Enlarge image | 1 1 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 3 3 FINAL DRAFT - 10/2/23 4 4 5 5 6 *231231* 6 7 Form M23, Claim for a Refund for a Deceased Taxpayer 7 8 You must include a copy of the decedent’s death certificate with this form. 8 9 Complete a separate form for each refund you are claiming. 9 10 10 11 11 12 DECEDENT FIRST NAME LAST NAMEXXXXXXXXXXXXX 999999999 12 Decedent’s First Name and Initial Decedent’s Last Name Decedent’s Social Security Number 13 13 14 CLAIMANT FIRST NAME LAST NAMEXXXXXXXXXXXXX 999999999 14 Claimant’s First Name and Initial Claimant’s Last Name Claimant’s Social Security Number 15 15 16 CLAIMANT ADDRESSSSXXXXXXXXXXXXXXXXXXXX Place an X if 11223333 16 Claimant’s Address (street, apartment, route) Decedent’s Date of Death (MM/DD/YYYY) 17 X a foreign address 17 18 CITYXXXXXXXXXXXXXXXXXXX XX 55555 2023 18 City State ZIP Code Tax Year 19 19 20 20 21 21 22 1. If you are claiming a decedent’s Homestead Credit Refund (for Homeowners) or Renter’s Property Tax Refund: 22 23 Check the one box that applies to you, skip the next section and sign below: 23 24 24 25 X a. I am the decedent’s surviving spouse. 25 26 26 27 X b. I am the decedent’s dependent. (To determine if you are a dependent, read “Who can claim the refund?” in the instructions on the back.) 27 28 28 29 X c. The refund is part of the estate. Check this box only if there is no surviving spouse or dependent and the check was received 29 30 before the decedent’s date of death, but was not cashed. 30 31 31 32 2. If you are claiming a decedent’s Individual Income Tax refund or Credit for Military Service in a Combat Zone: 32 33 Check the one box that applies to you: 33 34 34 35 X a. I am the decedent’s surviving spouse and I am filing X e. I am the decedent’s parent 35 36 a separate final income tax return for the decedent. 36 37 X f. I am the decedent’s sibling. 37 38 X b. I am the decedent’s surviving spouse and I am filing to claim 38 39 Credit for Military Service in a Combat Zone for the decedent. X g. I am the child of the decedent’s sibling. 39 40 40 41 X c. I am the decedent’s child. X h. I am the trustee or the personal representative of a trust 41 42 or estate (enclose the court document appointing you as 42 43 d. I am the decedent’s grandchild. the trustee or personal representative and a copy of your 43 X 44 driver’s license or other photo ID). 44 45 I request that the refund of the decedent named above be made to me. I declare the information I have provided on this form is correct and 45 46 complete to the best of my knowledge and belief. 46 47 47 48 11223333 1112223333 48 Signature of person claiming refund Date Daytime phone number 49 49 50 50 51 Waiver of right to Minnesota Individual Income Tax refund, Homestead Credit Refund (for Homeowners), Renter’s Property Tax 51 52 Refund, or Credit for Military Service in a Combat Zone due decedent 52 53 Along with the person named above, I/we the undersigned have an equal right to receive the Minnesota tax refund or credit for the year and dece- 53 54 dent above. I/we hereby inform the Minnesota Department of Revenue that I/we waive any and all right to this refund or credit, and I/we give permis- 54 55 sion for the Minnesota Department of Revenue to issue a check for the full amount of the tax refund or credit to the claimant only. 55 56 56 57 11223333 11223333 57 Signature Date Signature Date 58 58 59 11223333 11223333 59 Signature Date Signature Date 60 60 61 61 62 62 63 9995 63 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 8264 84 86 65 |
Enlarge image | Form M23 Instructions Use Form M23 to claim a refund for a deceased taxpayer for: • Property tax refund • Individual Income Tax refund • Credit for Military Service in a Combat Zone Complete a separate form for each refund you are claiming. Include the Death Certificate Include a copy of the decedent’s death certificate with the completed Form M23. We cannot process your claim without it. If the Decedent’s Return has not Been Filed, but will be Filed Electronically Complete Form M23 and attach a copy of the decedent’s death certificate with your electronic return. On Paper Include a completed Form M23 and a copy of the decedent’s death certificate with the return you send. If the Decedent’s Return has Already Been Filed We will issue the refund check to the decedent and mail it to the decedent’s address. If you are eligible to receive the decedent’s refund, mail the completed Form M23, a copy of the decedent’s death certificate, the refund check, and any other enclosures to: Minnesota Decedent Refund Mail Station 4110 600 N. Robert St. St. Paul, MN 55146-4110 Note: If the refund has not been issued, fax Form M23 and a copy of the decedent’s death certificate to 651-556-3124. If your claim is approved, we will reissue the refund check with the information from the accepted Form M23. Who can claim the refund? Homestead Credit Refund (for Homeowners) and Renter’s Property Tax Refund (Form M1PR) If the decedent died before filing their Form M1PR, or died after filing but before receiving the refund check, only the decedent’s surviving spouse or dependent can claim the refund. No one else, including the personal representative of the estate, can apply for the decedent’s refund. You are a dependent of the decedent if you could be claimed as a dependent on their income tax return. See IRS Publication 501 for more infor- mation. If the decedent did not file an income tax return and you are under age 19 (under age 24 if a full time student), or you did not have to file an income tax return for the years of the refund, check the Homestead Credit Refund (for Homeowners) and Renter’s Property Tax Refund instruc- tions to see if you are a dependent. If the decedent died after receiving the refund but had not cashed the check, the refund is considered part of the estate. Individual Income Tax refund or Credit for Military Service in a Combat Zone The personal representative of the decedent’s estate is entitled to claim income tax refund and credit for military service in a combat zone for the decedent. If you have been appointed as the decedent’s personal representative, do not file this form. Instead, when you file the decedent’s final tax return, enclose a copy of the court document showing your appointment as personal representative. Include a copy of your driver’s license or another photo ID. If no personal representative has been appointed, there is no surviving spouse, and the value of the estate is less than $50,000, you are entitled to claim this refund for the decedent only if you are the first living person on the list on Form M23. If more than one person can claim the refund If more than one person can claim the refund or credit, all eligible persons must agree which one will receive it. That person must then have all the other eligible persons give their consent by signing the waiver form at the bottom of Form M23. For example, if you are one of several children of the decedent, you must obtain the consent of the other children by having them sign the waiver form. If Taxes or Debts are Owed If the decedent owed any Minnesota or federal taxes, criminal fines, a debt to a state agency, district court, qualifying hospital, or public library, state law may require us to apply the refund or credit to the amount owed (including penalty and interest on the taxes). If the debt is less than the refund, you will receive the difference. Use of Information All information you provide on Form M23 is private by state law and cannot be given to others without your consent, except to the Internal Revenue Service (IRS), to other states that guarantee its privacy by law, to Minnesota courts, and to other Minnesota state, county and local government agencies. Social Security numbers are required under Minnesota Statute 289A.12, subdivision 13. Information not Required Information requested on Form M23 is required by law to determine if you are eligible to receive the decedent’s refund. The only information you are not required to provide is your telephone number. However, we ask that you provide it in case we have to contact you. If you do not provide the required information, we will send Form M23 back to you. |