Catalog Number 69801H www.irs.gov
Form
15107 (9-2017)
Form 15107
(September 2017)
Department of the Treasury - Internal Revenue Service
Information Request for a Deceased Taxpayer
Date received by IRS
Name and address of taxpayer(s) (number, street, city or town, state, ZIP Code)
Provide the information requested below. If you prefer to provide this information by telephone, call the IRS at the telephone number
listed on the letter this form was attached to.
1. Taxpayer's date of birth 2. Taxpayer's date of death
3. County and state of residence prior to death 4. County and state in which taxpayer died
5. Surviving spouse's
a. Name b. Telephone number
c. Address (number, street, city or town, state, ZIP Code)
6. Legal executor's or personal representative's
a. Name b. Telephone number
c. Address (number, street, city or town, state, ZIP Code)
7. Has a probate estate been opened for the decedent
If "Yes", indicate the court location and docket number of the probate proceedings
Yes No
a. Court location b. Docket number
8. Regardless of whether a probate estate has been opened, list assets owned by the decedent on the date of death, such as bank
accounts, stocks, bonds, real estate or personal property, whether owned direct by the decedent or held in a trust created by the
decedent
Enclose a copy of the death certificate (if available).
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