Pennsylvania Wrongful Death/Survival Action Request

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Wrongful Death/Survival Action Request
Wrongful Death/Survival Action Request - MCARE Settlements and Nonresident Decedent Settlements (REV-1517)Wrongful Death/Survival Action Request
REV-1517 (EX) MOD 01-20

MCARE Settlements and Nonresident Decedent Settlements

IMPORTANT INFORMATION FOR FIRMS REQUESTING
A WRONGFUL DEATH/SURVIVAL ACTION APPROVAL
LETTER FROM THE PENNSYLVANIA DEPARTMENT OF
REVENUE THAT INCLUDES PAYMENT FROM THE
MEDICAL CARE AVAILABILITY AND REDUCTION OF
ERROR FUND (MCARE) OR FOR A NONRESIDENT
DECEDENT

The following information should be supplied with each
request so that the request can be reviewed in a timely
manner:

The department will make every effort to process the
MCARE settlements or settlements for a nonresident
decedent in an expedited manner provided the following
conditions are met:

● If letters testamentary were granted, a copy of the
will.

● If the petition is being filed through regular mail, attach
a copy of this document to the top of the petition.

3. Information that will help support the allocation you are
requesting.

PA DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
ATTN: WRONGFUL DEATH/SURVIVAL
ACTION REQUEST
PO BOX 280600
HARRISBURG PA 17128-0600
● If
the
petition
is
being
emailed
to
[email protected], the subject line must
state “MCARE Settlement” or “Nonresident Decedent”.

1. A copy of the petition.
2. A copy of the letters granted by the Register of Wills
office.

● If letters of administration were granted, a listing of
the intestate heirs.

● Information on age, work history, educational
history, economic study, and pecuniary loss
suffered by wrongful death claimants.
NOTE: Item 3 is not required for a nonresident decedent.
If you have any questions, please contact this office directly
at 717-787-8327.
For additional information regarding wrongful death/survival
action settlements, see form REV-1518.

● If the petition is being faxed to 717-783-3467, attach a
copy of this document to the top of the petition before
the cover sheet.

www.revenue.pa.gov

REV-1517

Extracted from PDF file 2023-pennsylvania-rev-1517-instructions.pdf, last modified January 2020

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More about the Pennsylvania REV-1517 (Instructions) Individual Income Tax TY 2023

Instructions for the Wrongful Death/Survival Action Approval Letter

We last updated the Wrongful Death/Survival Action Request in February 2024, so this is the latest version of REV-1517 (Instructions), fully updated for tax year 2023. You can download or print current or past-year PDFs of REV-1517 (Instructions) 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 Tax Return
Form 40 Instruction Booklet	Income Tax Return Instruction Booklet (PA-40)
Form PA-40 SP	PA Schedule SP - Special Tax Forgiveness Tax Credit
Form PA-40 A	PA Schedule A - Interest Income
Form PA-40 PA-V	PA-40 Payment Voucher 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 REV-1517 (Instructions) 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 REV-1517 (Instructions)

We have a total of two past-year versions of REV-1517 (Instructions) in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2023 REV-1517 (Instructions)

Wrongful Death/Survival Action Request - MCARE Settlements and Nonresident Decedent Settlements (REV-1517)

2022 REV-1517 (Instructions)

Wrongful Death/Survival Action Request - MCARE Settlements and Nonresident Decedent Settlements (REV-1517)

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