Extracted from PDF file 2023-pennsylvania-form-rev-516.pdf, last modified September 2009Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516)
5160019105 (EX) 05-19 (FI) REV-516 OFFICIAL USE ONLY Bureau of IndIvIdual Taxes Po Box 280601 HarrIsBurg, Pa 17128-0601 SECTION I File Number NOTICE OF TRANSFER (FOR STOCKS, BONDS, SECURITIES OR SECURITY ACCOUNTS HELD IN BENFICIARY FORM) DECEDENT INFORMATION START Decedent’s Last Name Suffix Decedent’s First Name MI ➜ Date of Death (MMDDYYYY) Social Security Number County Decedent’s Street Address City State SECTION II ZIP Code CORPORATION, FINANCIAL INSTITUTION OR BROKER INFORMATION Name of Corporation, Financial Institution, Broker or Similar Entity Telephone Number Firm’s Street Address City State SECTION III ZIP Code ACCOUNT INFORMATION Account Title Account Number Account Balance Number of Beneficiaries (Include accrued interest through date of death) Account Type: Capital Stock SECTION IV Registered Bond Security Account Other RECIPIENT OF LETTER/PROOF OF NOTIFICATION Suffix Recipient’s Last Name Recipient’s First Name MI Recipient’s Street Address City State 5160019105 Reset Entire Form TOP OF PAGE ZIP Code 5160019105 PAGE 1 NEXT PAGE PRINT 5160019205 REV-516 (EX) MOD 05-19 (FI) SECTION V PREPARER INFORMATION (Complete if Name and Address is different than Recipient information.) Suffix Preparer’s Last Name Preparer’s First Name MI Preparer’s Street Address City State Date (MMDDYYYY) Preparer Signature ZIP Code Daytime Telephone Number PLEASE SIGN AFTER PRINTING. SECTION VI BENEFICIARY INFORMATION (List additional beneficiaries on Page 3.) Suffix Beneficiary’s Last Name Relationship to Decedent Beneficiary’s First Name Beneficiary’s Social Security Number Percent Taxable Beneficiary’s Street Address City State Suffix Beneficiary’s Last Name Relationship to Decedent ZIP Code Beneficiary’s First Name MI Beneficiary’s Social Security Number Percent Taxable Beneficiary’s Street Address City State Suffix Beneficiary’s Last Name Relationship to Decedent ZIP Code Beneficiary’s First Name MI Beneficiary’s Social Security Number Percent Taxable Beneficiary’s Street Address City State 5160019205 Reset Entire Form MI PREVIOUS PAGE ZIP Code 5160019205 PAGE 2 NEXT PAGE PRINT 5160019305 REV-516 (EX) MOD 05-19 (FI) SECTION VI cont. BENEFICIARY INFORMATION (Attach copies of page 3 to list additional beneficiaries.) Suffix Beneficiary’s Last Name Relationship to Decedent Beneficiary’s First Name Beneficiary’s Social Security Number Percent Taxable Beneficiary’s Street Address City State Suffix Beneficiary’s Last Name Relationship to Decedent ZIP Code Beneficiary’s First Name MI Beneficiary’s Social Security Number Percent Taxable Beneficiary’s Street Address City State Suffix Beneficiary’s Last Name Relationship to Decedent ZIP Code Beneficiary’s First Name MI Beneficiary’s Social Security Number Percent Taxable Beneficiary’s Street Address City State Suffix Beneficiary’s Last Name Relationship to Decedent ZIP Code Beneficiary’s First Name MI Beneficiary’s Social Security Number Percent Taxable Beneficiary’s Street Address City State 5160019305 Reset Entire Form MI PREVIOUS PAGE ZIP Code 5160019305 PAGE 3 NEXT PAGE PRINT THIS PAGE DOES NOT PRINT Pennsylvania Department of Revenue Instructions for REV-516 notice of Transfer rev-516 In (ex) 05-19 GENERAL INFORMATION SECTION II PURPOSE Section 6411 of the Probate, Estates and Fiduciaries Code (Title 20, Chapter 64, Pennsylvania Consolidated Statutes) sets forth the requirement of reporting to the Department of Revenue the transfer of securities. Enter the information of the entity that maintains the account. WHO MUST FILE Corporations, financial institutions, brokers, or similar entities are required to report. The beneficiary, trustee or representative of the estate may also notify the department if all the necessary information is available to them. WHAT TO REPORT Capital stock, registered bonds, a security or a security account which are held as follows: • Held as sole owner by the decedent with a sole beneficiary clause which controls distribution at the death of the decedent. • Held as a sole owner by the decedent with a primary and secondary (contingent) beneficiaries clause which controls distribution at the death of the decedent. INSTRUCTIONS If reporting more than one account, use a separate form for reporting each account. If there is a main account made up of sub-accounts, only report the main account number and total value including the value of all sub-accounts. Assets must be reported at their value as of the decedent’s date of death, including any accrued interest not yet credited or any dividend earned but not issued as of the date of death. If available, include a copy of the valuation report. Once a review of the form is complete, an acknowledgment letter, confirming notification of the asset to the department, will be issued to the person or entity reported in Section IV. The letter may be used to demonstrate compliance of section 6411. To ensure timely processing, each section of this form must be completed as instructed below. LINE INSTRUCTIONS SECTION I Enter the information for the decedent associated with the asset being reported. www.revenue.pa.gov SECTION III Enter the information for the asset being reported. Account Title: Enter the name or title of the account. Account Number: Enter the identifying number of the account being reported. Number of Beneficiaries: Enter the total number of beneficiaries of the account being reported. Account Balance: Enter the value of the account including any accrued interest not yet credited or any dividend earned but not issued as of the date of death. Account Type: Select the type of account that most closely describes the account being reported. If “Other” is used, enter the type of account in the space provided. SECTION IV Enter the information for the person or entity who should receive the acknowledgment letter that the asset has been reported to the department. SECTION V Enter the name and address of the person preparing this notice if the person is different from the person in Section IV. The preparer must sign and date the form and provide a daytime telephone number. SECTION VI Enter the information for each beneficiary of the account being reported. If additional beneficiary space is needed, use a separate sheet of Page 3 of this form. Mail completed form to: PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 REV-516 1 RETURN TO FORM
Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form) (REV-516)
We last updated the Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516) in February 2024, so this is the latest version of Form REV-516 , fully updated for tax year 2023. You can download or print current or past-year PDFs of Form REV-516 directly from TaxFormFinder. You can print other Pennsylvania tax forms here.
TaxFormFinder has an additional 174 Pennsylvania income tax forms that you may need, plus all federal income tax forms.
| Form Code | Form Name |
|---|---|
| Form REV-516 | Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516) |
| Form REV-1500 | Inheritance Tax Return - Resident Decedent |
| Form REV-1508 | Schedule E - Cash, Bank Deposits & Misc. Personal Property |
| Form REV-1511 | Schedule H - Funeral Expenses and Administrative Costs |
| Form REV-1737-1 | Nonresident Decedent Affidavit of Domicile Nonresident |
View all 175 Pennsylvania Income Tax Forms
Pennsylvania usually releases forms for the current tax year between January and April. We last updated Pennsylvania Form REV-516 from the Department of Revenue in February 2024.
About the Estate Tax
The IRS, and many states, impose an estate tax on the transfer of cash and property between a decedent and their beneficiaries. These taxes generally only apply to estates over a certain size threshold, generally several million dollars, and therefore only affects the largest few percent of estates in the United States.
We have a total of twelve past-year versions of Form REV-516 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form) (REV-516)
Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form) (REV-516)
Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form) (REV-516)
Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form) (REV-516)
Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form) (REV-516)
Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form) (REV-516)
Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516)
Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516)
Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516)
Request for Waiver or Notice of Transfer (For Stocks, Bonds, Securities or Security Accounts Held in Beneficiary Form (REV-516)
Request for Waiver or Notice of Transfer
Request for Waiver or Notice of Transfer
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