Form Rev-1737-1 Ex - Nonresident Decedent Affidavit Of Domicile Page 2
Download a blank fillable Form Rev-1737-1 Ex - Nonresident Decedent Affidavit Of Domicile in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Rev-1737-1 Ex - Nonresident Decedent Affidavit Of Domicile with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2NONRESIDENT DECEDENT AFFIDAVIT OF DOMICILE
(continued)
Page 2
9.
Did the decedent pay a tax on income or on intangible property to any state, county or municipality during the last five years?
If yes, where and when was it paid?
Yes
No
10. To what regional office of the Internal Revenue Service did the decedent forward his federal income tax returns during the last five years
preceding death?
11. At the time of death, did the decedent own, individually or jointly, any interest in real property, including lease-holds, or tangible personal property
located in Pennsylvania?
Yes
No
If yes, describe the property in detail.
12. In what business activities was the decedent engaged during the last five years preceding death?
Indicate whether decedent was employed or otherwise engaged in the business, and state the names and the addresses of the persons, firms or corpora-
tions with which the decedent had such business affiliations (Except for employer listed in #5).
13. What is the estimated gross value of the decedent’s estate, exclusive of real property and tangible property located outside of Pennsylvania?
14. At the time of death, did the decedent own or operate an automobile?
Yes
No
If yes, in which state was it registered?
15. At the time of death, was the decedent a member of a church or any other organization ?
Yes
No
If yes, provide the name and address of the church or any other organization.
16. State the purpose or reason the decedent owned real property in Pennsylvania.
17. Include any other information you wish to submit in support of the contention that the individual was not domiciled in Pennsylvania at the time
of death. If more space is needed, use additional sheets of paper of same size.
Name of Person Completing Affidavit
Relationship to Decedent
Street Address
City
State
ZIP Code
Under penalties of perjury, I declare that based on my personal knowledge of the decedent,
the information provided on this form is true, correct and complete.
Signature of Person Completing Affidavit
Date
MM/DD/YYYY
Signature of person completing affidavit. Please sign after printing.
BACK TO PAGE 1
PRINT FORM
Reset Entire Form
RETURN TO TOP
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial