1350                                      STATE OF SOUTH CAROLINA
                                       DEPARTMENT OF  REVENUE
                                                                                                                    SC 1310
                                       STATEMENT OF PERSON                                                          (Rev. 09/10/19)
                                             CLAIMING REFUND                                                           3258
dor.sc.gov                             DUE A DECEASED TAXPAYER
Tax year decedent (deceased taxpayer) was due a refund:
Calendar year                 , or fiscal year beginning (MM-YY)                                   ,  ending (MM-YY)
Name of decedent                                                   Decedent's Social Security Number

Date of death                                                      Name of claimant

Address of permanent residence or domicile on date of death        Claimant's mailing address

City, state, and ZIP                                               City, state, and ZIP

Part I   Check the one box that applies to you. Be sure to sign and date in Part III below.
A.       Surviving spouse requesting reissuance of a refund check.

B.       Personal representative appointed or certified by a court. Attach a court certificate showing your 
         appointment.

C.       Person, other than A or B, claiming refund for the decedent's estate. Complete Part II and attach a copy of 
         the death certificate or proof of death.
Part II  Complete only if you checked Box C above.
                                                                                                                    YES    NO
1. Did the decedent leave a will?
2. (a) Has a personal representative been appointed by a court for the estate of the decedent?
(b) If "No," will one be appointed?

If you answered "Yes" for (a) or (b), the personal representative must file for the refund.
3. As the person claiming the refund for the decedent's estate, will you pay out the refund according 
to the laws of the state where the decedent was a legal resident? 

If you answered "No," before the refund can be issued, submit a court certificate or other evidence that 
you are appointed as a personal representative or are otherwise entitled to receive the refund.
Part III Required: Signature and Verification

I request a refund of taxes overpaid by or on behalf of the decedent. I confirm that I have examined this claim and to the 
best of my knowledge and belief, it is true, correct, and complete.

Signature of person claiming refund                                                              Date

Attach completed form to the SC1040.

Social Security Privacy Act Disclosure 
It is mandatory that you provide your Social Security Number on this tax form if you are an individual taxpayer. 42 U.S.C. 405(c)(2)(C)(i) 
permits a state to use an individual's Social Security Number as means of identification in administration of any tax. SC Regulation 
117-201 mandates that any person required to make a return to the SCDOR must provide identifying numbers, as prescribed, for 
securing proper identification. Your Social Security Number is used for identification purposes. 

   32581027