2022
                            DELAWARE                                                 FORM
                            DIVISION OF REVENUE                                                       PIT-CFR
                            CLAIM FOR REFUND DUE ON BEHALF OF DECEASED TAXPAYER
                                                                 
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DECEDENT INFORMATION                                                       ESTATE INFORMATION
TAXPAYER ID                         DATE OF DEATH                                    TAXPAYER ID

FIRST NAME                     M.I. LAST NAME                              ESTATE NAME

ADDRESS                                                                    ADDRESS

CITY                                             STATE ZIP CODE            CITY                                      STATE                ZIP CODE

            CHECK THE BOX THAT APPLIES TO YOU (CHECK ONLY ONE BOX). MAKE SURE TO SIGN AND DATE IN PART 3 BELOW
PART
           A.  Personal representative appointed or certified by court. You MUST attach a court certificate showing your appointment.

           B.  Person, other than A, claiming refund for the decedent’s estate. Complete Part 2 and attach a copy of the death certificate or proof of death.
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            COMPLETE THIS PART ONLY IF YOU CHECKED BOX B ABOVE                                                                            YES     NO
PART
           1. Did the decedent leave a will?

           2a. Has a personal representative been appointed by a court for the estate of the decedent?
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           2b. If “NO”, will one be appointed?   If 2a or 2b is answered “YES”, 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 the answer to question 3 is “No”, a refund cannot be made until you submit a court certificate showing your appointment as 
        personal representative.
            SIGNATURE AND VERIFICATION (All filers must complete this part)
PART
              I request a refund of taxes overpaid by or on behalf of the decedent. Under penalties of perjury, I declare that I have examined this claim, and to 
              the best of my knowledge and belief, it is true, correct, and complete.

3
                YOUR SIGNATURE                                   DATE

                                                   Form to be submitted with the tax return seeking the refund.

        DFPITCFR2022019999V1
        Revision 20220516                                       Page  1