Fill and Sign the Residential Lease Agreement Template Seattle Washington Form

Government of the District of Columbia 2003 Form FR-147 Statement of Person Claiming Refund Due a Deceased Taxpayer OFFICIAL USE ONLY Important: Print in all CAPITAL letters in black ink. Personal information Deceased’s name Deceased’s social security number M.I. Last name M.I. Last name Date of death (MMDDYY) Your name Your home address (number and street) Apartment number City State Zip Statement Your relationship to the deceased Fill in only one: Spouse Administrator Executor Other Specify. Did the deceased leave a will? Yes No Has an executor or administrator been appointed for the estate? If no, will one be appointed? Yes Yes No No Will you pay out the refund to beneficiaries according to the laws of the state where the deceased was a legal resident? If no, a refund cannot be made until you submit a court certificate showing your appointment as a personal representative or other evidence that you are entitled, under DC law, to receive the refund. If other than the deceased, who paid deceased’s 2003 DC income tax? Name Relationship Signature I request a refund of taxes overpaid by or on behalf of the deceased. Under penalties of law, I declare that I have examined this claim and to the best of my knowledge it is correct. Your signature Date Attach this form to the deceased’s D-40 along with a copy of the death certificate or other proof of death. If you are filing as an administrator or executor, attach a copy of the court certificate of appointment. FR-147 Revised 1/04 Statement of Person Claiming Refund Due a Deceased Taxpayer Yes No