Decedent’s First Name and Inial Last Name Social Security Number
Claimant’s First Name and Inial Last Name Social Security Number
Claimant’s Address (street, apartment, route) Decedent’s Date of Death
City State ZIP Code Tax Year
If you are claiming the decedent’s Homestead Credit Refund (for Homeowners) or Renter’s Property Tax Refund:
Check the one box that applies to you, skip the next secon and sign below:
I am the decedent’s surviving spouse.
I am the decedent’s dependent. (To determine if you are a dependent, read “Who can claim the refund?” in the instrucons on the back.)
The refund is part of the estate. Check this box only if there is no surviving spouse or dependent and the check was received
before the decedents date of death, but was not cashed.
If you are claiming the decedent’s individual income tax refund and/or military service credit:
Check the one box that applies to you:
I am the decedents surviving spouse and I am ling
a separate nal income tax return for the decedent.
I am the decedents surviving spouse and I am ling to claim
credit for military service in a combat zone for the decedent.
I am the decedents child.
I am the decedents grandchild.
I request that the refund of the decedent named above be made to me. I declare the informaon I have provided on this form is correct and
complete to the best of my knowledge and belief.
Signature of person claiming refund Date Dayme phone number
Form M23, Claim for a Refund for a Deceased Taxpayer
You must include a copy of the decedent’s death cercate with this form.
Complete a separate form for each refund you are claiming.
*191231*
9995
Place an X if
a foreign address
Waiver of right to Minnesota income tax refund, homestead credit refund (for homeowners), renter’s property tax refund,
or credit for military service in a combat zone due decedent
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-
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-
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.
Signature Date Signature Date
Signature Date Signature Date
I am the decedents mother or father.
I am the decedents brother or sister.
I am the child of the decedents brother or sister.
I am the trustee and/or the personal representave of
a trust or estate (enclose the court document
appoinng you as the trustee or personal representave).
Form M23 Instrucons
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 Cercate
Include a copy of the decedent’s death certicate with the completed Form M23. Your claim cannot be processed without it.
If the Decedent’s Return has not Been Filed, but will be Filed
Electronically
For tax year 2016 or later, complete Form M23 and attach a copy of the decedent’s death certicate with your electronic return.
For tax year 2015 or prior, fax a completed copy of Form M23 and the decedent’s death certicate
to 651-556-3124
24 hours prior to
ling your electronic return.
On Paper
Include a completed Form M23 and a copy of the decedent’s death certicate with the return you send.
If the Decedent’s Return has Already Been Filed
The department 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 certicate, 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 the M23 and a copy of the decedent’s death certicate to 651-556-3124.
If your claim is approved, the department will reissue the refund check with the information from the accepted Form M23.
Who can claim the refund?
Homestead Credit Refund (for Homeowners) or Renter’s Property Tax Refund (Form M1PR)
If the decedent died before ling their Form M1PR or died after ling 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 the decedent’s income tax return.
If the decedent did not le an income tax return and you are under age 19 (under age 24 if a full time student), or you did not have to le an
income tax return for the years of the refund, check the Homestead Credit Refund (for Homeowners) and Renters Property T
ax Refund instruc
-
tion booklet 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.
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 personal representative, you do not have to le this form. Instead, when you le the decedent’s nal tax return,
enclose a copy of the court document showing your appointment as personal representative.
If no personal representative has been appointed, 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 rst 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 of the 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 the form.
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 nes, 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 dierence.
Use of Informaon
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. The Social Security numbers are required under M.S. 289A.12, subd. 13.
Informaon 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, the department will send Form M23 back to you.