MAINE
STATEMENT OF PERSON CLAIMING
FORM 1310ME
REFUND DUE A DECEASED TAXPAYER
Maine Revenue Services
Income/Estate Tax Division
For calendar year _________ , or other taxable year beginning
24 State House Station
______________ , 19 ______ and ending ____________ , 19 ____
Augusta, ME 04333-0024
Name of decedent
Name of person claiming refund
Please
Date of death
Social Security number
Number and Street
Social Security number
type
-
-
-
-
Number and Street (permanent residence or domicile on the date of death)
or
print
City or Town, State and ZIP Code
City or Town, State and ZIP Code
I am filing this statement as (check only one box): (see instructions on other side)
A.
Surviving spouse requesting reissuance of a refund check;
B.
Decedent’s personal representative. Attach a court certificate showing your appointment, or;
C.
Person other than A or B, claiming refund for decedent’s estate. Complete Schedule A below.
Schedule A (to be completed only if C above is checked)
Yes
No
1. Did the deceased leave a will? ...............................................................................................................
2. (a) Has a personal representative been appointed for the estate of the decedent? ................................
(b) If “No,” will one be appointed? .......................................................................................................
If 2(a) or (b) is checked “Yes,” the personal representative must file for the refund.
3. 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? ..............................................................
If “No,” a refund cannot be made until you submit a court certificate showing your appointment as
personal representative or other evidence that you are entitled, under state law, to receive the refund.
Signature and Verification
I request a refund of taxes overpaid by or on behalf of the decedent. I declare under penalties of perjury, that I have examined this
claim and to the best of my knowledge and belief, it is true, correct and complete.
Signature of person claiming refund _________________________________________ Date _______________
Rev. 10/96