Form RF-9 Decedent Refund Claim

915 SW Harrison St A DECEDENT REFUND City State Zip Code Kansas Department of Revenue Name of Claimant Social Security Number of EIN Relationship to Decedent Daytime Telephone Number inlcuding Area Code statement or funeral home notice) AND Topeka KS 66625 1000 (Rev 9/09) A copy of the Letters of Administration AND Additional copies of this and other tax forms are available from our office or web site: ksrevenue org Address of Claimant Check the appropriate box for the reason you are claiming the decedent s refund You must enclose the required documentation with each Form RF 9 See Documentation Required to Claim a Decedent Refund CLAIMANT INFORMATION (Please type or print): Claimant Information: Print or type all the requested information The claimant s Social Security Number (or EIN if a trust) must be given This is information the department will use to mail the refund check Please include a daytime phone number so we may contact you if we have questions Customer Relations/Wage Earner Death Certificate DECEDENT INFORMATION (Please type or print): Decedent Information: Print or type the decedent s full name first middle initial and last name Enter the date of death as mm/dd/yyyy Enter the decedent s Social Security Number Decedent Refund Claim Decedent s personal representative A court certificate of my appointment and proof of death are enclosed DOCUMENTATION REQUIRED TO CLAIM Fax: (785) 296 8989 Federal Form 1310 Statement of Person Claiming Refund Due a Deceased Taxpayer Funeral Home Notice GENERAL INFORMATION Heir at law No estate proceedings were held and there is no surviving spouse A copy of the death certificate or proof of death is enclosed I shall distribute the refund to the decedent s following heirs at law Heir at Law: If a refund of ANY amount is being requested by someone other than a surviving spouse you must submit TWO documents to support your claim for refund I agree to hold the state of Kansas and its agents harmless from any claim and all costs that may arise out of delivery of the decedent s refund to me I understand that I am required by Kansas law to distribute the refund to the decedent s estate or heirs I am filing this request for the decedent s refund as (check only one box): I declare under the penalties of perjury that to the best of my knowledge and belief this is a true correct and complete claim If the taxpayer died before filing the K 40 K 40H or K 40PT enclose the RF 9 and documentation with your form when it is filed If the taxpayer died after filing the income tax return homestead refund claim or the property tax relief claim mail or fax the RF 9 and documentation to: If you are a surviving spouse requesting a refund of OVER $100 you must submit TWO documents to claim the refund If you are an heir at law provide the name relationship and age of all the decedent s heirs at law; listing yourself on the first line If additional space is needed attach a separate sheet IMPORTANT: Complete a Form RF 9 for each tax year and each refund type Also enclose proof of death with each return Refer to the instructions on the back to complete an accurate claim for refund on behalf of a decedent INSTRUCTIONS FOR FORM RF 9 K 40 Individual Income Tax/Food Sales Tax Refund K 40H Kansas Homestead Claim K 40PT Kansas Property Tax Relief Claim for Low Income Seniors Kansas Form RF 9 Decedent Refund Claim Kansas Form RF 9 Decedent Refund Claim Name Relationship Age Obituary Statement Personal Representatives: A personal representative is the executor or administrator of the decedent s estate as certified or appointed by the court You must submit TWO documents to claim a decedent refund Phone: (785) 368 8222 Please contact our office if you have questions or need assistance in completing Form RF 9 Proof of death (death certificate obituary REFUND TAX YEAR: Calendar year: ; or fiscal year ending / / Refund Tax Year: Enter in the appropriate space the calendar tax year of the refund OR fiscal year end date of the decedent s refund REFUND TYPE (Check one): Refund Type: Check the appropriate box File a separate Form RF 9 for each type of refund RF 9 KANSAS SIGNATURE Signature of Claimant Date Signature: Read the statements at the bottom sign and date the form SPECIFIC INSTRUCTIONS Surviving spouse The refund claim is for a joint income tax return or homestead claim of a deceased spouse A copy of the death certificate or proof of death is enclosed Surviving Spouse: If you are a surviving spouse requesting a refund of less than $100 you must submit ONE of the following with your return TAXPAYER ASSISTANCE Taxpayer Assistance Center Kansas Department of Revenue 915 SW Harrison St 1st Floor Topeka KS 66625 2007 This form is used to claim a refund on behalf of a deceased taxpayer You MUST complete a separate Form RF 9 for each type of tax refund claimed For example if a decedent has a refund on an income tax and/ or food sales tax return(K 40) and a homestead refund (K 40H) for the tax year submit Form RF 9 and documentation with each or for each type of return