Pa Form 8857 - Request For Relief From Joint Liability Page 7

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6. If your (ex)spouse was self employed, did you assist him/her with the business?
Yes
No
If yes, what were your responsibilities?
7a. During the year(s) in question, did you have your own separate bank account?
Yes
No
If yes, indicate the type of account(s), the financial institution and account number(s).
7b. What funds were deposited to the account(s)?
7c. What bills were paid out of the account(s)?
8a. During the year(s) in question, did you and your (ex)spouse have any joint bank accounts?
Yes
No
If yes, indicate the type of account(s), the financial institution and account number(s).
8b. What access did you have to the account(s)?
8c. What funds were deposited to the account(s)?
8d. Who made the deposits?
8e. What bills were paid out of the account(s)?
8f. Who wrote the checks?
8g. Did you review the monthly bank statement?
Yes
No
8h. Did you balance the checkbook to the bank statement?
Yes
No
9. Did you pick up and open the household mail?
Yes
No
10. Identify any periods of separation between you and your (ex)spouse during the year(s) in question.
Form PA 12510
Page 2 of 4

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