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Pennsylvania Free Printable Statement of Financial Condition for Individuals (REV-488) for 2024 Pennsylvania Statement of Financial Condition for Individuals

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Statement of Financial Condition for Individuals
Statement of Financial Condition for Individuals (REV-488)

IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING (ET+) 02-22 REV-488 OFFICIAL USE ONLY STATEMENT OF FINANCIAL CONDITION FOR INDIVIDUALS If additional space is needed, attach separate sheet SECTION I Start TAXPAYER INFORMATION MM/DD/YYYY Date of Birth Taxpayer’s Name SSN ➜ Taxpayer’s Street Address City County Spouse’s Name (if applicable) State Date of Birth ZIP Code SSN Spouse’s Street Address (if different from above) City County Phone Number SECTION II Marital Status State ZIP Code Number of Exemptions Claimed on W-4 EMPLOYMENT INFORMATION Employer or Business Name Employer or Business Street Address City County Business Phone Number Occupation Paydays State Fill In Appropriate Oval Wage Earner Partner ZIP Code Sole Proprietor Spouse’s Employer or Business Name Employer or Business Street Address City County Business Phone Number SECTION III Occupation Paydays State Fill In Appropriate Oval Wage Earner Partner ZIP Code Sole Proprietor PERSONAL INFORMATION Name of Next of Kin or Other Reference Phone Number Next of Kin or Other Reference Street Address City County State ZIP Code Dependents Living in Your Household (exclude husband and wife) AGE Reset Entire Form RELATIONSHIP TOP OF PAGE AGE PAGE 1 RELATIONSHIP NEXT PAGE PRINT REV-488 (ET+) 02-22 SECTION IV GENERAL FINANCIAL INFORMATION Latest PA Income Tax Return Filed (Tax Year) Adjusted Gross Income on Return Bank Accounts (include Savings and Loans, Credit Unions, IRA and KEOUGH accounts, Certificates of Deposit, etc.) ADDRESS NAME OF INSTITUTION TYPE OF ACCOUNT ACCOUNT NUMBER BALANCE $ $ $ $ TOTAL (Enter in Section V, Line 2) $ Bank Charge Cards, Lines of Credit, etc. TYPE OF ACCOUNT OR CARD NAME AND ADDRESS OF FINANCIAL INSTITUTION MONTHLY PAYMENT AMOUNT OWED CREDIT AVAILABLE $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ TOTAL (Enter in Section V, Line 8) $ Safe Deposit Boxes Rented or Accessed (list all locations, box numbers and contents) BOX NUMBER CREDIT LIMIT SAFE DEPOSIT BOX LOCATION CONTENTS Real Estate Property REAL PROPERTY DESCRIPTION TYPE OF OWNERSHIP ADDRESS (INCLUDE COUNTY AND STATE) a. b. c. d. Life Insurance NAME OF LIFE INSURANCE COMPANY Reset Entire Form PREVIOUS PAGE POLICY NUMBER TYPE PAGE 2 FACE VALUE AVAILABLE LOAN VALUE $ $ $ $ $ $ $ $ NEXT PAGE PRINT REV-488 (ET+) 02-22 SECTION IV GENERAL FINANCIAL INFORMATION (cont.) Additional Information (court proceedings, bankruptcies, repossessions, recent transgers of assets for less than full value, anticipated increases in income, condition of health, etc., include information on trusts, estates, retirement plans, etc., on which you are a participant of beneficiary) SECTION V ASSET AND LIABILITY ANALYSIS (A) ASSET OR LIABILITY (C) CURRENT MARKET VALUE (B) DESCRIPTION (D) LIABILITIES BALANCE DUE (E) AMOUNT OF MONTHLY PAYMENT 1. Cash 2. Bank Accounts 3. Stocks, bonds, investments $ $ $ 4. Cash or loan value of insurance $ $ $ a. $ $ $ b. $ $ $ a. $ $ $ b. $ $ $ a. $ $ $ b. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 5. 6. 7. 8. 9. Vehicles (model, year, license) Real Property Other Assets $ $ Bank Revolving Credit a. Other Liabilities (include judgements, notes and other b. charge accounts) c. 10. Federal Taxes Owed 11. State Taxes Owed 12. TOTALS Reset Entire Form PREVIOUS PAGE PAGE 3 NEXT PAGE PRINT REV-488 (ET+) 02-22 SECTION VI INCOME AND EXPENSE ANALYSIS PART A - INCOME SOURCE GROSS 13. Wages/Salary (Taxpayer) 14. Wages/Salary (Spouse) to be completed if you are married even if your spouse is not liable for the tax. This information is necessary in order for the Department of Revenue to calculate household income and expenses. 15. Interest - Dividends 16. Net business Income (from Form REV-484 or REV-488) 17. Rental Income 18. Pension (Taxpayer) Source: 19. Pension (Spouse) Source: 20. TOTAL NET $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ PART B - NECESSARY LIVING EXPENSES 21. Rent/House Payment $ 22. Groceries $ 23. Allowable Installment Payments $ 24. Utilities $ 25. Transportation $ 26. Insurance $ 27. Medical $ 28. Estimated Tax Payments (federal-state) $ 29. Other Expenses (specify) $ 30. TOTAL $ 31. Net Difference (income less necessary living expenses) SECTION VII $ CERTIFICATION Under penalties of perjury, I declare that to the best of my knowledge and belief this statement of assets, liabilities and other information is true, correct and complete. MM/DD/YYYY Print Name Signature Date SIGN AFTER PRINTING Spouse, Attorney or Accountant Print Name Reset Entire Form PREVIOUS PAGE Spouse, Attorney or Accountant Signature (POA Attached) SIGN AFTER PRINTING PAGE 4 NEXT PAGE Date PRINT Instructions for REV-488 Statement of Financial Condition for Individuals REV-488 IN (ET+) 02-22 GENERAL INFORMATION The Statement of Financial Condition for Individuals provides the Pennsylvania Department of Revenue with credit and statistical information that will be utilized in evaluating an individual’s financial status. Every line of the financial statement must be completed and should reflect accurate information and amounts. If a line is not applicable to you, respond "N/A". An incomplete Statement of Financial Condition for Individuals will not be considered. The Statement of Financial Condition for Individuals is presented in six sections. Instructions are provided only for lines requiring clarification. Most of the requested items are self-explanatory and need no further interpretation. LINE INSTRUCTIONS SECTION I TAXPAYER INFORMATION Please verify the Social Security numbers reported. SECTION II EMPLOYMENT INFORMATION This section should report all full-time and/or part-time employers that currently make payment(s) to you in the form of wages, salaries and/or commissions for services performed. You may provide attachments if necessary. SECTION III PERSONAL INFORMATION Provide personal and household information regarding you, your spouse and/or your dependents. SECTION IV GENERAL FINANCIAL INFORMATION All information furnished in this section should be verified for accuracy. The department may conduct an inquiry to substantiate this information. BANK CHARGE CARD Include any line of credit available to you from a company credit union. REAL PROPERTY Report all business real estate holdings as well as your personal residence. www.revenue.pa.gov RETURN TO FORM PREVIOUS PAGE Report insurance information as verified through your insurance agent. ADDITIONAL INFORMATION Report any extraordinary situations, such as recent transfers of assets, court proceedings and anticipated changes in employment. SECTION V ASSET AND LIABILITY ANALYSIS This section resembles a balance sheet and should reflect accurate amounts for assets owned and debts owed. LINE 1 CASH Report actual cash on hand, not cash in banks or other financial institutions. LINE 5 VEHICLES Report the current market value of your vehicle(s) as determined in an automobile blue book or by other property valuation sources. LINE 7 Report other assets such as furniture, recreational vehicles, recreational or hobby tools, machinery and equipment and miscellaneous household assets. LINE 9 Report all other liabilities and debts owed for medical bills, dental bills and educational expenses, including any formal promissory note, loan arrangement or financial obligation currently assigned to you. LINES 10 - 11 FEDERAL/STATE TAXES OWED Report all delinquent federal and state taxes. LINE 12 TOTALS Report totals for all entries made in each column. NEXT PAGE REV-488 PRINT 1 SECTION VI LINE 23 MONTHLY INCOME AND EXPENSE ANALYSIS Report all sources of income, both gross and net, earned and/or received on a monthly basis and all sources of necessary living expenses paid and/or incurred on a monthly basis. Additional lines have been provided for reporting income and/or expense items not already itemized in Section V. Each entry should be verified for accuracy. The department may request supportive documents to substantiate this information. Report allowable installment payments, the minimum payments on secured or legally perfected debts (car payments, judgments, etc.). Do not include payments on encumbered assets (boats, recreational vehicle, etc.), which are not necessary living expenses. LINES 13 - 14 WAGES/SALARY Report gross and net income figures obtained from all of your wage statements. If you are paid on a weekly basis, multiply your weekly gross and net salary by 4.3 to arrive at your monthly gross and net income. LINE 20 TOTAL INCOME Report total income, both gross and net, from all income sources identified under Items 13-19. LINE 30 TOTAL Report total expenses from all liability sources identified under Lines 21-29. SECTION VII CERTIFICATION Signature by you, your spouse or your attorney/accountant (POA attached), certifies that statements and entries contained in the Statement of Financial Condition for individuals and/or accompanying schedules are correct to the best knowledge and belief of the undersigned. Provide your signature along with the date your signature was posted. If a joint income tax return was filed, your spouse’s signature must also be provided. LINES 21 - 29 NECESSARY LIVING EXPENSES Report accurate amounts for expenses verified by examining your checkbook for the last six months. 2 REV-488 RETURN TO FORM PREVIOUS PAGE www.revenue.pa.gov PRINT
Extracted from PDF file 2023-pennsylvania-form-rev-488.pdf, last modified March 2022

More about the Pennsylvania Form REV-488 Individual Income Tax TY 2023

We last updated the Statement of Financial Condition for Individuals in February 2024, so this is the latest version of Form REV-488, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form REV-488 directly from TaxFormFinder. You can print other Pennsylvania tax forms here.

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Other Pennsylvania Individual Income 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 PA-40 Pennsylvania Income Tax Return
Form 40 Instruction Booklet Income Tax Return Instruction Booklet (PA-40)
Form PA-40 SP PA Schedule SP - Special Tax Forgiveness
Form PA-40 A PA Schedule A - Interest Income
Form PA-40 PA-V PA-40 Payment Voucher

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-488 from the Department of Revenue in February 2024.

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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 Pennsylvania Form REV-488

We have a total of three past-year versions of Form REV-488 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2023 Form REV-488

Statement of Financial Condition for Individuals (REV-488)

2022 Form REV-488

Statement of Financial Condition for Individuals (REV-488)

2021 Form REV-488

Statement of Financial Condition for Individuals (REV-488)

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