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Pennsylvania Free Printable Safe Deposit Box Inventory (REV-485) for 2024 Pennsylvania Safe Deposit Box Inventory

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Safe Deposit Box Inventory
Safe Deposit Box Inventory (REV-485)

4850019101 (EX) MOD 08-19 REV-485 BurEau Of InDIvIDual TaXEs PO BOX 280601 HarrIsBurg, Pa 17128-0601 START ➜ SECTION I SAFE DEPOSIT BOX INVENTORY DECEDENT INFORMATION Decedent Last Name Decedent First Name Decedent Middle Name County File Number SECTION II PLEASE USE ORIGINAL FORM ONLY Date of Death MM/DD/YYYY SSN (required) REQUESTER INFORMATION Name of Person Requesting the Opening of the Safe Deposit Box Street Address City Signature Title State ZIP Code Date MM/DD/YYYY SIGN AFTER PRINTING Name of Person(s) Present at the Box Opening Relationship (if any) Street Address City State ZIP Code State ZIP Code Please attach additional sheets if more people are present. SECTION III FINANCIAL INSTITUTION INFORMATION Name of Financial Institution Street Address City Name of Person Making Last Entry Date of Last Entry Date of Contract to Rent BoxMM/DD/YYYY Number of Box Time of Last Entry HH:MM Title Under Which Box is Requested Name of Person(s) Having Access to Box Street Address City State ZIP Code Please attach additional sheets if necessary. Name of Individual Taking Inventory Title 4850019101 Reset Entire Form TOP OF PAGE 4850019101 PAGE 1 NEXT PAGE PRINT 4850019201 rEv-485 (EX) MOD 08-19 SECTION IV INVENTORY Was a Will in the Box? Yes If Yes, Date of Will No MM/DD/YYYY Name of Personal Representative (If Named in the Will) Street Address City State ZIP Code State ZIP Code Name of Attorney (If Any) Street Address City ITEM NO. ITEM DESCRIPTION Please attach additional sheets if necessary. SECTION V CERTIFICATION I certify under penalty of perjury that the above record is correct and complete to the best of my knowledge and belief. Name Signature Title SIGN AFTER PRINTING Telephone Number Email Address Date 4850019201 Reset Entire Form PREVIOUS PAGE MM/DD/YYYY 4850019201 PAGE 2 NEXT PAGE PRINT Pennsylvania Department of Revenue Instructions for REV-485 safe Deposit Box Inventory rEv-485 In (EX) MOD 08-19 GENERAL INFORMATION The Department is authorized by law, 42 U.S.C. §405 (c)(2)(C)(i), to require disclosure of Social Security numbers in connection with administering state tax laws. The Department uses the Social Security number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities. The state law prohibits the Commonwealth’s personnel from disclosing confidential tax information except for official purposes. LINE INSTRUCTIONS SECTION I DECEDENT INFORMATION Enter information for the decedent, and the county file number. SECTION II REQUESTER INFORMATION Enter the name and address of the person requesting the opening of the safe deposit box. The requester must then sign and date. SECTION IV INVENTORY Indicate if a will is in the box. If so enter the date. Enter the name of the personal representative (if named in the will) along with address. Enter the name of attorney present (if any) along with address. List the items with description, and attach additional sheets if necessary. Be sure to include: • Cash: Report total only. • Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. • Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. • Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) The name and address of any present parties must be listed along with relationship (if any) to the decedent. Please attach additional sheets if needed. • Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. SECTION III • Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. FINANCIAL INSTITUTION INFORMATION Enter the name and address of the financial institution where the safe deposit box is located. • Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. Also list the name of person making last entry along with the date and time. Include the date of contract, number of box and title under which box is requested. • All other contents. Enter the name of person(s) having access to box along with their address. NOTE: Attach additional 81/2” x 11” sheet(s) if necessary. Return completed form to: PA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 Enter the name and title of the individual taking the inventory. www.revenue.pa.gov REV-485 1 RETURN TO FORM
Extracted from PDF file 2023-pennsylvania-form-rev-485.pdf, last modified September 2019

More about the Pennsylvania Form REV-485 Estate Tax TY 2023

We last updated the Safe Deposit Box Inventory in February 2024, so this is the latest version of Form REV-485, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form REV-485 directly from TaxFormFinder. You can print other Pennsylvania tax forms here.

Other Pennsylvania Estate Tax Forms:

TaxFormFinder has an additional 174 Pennsylvania income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form REV-1500 Inheritance Tax Return - Resident Decedent
Form REV-516 Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516)
Form REV-1508 Schedule E - Cash, Bank Deposits & Misc. Personal Property
Form REV-1737-A Inheritance Tax Return - Nonresident Decedent
Form REV-1510 Schedule G - Inter-Vivos Transfers and Misc. Non-Probate Property

Download all PA tax forms View all 175 Pennsylvania Income Tax Forms


Form Sources:

Pennsylvania usually releases forms for the current tax year between January and April. We last updated Pennsylvania Form REV-485 from the Department of Revenue in February 2024.

Show Sources >

About the Estate Tax

The IRS, and many states, impose an estate tax on the transfer of cash and property between a decedent and their beneficiaries. These taxes generally only apply to estates over a certain size threshold, generally several million dollars, and therefore only affects the largest few percent of estates in the United States.

Historical Past-Year Versions of Pennsylvania Form REV-485

We have a total of twelve past-year versions of Form REV-485 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form REV-485

Safe Deposit Box Inventory (REV-485)

2022 Form REV-485

Safe Deposit Box Inventory (REV-485)

2021 Form REV-485

Safe Deposit Box Inventory (REV-485)

2020 Form REV-485

Safe Deposit Box Inventory (REV-485)

2019 Form REV-485

Safe Deposit Box Inventory (REV-485)

2018 Form REV-485

Safe Deposit Box Inventory (REV-485)

2017 Form REV-485

Safe Deposit Box Inventory (REV-485)

2016 Form REV-485

Safe Deposit Box Inventory (REV-485)

Forms/Publications 2015 Form REV-485

Safe Deposit Box Inventory (REV-485)

Safe Deposit Box Inventory (REV-485) 2014 Form REV-485

Safe Deposit Box Inventory (REV-485)

Safe Deposit Box Inventory (REV-485) 2012 Form REV-485

Safe Deposit Box Inventory (REV-485)

Safe Deposit Box Inventory (REV-485) 2011 Form REV-485

Safe Deposit Box Inventory (REV-485)


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