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Hawaii Free Printable Form N-110, Rev 2018, Statement of Person Claiming Refund Due a Deceased Taxpayer for 2019 Hawaii Statement of Person Claiming Refund Due to a Deceased Taxpayer

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Statement of Person Claiming Refund Due to a Deceased Taxpayer
Form N-110, Rev 2018, Statement of Person Claiming Refund Due a Deceased Taxpayer

Clear Form FORM STATE OF HAWAII — DEPARTMENT OF TAXATION (REV. 2018) Statement of Person Claiming Refund Due a Deceased Taxpayer N-110 or other taxable year beginning For Calendar Year ,      , and ending ,  (NOTE: References to “married” and “spouse” are also references to “in a civil union,” and “civil union partner,” respectively.) Name of decedent Please type or print Date of death Decedent’s Social Security Number Name of person claiming refund Your Social Security Number Home address (number and street). If you have a P.O. box, see instructions. Apt. No. City, town, or post office, state and Postal/ZIP code. If you have a foreign address, see instructions. Part I A B  Surviving spouse requesting reissuance of a refund check. See instructions.  Court-appointed or certified personal representative. Attach a court certificate showing your appointment, unless previously C Check the box that applies to you. Check only one box. Be sure to complete Part III below. filed. See instructions.  Person, other than A or B, claiming refund for the decedent’s estate. Also, complete Part II. Attach a copy of the proof of death, unless previously filed. See instructions. State your relationship to the decedent                                               Part II Complete this part only if you checked the box on line C above. YES NO 1 Did the decedent leave a will?............................................................................................................................................... 2 (a) Has a court appointed a personal representative for the estate of the decedent?.......................................................... (b) If you answered “No” to 2(a), will one be appointed?...................................................................................................... If you answered “Yes” to 2(a) or 2(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” to 3, a refund cannot be made until you submit a court certificate showing your appointment as personal representative or other evidence that you are entitled, under State law, to receive the refund. Part III Signature and verification. All filers must complete this part. I hereby make a request for refund of taxes overpaid by or on behalf of the decedent and declare under penalties set forth in section 231-36, HRS, that I have examined this claim and to the best of my knowledge and belief, it is true, correct, and complete. Signature of claimant  Date General Instructions Who Must File NOTE: Hawaii’s laws that apply to a husband and wife, spouses, or person in a legal marital relationship shall be deemed to apply to partners in a civil union with the same force and effect as if they were “husband and wife,” “spouses,” or other terms that describe persons in a legal marital relationship. If you are claiming a refund on behalf of a deceased taxpayer, you must file Form N-110 unless either of the following applies: Purpose of Form Use Form N-110 to claim a refund on behalf of a deceased taxpayer. • You are a surviving spouse filing an original or amended joint return with the decedent, OR • You are a personal representative (as discussed below) filing an original Form N-11 or N-15 for the decedent and a court certificate showing your appointment is attached to the return. Example. Assume Mr. Green died on January 4 before filing his tax return. On April 3 of the same year, you were appointed by the court as the personal representative for Mr. Green’s estate and you (Continued on back) FORM N-110 N110_I 2018A 01 VID01 ID NO 01 FORM N-110 (REV. 2018) PAGE 2 file Form N-11 for Mr. Green. You do not need to file Form N-110 to claim the refund on Mr. Green’s tax return. However, you must attach to his return a copy of the court certificate showing your appointment. Personal Representative For purposes of this form, a personal representative is the executor or administrator of the decedent’s estate, as certified or appointed by the court. A copy of the decedent’s will cannot be accepted as evidence that you are the personal representative. Additional Information you have already sent the court certificate to the Department of Taxation, complete Form N-110 and write “Certificate Previously Filed” at the bottom of the form. Line C Check the box on line C if you are not a surviving spouse claiming a refund based on a joint return and there is no court-appointed personal representative. You must also complete Part II. If you check the box on line C, you must attach the proof of death. If you have already sent the proof of death to the Department of Taxation, complete Form N-110 and write “Proof of Death Previously Filed” at the bottom of the form. For more details, see Death of Taxpayer in the instructions for Form N-11 and N-15. See federal Publication 559, Survivors, Executors, and Administrators, for a discussion on this matter. The proof of death must be an authentic copy of either of the following: • The death certificate, or Specific Instructions • The formal notification from the appropriate government office (such as, Department of Defense) informing the next of kin of the decedent’s death. P.O. Box Enter your box number only if your post office does not deliver mail to your home. Foreign Address – If your address is outside the United States or its possessions or territories, enter the information in the following order: City, province or state, and country. Follow the country’s practice for entering the postal code. Do not abbreviate the country name. Line A Check the box on line A if you received a refund check in your name and your deceased spouse’s name. You can return the jointname check with Form N-110 to the Department of Taxation. A new check will be issued in your name and mailed to you. State your relationship to the decedent in the space provided. Example. Your father died on August 25. You are his sole survivor. Your father did not have a will and the court did not appoint a personal representative for his estate. Your father is entitled to a $300 refund. To get the refund, you must complete and attach Form N-110 to your father’s final return. You should check the box on line C of Form N-110, answer all the questions in Part II, and sign your name in Part III. You must also attach a copy of the death certificate or other proof of death. In the space provided, state that you are the decedent’s child. Lines 1-3 If you checked the box on line C, you must complete lines 1 through 3 in Part II. Line B Check the box on line B only if you are the decedent’s courtappointed personal representative claiming a refund for the decedent on an amended individual income tax return. You must attach a copy of the court certificate showing your appointment. If MAILING ADDRESS Hawaii Department of Taxation P. O. Box 3559 Honolulu, Hawaii 96811-3559
Extracted from PDF file 2018-hawaii-form-n-110.pdf, last modified August 2003

More about the Hawaii Form N-110 Individual Income Tax TY 2018

We last updated the Statement of Person Claiming Refund Due to a Deceased Taxpayer in February 2019, so this is the latest version of Form N-110, fully updated for tax year 2018. You can download or print current or past-year PDFs of Form N-110 directly from TaxFormFinder. You can print other Hawaii tax forms here.

Other Hawaii Individual Income Tax Forms:

TaxFormFinder has an additional 164 Hawaii income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form N-11 Individual Income Tax Return (Resident Form)
Form N-15 Individual Income Tax Return (Nonresidents and Part Year Residents)
Income Tax Instructions Hawaii Income Tax Instruction Booklet
Form N-101A Application for Automatic Extension of Time to File Tax Return
Form N-200V Individual Income Tax Payment Voucher

Download all HI tax forms View all 165 Hawaii Income Tax Forms


Form Sources:

Hawaii usually releases forms for the current tax year between January and April. We last updated Hawaii Form N-110 from the Department of Taxation in February 2019.

Show Sources >

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Hawaii Form N-110

We have a total of six past-year versions of Form N-110 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2018 Form N-110

Form N-110, Rev 2018, Statement of Person Claiming Refund Due a Deceased Taxpayer

2017 Form N-110

Form N-110, Rev 2016, Statement of Person Claiming Refund Due a Deceased Taxpayer

2016 Form N-110

Form N-110, Rev 2016, Statement of Person Claiming Refund Due a Deceased Taxpayer

Forms 2012 2015 Form N-110

Form N-110, Statement of Person Claiming Refund Due a Deceased Taxpayer

Forms 2012 2014 Form N-110

Form N-110, Statement of Person Claiming Refund Due a Deceased Taxpayer

Forms 2007 2011 Form N-110

Form N-110, Statement of Person Claiming Refund Due a Deceased Taxpayer


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