REV-1313 (Ex) 05-17

                                    APPLICATION FOR REFUND
                                             OF PENNSYLVANIA
      BuREAu of INDIVIDuAL TAxES
      Po Box 280601                 INHERITANCE/ESTATE TAX
      HARRISBuRg PA 17128-0601

 INSTRUCTIONS
 Complete all requested information and mail to: PA DEPARTMENT of REVENuE, BuREAu of INDIVIDuAL TAxES,
 Po Box 280601, HARRISBuRg, PA, 17128-0601. See additional instructions on the reverse side.

 DECEDENT INFORMATION
START Decedent Name                                                                           file Number              Date of Death        Social Security Number
Ü
                                                                                       MM/DD/YYYY
 REFUND INFORMATION
 Amount Requested:  $

 Requesting a refund on: (check only one box)
 ooriginal or Supplemental Probate Return                   oRemainder Return                   oEstate Tax
 oTransferee Return – Provide ACN                              oJoint/Transfer on Death Asset – Provide ACN

 List Receipt Number(s) of all payments made for the Return Type or ACN for which you are requesting a refund.
                 RECEIPT NuMBER                      PAYMENT AMouNT                           RECEIPT NuMBER                      PAYMENT AMouNT

                                                                If additional space is needed, attach on a separate sheet of paper.
 EXPLANATION OF OVERPAYMENT

                                                                If additional space is needed, attach on a separate sheet of paper.
 REQUESTOR INFORMATION
      Name                                                                                          Phone Number                          Email Address (optional)

      Street                                                                                         City                                          State              ZIP Code

 By signing below, I declare under penalty of law that the information provided is true and correct; and that the refund being
 requested was paid by me or a party legally represented by me.

      Please sign after printing. The Department does not accept electronic signatures.
                                                        Requestor Signature                                                                           Date MM/DD/YYYY

                        Please allow six to eight weeks for the processing of your refund request.

      Reset Entire Form TOP OF PAGE                                                    NEXT PAGE                                                                              PRINT

No text to extract.

                                                                                   Pennsylvania Department of Revenue

                                                                                   Instructions for REV-1313
REV-1313 IN (Ex) 05-17                        Application for Refund of Pennsylvania Inheritance/Estate Tax

                                            providing  all  taxes  assessed  are  paidrefund.  The  receipt  numbers  listed
   REFUND INSTRUCTIONSin  full.  Such  requests  should  be  filedmust  be  for  payments  made  by
This application must be filed with the PAwith  the  Board  of  Appeals,  PO  BOXeither the individual who paid the tax
Department of Revenue within three yearsrg, 281021, PA  17128-1021.Harrisbu                                on  an  asset  billed  separately  from
after  payment  or  final  determination  ofmThe               petition                   for          isthe estateavailable(Joint/Transfer onatDeath
the tax, whichever is later. See Sectionwww.boardofappeals.state.pa.us.Asset or Transferee Return Type) or
2181  (d)  of  the  Inheritance  and  Estate                                                               the party or party’s assignee for the
Tax Act for statutory alternatives.FORM INSTRUCTIONSestate (the executor or administrator
If  the  issue(s)  involved  in  this  refund                                                              of  the  estate;  or  the  attorney  for
                                            Decedent Information:
application is/are similar to the issue(s)                                                                 the  estate)  for  which  the  refund  is
                                            Complete  all  fields  for  the  decedent’s
in any litigation pending before a court of                                                                being  requested.If additional space
                                            estate  for  which  a  refund  is  being
law,  file  your  refund  request  after  final                                                            is needed, attach on a separate sheet
disposition of such pending litigation.     requested.  For Transferee Returns and                         of paper.
                                            Joint/Transfer on Death, the ACN can be
This  application  cannot  be  used  as  afound on the Commonwealth AssessmentExplanation of Overpayment:
substitute for an appeal from an allegedly  Notice.                                                  Provide the reason for the overpayment
erroneous appraisement, the disallowance                                                             or  refund. If additional space is needed,
of deductions or an incorrect assessmentRefund Information:attach on a separate sheet of paper.
of tax. See Section 2186 of the Inheritance   ●Enter  the  amount  being  requested
and Estate Tax Act for correct procedure      for refund.                                            Requestor Information:
with respect to such appeals.                                                                        Enter  all  information  of  the  person
                                                 ●Check the box for the return type or
                                                                                                     requesting the refund.  
If  all  or  part  of  the  refund  amountACN you are requesting a refund.  A
requested  within  this  application  is      separate application should be usedmustThisbeapplicationcompleted and
claimed to be as the result of an issueif  you  are  requesting  a  refund  onsigned by the party that paid the tax or
not  previously  raised,  and  where  the     more than one return or ACN.                           that party’s assignee, assessed individual,
statutory  appeal  provisions  of  Section                                                           the  administrator  or  executor  of  the
2186 of the Inheritance and Estate Tax           ●Enter  each  receipt  number  of  pay-             estate or the attorney or correspondent
Act  have  expired,  a  petition  for  refund the ments return made type  orNo for other  requestor  isof  the  estate. 
may be filed with the Board of Appeals are  requesting ACN  that ayou                                acceptable.

www.revenue.pa.gov                                                                                                          REV-13131
                                                                                                                           RETURN TO FORM