Section I, lines 1 to 3
Your name and taxpayer identification number, a spouse's name and number, the current address, and a phone number for reaching you between 8 a.m. and 4 p.m.
3911
Taxpayer Statement Regarding Refund
- Agency
- IRS
- Revision
- Rev. 10-2022
- Fillable fields
- 49
- Pages
- 2
- Official source
- IRS form page
- Checked
- October 21, 2026
Form 3911: Taxpayer Statement Regarding Refund
Form 3911 is the Taxpayer Statement Regarding Refund. The About page says it is completed by the taxpayer to provide the IRS with information needed to trace the nonreceipt or loss of an already issued refund check. The form says to complete the entire form if you did not receive your refund or if the refund check you received was lost, stolen or destroyed.
The form has three sections: your name, taxpayer identification number, address and return details; the refund information boxes; and a certification signed under penalties of perjury. A separate Form 3911 is completed for each refund. The form says to return it in the envelope provided or by fax, and the About page lists mailing addresses and fax numbers by state.
You can fill out Form 3911 free in your browser on this page and download the result without an account.
What's on Form 3911
Lines 4 to 6
The name and address exactly as they appeared on the return, and the name and address of any representative authorized to receive the refund check.
Line 7: return and refund details
Type of return, tax period, check or direct deposit, refund amount, date filed, the bank where you normally cash or deposit checks, account type, bank RTN and account number.
Section II: refund information
Line 8 for a refund not received, or a check that was lost, stolen or destroyed. Line 9 for a refund check that was received and signed.
Section III: certification
A statement under penalties of perjury that asks for a replacement refund and agrees to return one if two refunds arrive, with signatures on lines 10 and 11.
How to fill out Form 3911
- 1
Names and numbers
Print current names, taxpayer identification numbers and the address with ZIP code. For a joint return, enter both spouses on lines 1 and 2. The form says parts that do not apply may be marked N/A.
- 2
Line 4
Enter the name and address exactly as they appeared on the tax return. If nothing changed, the form says to enter N/A.
- 3
Line 7
Check the type of return and the type of refund, and enter the tax period, refund amount, date filed and bank details.
- 4
Section II
Check every box that applies. The form notes that the law does not allow a replacement check if you endorsed it and someone other than you cashed it, since that person did not forge your signature.
- 5
Sign
Sign and date on line 10. A spouse signs on line 11 when the refund was from a joint return. For businesses, line 11 holds the title of the person who signed above.
Why fill Form 3911 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
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- The official blank straight from the IRS, not a copy someone retyped
- Works on a phone, tablet or computer
Where to send it and what to know
Where to send it
The form says to return it in the envelope provided or fax it. The About page lists a refund inquiry unit address and fax number by state, for example Andover, MA 01810 and 855-253-3175 for Maine, Maryland, Massachusetts, New Hampshire and Vermont.
Fax only Form 3911
The About page says not to send anything other than a Form 3911 to the fax numbers it lists.
Business entities
The About page says states west of the Mississippi submit to Ogden and states east of it to Cincinnati, with Arkansas and Louisiana going to Cincinnati and Wisconsin to Ogden.
One form per refund
The form says a separate Form 3911 is completed for each refund for which information is requested.
Self-help first
The About page says taxpayers expecting a paper check who file as Single, Married filing Separate or Head of Household are encouraged to begin a trace through self-help methods such as Where's My Refund?.
Related forms
Who fills out Form 3911?
The About page says the taxpayer completes the form. It covers individual and business returns.
Official sources and the blank
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Questions about Form 3911
When is Form 3911 used?
The form says to complete it if you did not receive your refund or if the refund check you received was lost, stolen or destroyed.
Do both spouses sign?
The form says that if the refund was from a joint return, both spouses sign before the IRS can begin a trace.
Can Form 3911 be faxed?
Yes. The form says to return it in the envelope provided or fax it, and the About page lists fax numbers by state.
What if I signed the check and someone else cashed it?
The form says the law does not allow a replacement check if you endorsed it and someone other than you cashed it, since that person did not forge your signature.
What about a check older than one year?
The form says a check not cashed within one year of the issue date can no longer be cashed, and to contact the IRS for instructions on how to return it.
Is one form enough for several refunds?
No. The form says a separate Form 3911 is completed for each refund.