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Get DC FR-147 2019-2022

Government of the District of Columbia tatement of Person 2017 FR-147 S Claiming Refund Due a Deceased Taxpayer 171470110000 Important Print in CAPITAL letters using black ink. l OFFICIAL USE ONLY Vendor ID 0000 Personal information Deceased s First name M. I. Last name Date of death MMDDYYYY Name of person claiming refund First name Home address number street and suite/apartment number if applicable City State Zip code 4 Statement of Claimant Your relationship to the deceased Spouse/registered domestic partner Fill in only one Other Administrator Executor 4Specify Did the deceased leave a will Yes No Has an executor or administrator been appointed for the estate If no will one be appointed 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 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 2017 DC income tax Name Claimant s TIN Relationship to deceased Signature I request a refund of DC income tax 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. Signature of person claiming refund 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. l OFFICIAL USE ONLY Vendor ID 0000 Personal information Deceased s First name M. I. Last name Date of death MMDDYYYY Name of person claiming refund First name Home address number street and suite/apartment number if applicable City State Zip code 4 Statement of Claimant Your relationship to the deceased Spouse/registered domestic partner Fill in only one Other Administrator Executor 4Specify Did the deceased leave a will Yes No Has an executor or administrator been appointed for the estate If no will one be appointed 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 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 2017 DC income tax Name Claimant s TIN Relationship to deceased Signature I request a refund of DC income tax 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. If other than the deceased who paid deceased s 2017 DC income tax Name Claimant s TIN Relationship to deceased Signature I request a refund of DC income tax 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. Signature of person claiming refund Date Attach this form to the deceased s D-40 along with a copy of the death certificate or other proof of death.

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