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Get GA DoR 5347 2018-2024

Security Number Date of Death Name of Claimant Claimant s Social Security Number Tax Year of Refund Check Address of Claimant Relationship to Decedent: Section 2 Administrator/Executor Brother/Sister Surviving Spouse Parent Other Check the ONE box that applies to you after reviewing the instructions. Be sure to sign Section 4. Line A Surviving spouse requesting reissuance of a refund check. Attach original check & copy of death certificate. Line B Co.

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