer degree. 4. As the person claiming the refund for the decedent’s estate, I will pay out the refund according to the laws of the state where the decedent was a legal resident at the time of death. 5. As the claiming heir of the decedent, I am entitled to payment or delivery of the Georgia tax refund. _________________________________ _________________________________ Signature of Claimant Printed Name Notarization. For a public notary to complete. SEAL Sworn and subscribed before me this __________ day of ______________________, 20________. _________________________________ __________________________ Signature of Notary Notary Commission Expires Section 4 Signature and Verification. ALL CLAIMANTS must complete this section. 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. I understand that to willfully prepare or present a document that is fraudulent or false is a felony under O.C.G.A. § 16-10-20. Signature of Claimant: Date: General Instructions Purpose of Form Use Form GA-5347 to claim a refund on behalf of a deceased taxpayer. Who Must File Only file this form if you need a refund check which was issued in the deceased taxpayer’s name to be reissued in the name of the surviving spouse, estate, or otherwise rightful heir. Where to File Mail a completed copy of Form GA-5347 and the appropriate documents listed below to: Georgia Department of Revenue P.O. Box 740389 Atlanta, GA 30374-0389 Personal Representative For purposes of this form, a personal representative is the executor or administrator of the decedent’s estate, as certified or appointed by a court. A copy of the decedent’s will is not by itself evidence that you are the personal representative. Specific Instructions Section 1 – Decedent & Claimant’s Information Enter the name, date of death, and social security number of the decedent. The claimant must also enter name, address, and social security number. Make sure to enter this information accurately, as the Department will send the reissued refund check to the claimant’s address entered here. Section 2 – Claim Type Line A Check the box on Line A if you are a surviving spouse and you received a joint refund check in your and your deceased spouse’s names. In addition to this form, you must also attach and send the original joint-name check and a copy of the death certificate to the address above. A new check will be issued in your name and mailed to you. Line B Check the box on Line B only if you are the decedent’s court-appointed personal representative claiming a refund on behalf of the decedent’s estate. In addition to this form, you must also attach and send the original check in the deceased’s name, a copy of the death certificate, and a copy of the court document showing your appointment (e.g. Letter of Testamentary or Letter of Administration) to the address above. A new check will be issued in the estate’s name and mailed to you. Line C Check the box on Line C only if you are not a surviving spouse claiming a refund based on a joint return and there is no court-appointed personal representative. Claimants may only check the box on Line C if the decedent’s original refund check was for less than $1,000. For refund checks in amounts equal to or greater than $1,000, you must check the box on either Line A or Line B and obtain the appropriate documentation. If you qualify as a Line C claimant, complete Section 3. In addition to this form, you must also attach and send the original check in the deceased’s name and a copy of the death certificate to the address above. A new check will be issued in your name and mailed to you. Section 3 – Claimant’s Affidavit Check the box in Section 3 only if you are Line C claimant. Complete the affidavit and certify that each statement is true by initialing on the line to the right of each numbered statement. The affidavit in Section 3 must be notarized by a public notary. Section 4 – Signature You must sign in Section 4 for Form GA-5347 to be effective.
Extracted from PDF file 2023-georgia-form-ga-5347.pdf, last modified June 2018

More about the Georgia Form GA-5347 Individual Income Tax TY 2023

Form GA-5347 is used to file a claim for a refund on behalf of a deceased taxpayer

We last updated the Deceased Taxpayer Refund Check Claim in February 2024, so this is the latest version of Form GA-5347 , fully updated for tax year 2023. You can download or print current or past-year PDFs of Form GA-5347 directly from TaxFormFinder. You can print other Georgia tax forms here.

Other Georgia Individual Income Tax Forms:

TaxFormFinder has an additional 30 Georgia income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 500 Individual Income Tax Return
Form G-4 Employee Withholding
Form IT-511 Individual Income Tax Booklet
Form 525-TV Individual Tax Payment Voucher
Form 500-ES Estimated Quarterly Tax Return

Download all GA tax forms View all 31 Georgia Income Tax Forms


Form Sources:

Georgia usually releases forms for the current tax year between January and April. We last updated Georgia Form GA-5347 from the Department of Revenue in February 2024.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Georgia Form GA-5347

We have a total of two past-year versions of Form GA-5347 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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