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Pennsylvania Free Printable Wrongful Death/Survival Action Request - MCARE Settlements and Nonresident Decedent Settlements (REV-1517) for 2024 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 1
Extracted from PDF file 2023-pennsylvania-rev-1517-instructions.pdf, last modified January 2020

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
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 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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