Form 1310n - Nebraska Statement Of Person Claiming Refund Due To A Deceased Person Page 2
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2Instructions
Who Must File. File Form 1310N if you are claiming a refund on behalf of a deceased person. Do Not file Form 1310N
if you are a surviving spouse filing a married, filing jointly return with the deceased person.
When and Where to File. If you are e-filing the income tax return, Form 1310N and required supporting documentation
may be submitted as an attached PDF document if your software supports these types of attachments. If the supporting
documentation is not received with the return, the Department may request the required documentation during the processing
of your return. This may result in a delayed refund.
If you are filing a paper income tax return, you must attach Form 1310N, and any other required documentation, to the
deceased person’s Nebraska Individual Income Tax Return, Form 1040N or 1040XN, and mail to:
Nebraska Department of Revenue
PO Box 98911
Lincoln, Nebraska 68509-8911
Personal Representative. For purposes of this form, a personal representative includes:
P An executor; or
P An administrator of the deceased person’s estate, as certified or appointed by the court.
When a person claiming a refund is the personal representative of the deceased person’s estate, proof of appointment must
be attached to Form 1040N or 1040XN. Proof of appointment may include a copy of:
P Court order; or
P Copy of the deceased person’s probated will.
Trust agreements or affidavits for transfer of personal property are not accepted.
Specific Information
Part I, Box A, Surviving Spouse. Check box A if you received a refund check in your name and your deceased spouse’s
name. You can return the joint-name check with Form 1310N to:
Nebraska Department of Revenue
PO Box 98911
Lincoln, Nebraska 68509-8911.
A new check will be issued solely in your name and mailed to you.
Part I, Box B, Personal Representative. Check box B only if you are the deceased person’s court-appointed or
certified personal representative claiming a refund for the deceased person on Form 1040N or Form 1040XN. A copy of your
appointment, as described above, must be attached to the return being filed. Complete Part III.
Part I, Box C, All Other Persons. Check box C if you are not a surviving spouse claiming a refund based on a joint return
and there is no court-appointed or certified personal representative. Claimants may be any person in charge of the deceased
person’s affairs. Complete Parts II and III.
Attach a copy of the following forms of proof of death:
P Death certificate (need not be certified); or
P The formal notification from the appropriate government office (for example, Department of Defense, Department of
Health and Human Services, Department of State, etc.) informing the next of kin of the decedent’s death.
If you have already sent proof of death to the Department, write “Proof of Death Previously Filed” at the bottom of the form
when filing Form 1310N.
Example. Mr. Brown died on August 23. His son is his sole survivor. Mr. Brown did not have a will and the court
did not appoint a personal representative for his estate. Mr. Brown was entitled to a $330 refund. To receive the
refund, his son must complete and attach Form 1310N to his father’s final income tax return. He must check box C of
Form 1310N, answer all the questions in Part II, and sign his own name in Part III. He must also attach a copy of the
death certificate or other proof of death.
Part II, Lines 1-3. If you check box C, you must complete lines 1 through 3 of Part II.
Part III. All filers of Form 1310N must complete this.
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