Rev 485 Ex Form PDF Details

Are you confused about the Rev 485 Ex Form? Do you want to make sure that this form is properly completed and understood by all parties involved? You’ve come to the right place! We'll help you understand exactly what this paperwork entails, explain why it's important, and provide tips on how to fill out the form. By mastering the Rev 485 Ex Form process, your business will be able to maximize its financial reporting accuracy while preserving liquidity. Read on for more information so that you can master this potentially complex document!

QuestionAnswer
Form NameRev 485 Ex Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesYY, Suffix, rev 485, Commonwealths

Form Preview Example

48500041046

REV-485 EX (05-04)

SAFE DEPOSIT

BOX INVENTORY

 

 

 

 

PA Department of Revenue

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE USE ORIGINAL FORM ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Social Security or Death Certificate Number

Date of Death

 

 

 

 

 

 

County Code Year

 

File Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Decedent’s Last Name

 

 

 

 

 

 

Suffix

 

 

 

 

 

 

First Name

 

 

 

 

MI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

ADDRESS OF DECEDENT

STREET:

 

 

 

 

 

 

 

 

 

 

CITY:

 

STATE:

ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX

 

 

 

 

 

 

 

 

NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREETADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY:

 

STATE:

ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

NAME, ADDRESS AND RELATIONSHIP(IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING

 

 

 

 

 

a. NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

RELATIONSHIP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREETADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY:

 

STATE:

ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

RELATIONSHIP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREETADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY:

 

STATE:

ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

RELATIONSHIP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREETADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY:

 

STATE:

ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

NAME AND ADDRESS OF FINANCIALINSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED

 

 

 

 

 

 

 

NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREETADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY:

 

STATE:

ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

NAME OF PERSON MAKING LAST ENTRY

 

 

 

 

 

 

 

 

 

 

 

7

DATE AND TIME OF LAST ENTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

 

DATE OF CONTRACT TO RENT BOX

9

NUMBER OF BOX

 

 

 

10

TITLE UNDER WHICH BOX IS REQUESTED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. NAME:

 

 

 

 

 

 

 

 

 

b. NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREETADDRESS:

 

 

 

 

 

 

 

 

 

STREETADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY:

 

 

 

STATE:

ZIP CODE:

 

 

CITY:

 

STATE:

ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

WAS AWILLIN THE BOX?

YES

NO

If yes, a. Date of will:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b.Name and address of personal representative, if named in the will NAME:

STREETADDRESS:

CITY:

STATE:

ZIP CODE:

c.Name and address of attorney, if any NAME:

STREETADDRESS:

CITY:

STATE:

ZIP CODE:

48500041046

48500041046

REV-485 EX SAFE DEPOSIT BOX INVENTORY

INSTRUCTIONS

Page of

(1)Cash: Report total only.

(2)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.

(3)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.

(4)Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)

(5)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.

(6)Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.

(7)Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible.

(8)All other contents.

 

(9) Return completed form to:

DEPARTMENTOF REVENUE

 

 

INHERITANCE TAX DIVISION

 

 

DEPT. 280601

 

 

HARRISBURG, PA17128-0601

 

 

ITEM

 

ITEM DESCRIPTION

NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I CERTIFYUNDER PENALTYOF PERJURYTHAT THE ABOVE RECORD IS

PERSON RECEIVING COPYOF

CORRECT AND COMPLETE TO THE BEST OF MYKNOWLEDGE AND BELIEF.

SAFE DEPOSIT BOX INVENTORY:

SIGNATURE

 

SIGNATURE

 

 

 

 

 

PRINT NAME

 

PRINTNAME AND CHECK APPROPRIATE BOX BELOW:

 

 

 

 

PRINTTITLE

DATE

CHECK APPROPRIATE BOX:

 

 

 

Executor(trix)

Administrator(trix)

 

 

Estate Representative

Joint owner of safe deposit box

 

 

 

 

 

NOTE: Attach additional 81/2x 11sheet(s) if necessary or use duplicates of this page of form.

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.

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Step 1: First, access the pdf editor by clicking the "Get Form Button" at the top of this site.

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It is actually an easy task to complete the pdf adhering to our helpful guide! This is what you should do:

1. It is critical to fill out the rev 485 accurately, thus be attentive while working with the segments that contain all of these blanks:

depositor conclusion process explained (stage 1)

2. Right after this section is filled out, go on to type in the applicable details in these - NAME AND ADDRESS OF FINANCIAL, NAME, STREET ADDRESS, NAME OF PERSON MAKING LAST ENTRY, CITY, STATE, ZIP CODE, DATE AND TIME OF LAST ENTRY, DATE OF CONTRACT TO RENT BOX, NUMBER OF BOX, TITLE UNDER WHICH BOX IS REQUESTED, NAME AND ADDRESS OF PERSONS HAVING, a NAME, b NAME, and STREET ADDRESS.

depositor completion process clarified (step 2)

3. This next part is all about REV EX, SAFE DEPOSIT BOX INVENTORY, Page, INSTRUCTIONS, Cash Report total only, Stocks List in detail every, Obligations of US Government, ie jointly held payable on death, Bonds Designate by name amount, Bank and Savings and Loan, and branch and balance, Jewelry Coins Stamps Manuscripts, Deeds Mortgages Current Insurance, All other contents, and Return completed form to - complete these blanks.

How one can fill in depositor portion 3

4. The next subsection will require your information in the following areas: I CERTIFY UNDER PENALTY OF PERJURY, PERSON RECEIVING COPY OF, SIGNATURE, PRINT NAME, and PRINT NAME AND CHECK APPROPRIATE. Remember to fill in all of the needed info to go forward.

Filling in segment 4 of depositor

Lots of people often make mistakes while completing PERSON RECEIVING COPY OF in this area. Ensure that you re-examine what you type in here.

5. This final step to submit this document is crucial. Make sure you fill out the required blank fields, consisting of PRINT TITLE, DATE, CHECK APPROPRIATE BOX, Executortrix, Administratortrix, Estate Representative, Joint owner of safe deposit box, and NOTE Attach additional x sheets, prior to using the form. Neglecting to accomplish that can lead to a flawed and potentially nonvalid paper!

depositor completion process detailed (portion 5)

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