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INSTRUCTIONS
ASSETS _ Describe all Real Estate lecated in Pennsylvania and held salely by decedent or held jaintly with another porty
or parties as tenants in col'Tltlon or os' joint tenants with right of survivorship. Include the decedent's percentage of ownership
and the estimated market value. List all tangible and intangible personal property owned individually by the decedent or
jointly with another party or partios as joint tenants with right of survivorship at the time of death. Include intangible
personal property titled in the name of the dec~dent, but payable at death to another party or parties including but not limited
to P.O.D. U.S. Savings Bonds and tentative trust accounts. List any property transferred by the decedent, within two years
of death for which he/she did not receive valuable and adequote consideration.
DEBTS & DEDUCTIONS _ Unsotisfied liabilities incurred by the decedent prior to his/her death are deductible against
his/her taxable estate. In addition to debts incurred by the decedent, other items arc claimable including the cost of
administration, attorney fees, fiduciary fees, funeral and buriol expenses including the cost of a burial lot, tombstone or
grave marker.
Evidence to support the decedent's or the Estote's liability for the debts being claimed should be attached to this return,
A family exemption of $2,000,00 may be claimed by a spouse of a decedent who died damidled in Pennsylvania, If there
is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is member of the same household
can claim the exemption. In the event, there is no such spouse or child, the exemption can be claimed by a parent or parents
who are members of the some household as the decedent.
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INFORMATION
PLACE FOR FILING _ The return is to be filed in duplicate with the Register of Wills of the caunty wherein the decedent
.resided.
rJME FORJILING - The return is due nine months after t.he decedent's death, unless on extension for filing has bt'cn
applied for and granted by the Secretary of Revenue within the nine-month perio~.
FAILURE TO. FILE RETURN _ Section 791 of the 1961 Statute provides thot",. .any person who willfully fails to file
a return or other report required of him shall be personally liable. . .to 0 penalty of 25% of the tax ultimately found
.to be due or $1,000 whichever is the less to be recovered by the Department of Revenue as debts of like amount ore
recoverable by law."