REV-1648 EX (02-09) Bureau of Individual TaxesPO Box 280601 Harrisburg PA 17128 SCHEDULE NSPOUSAL POVERTY CREDITFOR DATES OF DEATH 01/01/92 TO12/31/94ESTATE OFFILE NUMBERThis schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet.PART I - CALCULATION OF GROSS ESTATE1 .Taxable assets total from Line 8 (cover sheet) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 .2.Insurance proceeds on life of decedent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.3.Retirement benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.4.Joint assets with spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.5.PA Lottery winnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.6a.Other nontaxable assets: List and attach schedule if necessary . . 6a.6b.6c.6d.6.SUBTOTAL (Lines 6a, b, c, d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.7.Total gross assets (Add Lines 1 thru 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.8.Total actual liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.9.Net value of estate (Subtract Line 8 from Line 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.If Line 9 is greater than $200,000 - STOP. The estate is not eligible to claim the credit. If not, continue to Part II.PART II - CALCULATION OF JOINT EXEMPTION INCOME - Attach copies of federal income tax return for decedent and spouse.Income:1.TAX YEAR: 192.TAX YEAR: 193.TAX YEAR: 19a.Spouse . . . . . . . . . . . . .1a.2a.3a.b.Decedent . . . . . . . . . . .1b.2b.3b.c.Joint . . . . . . . . . . . . . .1c.2c.3cid.Tax-exempt income . . . .1d.2d.3d.e Other income notlisted above . . . . . . . . .1e.2e.3e.f.Total . . . . . . . . . . . . . .1f.2f.3f.4.Average joint exemption income calculation4a.Add joint exemption income from above:(1f)+ (2f)+ (3f)=(367 3)4b. Average joint exemption income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .=If line 4(b) is greater than $40,000 - STOP. The estate is not eligible to claim the credit. If not, continue to Part III.PART III - CALCULATION OF SPOUSAL POVERTY CREDIT FOR RESIDENT AND NONRESIDENT ESTATES1.Insert amount of taxable transfers to spouse or $100,000, whichever is less . . . . . . . . . . . . . . . . . . . . . . . .1.2.Multiply by credit percentage (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.3.This is the amount of the Resident Spousal Poverty Credit. Include this figurein the calculation of total credits on Line 18 of the cover sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.4.For nonresidents, enter the ratio of the decedent220s gross estate in PA to the value of thedecedent220s gross estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.5.Multiply Line 3 by Line 4 and enter the total here. This is the amount of the Nonresident SpousalPoverty Credit. Include this figure in the calculation of total credits on Line 18 of the cover sheet. . . . . . . . . . .5. American LegalNet, Inc. www.FormsWorkFlow.com