RPD - 41083
Rev. 01/06/2012
                STATE OF NEW MEXICO - TAXATION & REVENUE DEPARTMENT

                                   AFFIDAVIT TO OBTAIN REFUND
                OF NEW MEXICO TAX DUE A DECEASED TAXPAYER

Purpose of Form. Form RPD-41083 is to be used to claim a refund of New Mexico tax on behalf of a deceased taxpayer.

Who Must File.  If you are a court-appointed or certied personal representative, you must include Form RPD-41083 with the taxpayer's refund 
claim (New Mexico income tax return). Complete Part 1: Afdavit for Personal Representative, and sign the afdavit. Notary is not required.

If you are not a surviving spouse, and no personal representative has been appointed, you must include Form RPD-41083 with the taxpayer's 
refund claim (New Mexico income tax return). Complete Part 2: Afdavit for Successor, and sign and notarize the afdavit.

Tax year decedent was due a refund:
Calendar year_________ or other tax year beginning ________________________  and ending ____________________ 
Name of decedent

Date of death                              Decedent's social security number 

Name of person claiming refund                                           Claimant's social security number 

Claimant's mailing address                                                          Claimant's contact number 

City                                                                     State                                  ZIP code

Part 1: Afdavit for Personal Representative

____________________________________________, the afant herein, having been duly sworn, states upon oath:
1.   That he or she has been appointed by a court as the personal representative for the estate of the decedent.
2.   That a copy of that court appointment is attached.
3.   That a copy of the death certicate or proof of death is attached. (An original or an authentic copy of a telegram or letter from the
     Department of Defense notifying the next of kin of the decedent's death will constitute proof of death.)
4.   That a refund claim (New Mexico income tax return) on behalf of the decedent is attached.

Part 2. Afdavit for Successor.
_____________________________________________, the afant here in, having been duly sworn, states upon oath:
1.   That he or she is the successor of _________________________________________, deceased.
2.   That the value of the entire probate estate of the decedent, wherever located, less liens and encumbrances, does not exceed
     $50,000.
3.   That thirty (30) days have elapsed since the death of the decedent.
4.   That the afant, as successor of the decedent, is entitled to the payment of any sums of money due and owing to the decedent.
5.   That a copy of the death certicate or proof of death is attached. (An original or an authentic copy of a telegram or letter from the
     Department of Defense notifying the next of kin of the decedent's death while in active service will constitute proof of death.)
6.   That a refund claim (New Mexico income tax return) on behalf of the decedent is attached.

     I request a refund of taxes overpaid by or on behalf of the decedent. Under penalty 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.

               Signature of person claiming refund  _________________________________________   Date _____________

               Subscribed and sworn before me this ___________ day of _______________________________, 20________

               Notary Public ___________________________________________ My Commission Expires ______________

RPD - 41083                   STATE OF NEW MEXICO - TAXATION & REVENUE DEPARTMENT
Rev. 01/06/2012
                              AFFIDAVIT TO OBTAIN REFUND
               OF NEW MEXICO TAX DUE A DECEASED TAXPAYER
                                               Instructions
WhO MUST FIlE.  

If you are a court-appointed or certied personal representative, you must le Form RPD-41083 with the taxpayer’s 
refund claim (New Mexico Personal Income Tax Return). Complete Part 1: Afdavit for Personal Representative, 
sign and date the afdavit. A notary is not required. Attach the completed Form RPD-41083 and a copy of the 
death certicate or other proof of death to the taxpayer’s refund claim. Complete the deceased taxpayer and 
claimant information on page 1 of the New Mexico Personal Income Tax Return, include all attachments, and 
mail to the address below.

If you are a successor who is not a surviving spouse ling an original or amended joint return with the decedent 
and no personal representative has been appointed, you must le Form RPD-41083 with the taxpayer’s refund 
claim (New Mexico Personal Income Tax Return). Complete Part 2: Afdavit for Successor, sign and date the 
afdavit.  A notary is required. Attach the completed Form RPD-41083 and a copy of the death certicate or other 
proof of death to the taxpayer’s refund claim. Complete the deceased taxpayer and claimant information on page 
1 of the New Mexico Personal Income Tax Return, include all attachments, and mail to the address below.

Mail your New Mexico Personal Income Tax Return to:  

               New Mexico Taxation and Revenue Department
               P. O. Box 25122
               Santa Fe, New Mexico 87504-5122.

WhO ShOUlD NOT FIlE ThIS FORM.

If you are a surviving spouse ling an original or amended joint return with the decedent, you DO NOT need to le 
this form. When a deceased taxpayer’s information is completed on page 1 of the New Mexico Personal Income 
Tax Return (Form PIT-1) and a copy of the death certicate or other proof of death is attached to the PIT-1, a 
warrant will automatically be issued to the surviving spouse.

If you are a trustee designated by the trust to manage the decedent’s affairs, you DO NOT need to le this form.   
When a deceased taxpayer’s information is completed on page 1 of the New Mexico Personal Income Tax Return 
(Form PIT-1) and a copy of the death certicate or other proof of death is attached to the PIT-1, a warrant will 
automatically be issued to the estate of the decedent.

DEFINITIONS

Proof of Death
The proof of death must be an authentic copy of either of the following:
 the death certicate, or
 the telegram or letter from the Department of Defense notifying the next of kin of the decedent’s death while 
  in active service.

Personal Representative
For purposes of this form, a personal representative is the executor or administrator of the decedent’s estate, as 
certied or appointed by the court.  A copy of the decedent’s will cannot be accepted as evidence that you are 
the personal representative.

Successor
For purposes of this form, a successor is a person, other than a creditor, who is entitled to property of a decedent 
under the decedent’s will or the Uniform Probate Code, Section 1-21(42).