Form Rev-1313 Ex - Application For Refund Of Pennsylvania Inheritance/estate Tax

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APPLICATION FOR
REV-1313 EX (7-14)
Official Use Only
REFUND OF
PENNSYLVANIA
INHERITANCE/ESTATE
BUREAU OF INDIVIDUAL TAXES
TAX
PO BOX 280601
HARRISBURG, PA 17128-0601
See Instructions on Reverse
TO:
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
FROM:
Official Representative
Decedent Information
START
Name
Name of Decedent
Enter First Line of Address Here
Address
File Number
Example 08/15/2004
Enter Second Line of Address Here
Date of Death
Enter City, State and ZIP Code Here
Social Security Number
Phone Number
Email Address
The undersigned requests a refund in the amount of $
for the above-referenced
decedent’s estate.
REFUND REQUESTED ON:
Original or Supplemental
Joint/Trust Assets
Remainder Return
Estate Tax
Probate Return
EXPLANATION OF OVERPAYMENT
Example 08/15/2004
Please sign after printing. The Department does not accept electronic signatures.
Signature
Date
Please allow six to eight weeks for the processing of your refund request.
Return to top of page.
PRINT FORM
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