HomeMy WebLinkAbout79-00347
I
Cf)MMONWEII~ HI OFPENNSVLVilNliI .LAPPLICATION FOR AND CONSENT '*
' D~PilRTMeNT OF REVENue . TO TRANSFER SECURITIES
HUREilU OP COUNTY COLLECTIONS REGISTERED IN THE NAME
. OF A RESIDENT DECEDENT
---"-"--'--,"--'.-~- _.__........__.____.._._._,,_,......___u__ ..-'-. --.-.'-D-ATE.~o- ,..22;' 79 --...----
~ (MUST ~e FILED IN TRIPLICATE) ----
TO THE PENNSYLVANIA DEPARTMENfoF REVENUE,
Application II hereby modo far a en..nt to tho trona fer of tho following ..aurltln of 0 Ponnlylvanla
Corporctlon cr a Nctlonal Banking Auoclallon located In Ponnaylvanlal
He ':-/a '.l-li/',I
(a) 249 (b)--.ll!.l1adtbhla. Ibotrlcl '-o.QIUmIll.----,.--:-- (a) .. QClJlll!lOl\
(NOTE, 'In dOlarl\lIng loaurltln ontor In (a), ab 0/0, olth~r tho number of Ihare. of ..oak Of the faae am.o !It of
reglltered bend.,"ln (b), tho nom, of the luul!lg aompany and In (e) the alc.1 of at oak or the .tatod Int.rn rate
cnd maturity. dctp. o. registered bj!nds,) ,
7t9;}h10/4/?l, 10-1,..,a, 10/14/15
ISSUED ON .10 1 t. , ond having a TOTAL MARKET VA'LU~ OF $ . '984.0Q
(D.") '. '
01 of the dattof deathf the decedent, Wll1)ur N. ""o1vor , cn 4!'J$-1.t
(Ham. 01 D...d.n') (pa"'o' d..th)
who was Inte of41'. r.al'k ,Ao~...j"LritW OWllbQl'lnntJ....QUIllllrlJlJuL ,. .
(SH..' and N~mb.,) (P.II Offlo.) (C.~n'y)
J..mO
($,a'.)
The securities are roglstorod 01 followsl.~l1bur N..._M~O_~!,~~,"~..Mlrlll1\o.. MaoXvor....JLI.
. ,. (Nom. ., n.m., In whloh .."lfl.a,.. .,, "glller.d) .
",ell\lt~I!'floAlf~)~l~l~l" M,~~IVOr, 41U!l.r!LAv'~Ltfew O~.b8l'1.nd. 'a. ~1070
EXECUTOR ' ) (Nom.) (Add....). .' .
NAME OF APPLICANT .M.l",A~_Jl~ MaoIvol'
.'urz ltllS hrlc Aye.
COUNTY FILE NUMBER~L2..~~ ADDRESS OF APPLICANL_:~lIUl4-Plh
~1
BUREAU FILE NUMBER .0 SIGNA TUR E OF APPLICANT \, ".";1. '/i""'L/
HOTICEI IP YOU PAIL TO PROPERLY PILL IHA~Y PORTION OP THIS APPLI ATION, IT WILL OT BE
CONSIDBRED COMPLETE AND WILl. BE RETURNED TO YOUPOR COMPLETION,
.-..'-......_---_.~~--_.. -
COMMONWEALtH OF PENNSYL V ANIX-':OEPARTMENToF'REVENUe.'.'
CONSENT TO lRANSEER,SECURITIES DA TE t,p, ~S - ~ eL
I hore~y ccnaent to the ttcnsf" of tht ab9v~ securities now rogl81ered I~. the neme of the aforOlol~
Decedent end wolve tho filing of 0 cettlflce.te aettlfylng to the paymontof the transl" IH~orltanco ta~ to whlah
the property of laid Docedent Is mode sublect purluont to tho provlllons of the Acto'f June 20, 19)9,~,L. 521,
as amendod and tho Aat of June IS, 1961, P,L. 373, cs amended, This Is cliO In cccctd<mcewlth the provlslonl
of the. Act of April 9, 1929, P.L. 343.
This Consonl to Transfer the herein delcrlbed property operates cnly In referenae to the IItolt o~ the
obovo.nan1ed Decedent..
,
.
'~~'..
~-
'--~~(fili;T~---nn-.-(c.';;;'i)'-'._.nn_.___.~.
rl(-;C'12 IIHi~)
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
'*
C,oMMO~WEA~ HI OP PEtH-lSVL.VANIA
DEPARTMENT DF REVENUE
BUREAU OF COUNTY CO~~eCTlONS
,---~.~~~-_.-------------~-,
.__~.~~._u~n~'_~_.'.__~_.~_'~'_'_~~'~""___.'_"'_ ~--~,..
~(MUST B,E fiLED IN TRIPLICATE)
TO THE PEt-iNSYL VANIA DEPARTMENT OF REVENUEI ' ..
. Appllgallcn Is hereby moM for c; onnnt to the Itanafer of tholcl\owlno naurltl.. '01 a Pennaylvanla
Cctporatlan ~r c National Ocnklng A..a~latlon located In Pennlylvanlcl '
DATE
,:1..1)2-7..2_
(a) 80 (b)jjJJ.:U,DahCl\I.e lUeotrlaJlorport\:\l1on .,_(c)~90 ....,--
(NOTEI In'deacrlhlno ncurltl.. onter In (a), ab 010, either the number of shcru of .toak or the fact amount of
reglster.d booda, In (b), ,th. name c'f the I..ulng company and In (g) the c\c..of stock or the stated Interest rote
pnd maturity da, to 01 re.lJIst,red bOJ1~s,) I / .
8/aO/<<tPJ. It/11+1!''?. 1 6 60. " .
ISSUED ON 1/6l~9. 11/'32ZZ~ and having a TOTAL MARKET V A/LUe OF $ 14".10'
(Pat.) ,
01 cl the date of death of the decedent, WUbur ~.~ M"-oIvor , on l+"U-79 .
. (Ham. of D...d.nt) (Pal. af~..th)
who was late of 1+1 SPark".,... He", QUllberlunl1 ,
(51,..1 and Numb.,) ,(po.t Off'..)
.J1Y1I.l1J.r ~fln4
(County)
. P'L..._
(Sta,.)
,
Jhe lOCurltl" are reglstored CI fol\cwll ~)!U\)ur N L.Mf!tlVJ~~~ fitaoIvOI"~ J .T./&
(Namu a, namo. In whl.h ..,llff.atll are ',Vl.t.red)
"
~1I,ltlKlfR""'efl)Mlrll11la. Ma'Ivor, 415 Pllrk Av'" New CUllberlRnl1, pa. 17070
eXECUTOR) "(Ham;j-." ' -~._..._--_. (Ad~t...) "
. . ' '" NAME OF APPLICANT. MiriNII It, Mila IvaI' ",.
" ,.~;~7 " 4111 P.rlc Ave.
COUNTY FILE NUMBER ~/.7'-1',ff!9 ADDRESS OF APPLICANT_Jia'-Oli.blX'h~~,p4. ~7D"'-
~~~~~~ F:~~~~~~liRTO PROPPRLY PIL~\~N:N~U~;R~io~~~L~~,~NA~pu1f;;'~~~~' ~t~~ 'l:)~pd;?'d-
CONSIDBRPD COMPLPTS AND WILL IU RnURNED TO YOU PQR COMPLBTION,
COMMONWEALTH ,OF PENNSYLVANIA - DePARTMENT OF REVENUE
. ,CONSeNT TO TRANSF~KSEC~RITIES DATeL.:,.f.- 1j
I hereby gonspnt to the tronlferaftho cbove socurltlosncw roglsteredln the nom' of .th. afcreaald
D.cedentand walvo tho flllnoof a'certlflcalO certlfylngtc tho payment of the transferlnh.rltanceJox to which
Ihoprcpotty of scld Doced.nt Ism~de subloct pursuant tO,the provlslon,of the Act of June 20, 1919,P,L, 521,
"
al omend,edcnd the Act of June 15, 1961,'P.L, 373, c,, amended. Thll Is clsc In accordance wltlithe ptovlllcns
01 the Agt 01 April 9,1929, P.L. 343.
This, Can.ent to Transfor the heroin desctlbedprapeity cperot.. cnlyln reference to,lh, ..tote of the
.obovo.namod ,Decedent,
*
_......-(Ti\I.j~-.~------(Co;.;;yr--~..-
flCC'H 1i/'1l",1
COMMONWEAl,TH OF PENNSYLVANIA J APPLICATION FOR AND CONSENT
. DEPARTMENT OF REVENUE TO TRANSFER SECURITIES
BUREAU 'op COUNTY CO~~ECTIONS REGISTERED IN THE NAME
. OF A RESIDENT DECEDENT
.......-.-~__.___..___~_...__..._..u._----.-.-_~ _...._~_..__..~~ ___....._u_.._..~ ~ .....,. .~+ ......,*___'._~
'*
~ (MUST Be FILeD IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE,
Appllo~tlon II h,reby mode /cr conlOnt to the tr~n~/er of the /ollowlng IOcurlllOl 0/. a P,nnlylyanla
Corpcratlon or 0 Notlon~1 Blir,klng A..ocl~lIon loc~ted In PennlylY~nlo'
DATE
.5..22..79
(~)_ 80 (b)__ IN~ Oorpot'!lt1on' _____ .__(0) common
(NOTE, In dOlcrlblng 10cutlll08 ontet In.(a), ~b 010, olthor tho numbet 0/ _harll c/ Itock or the/ace ~mounl 0/
roglltored bondI, In (b), tho n~me c/ the ISlulng ccmp~ny and In (c) tho cla88 0/ Itock or tho I,cted Int"OIt rate
cnd m~turltyd~te c/ regl_tored bond..) .
ISSUED ON
'..29.68
, ond h~ylng c TOTAL MARKET VAWE OF $
Wilb~rN. MftoIvor
3S~4.80
'...
. (Pa,o)
01 0/ tho d~t. 0/ do~th 0/ tho docedent,
, on
4.2S..79
(Pat. ., d.ath)
Pat
(510'0)
"
(l'Iamo .f p...dontl
who wq' '~to cl...
415. Ptlrk Avo...
Now OUllIbet'!lI.nd
(po.t Offl.o)
O~tlberlll.nd
(County)
(5t,oot ond l>Iumb.,) ,
Tho lecurl'il08 ~re rltgllterod~1 /Qllcwl,__~llb!Ar N_~._ Mll~vor _~.MlrlMl K. MRCllvor. .1T!B
(NoRla 0, na",,1 In wh.I.'h .."If/.a'.. ar. ,.gllt.r.d)
M1r111m &,-~.!11vc)r. 41_.LlftrJtMt.\..t N..Vi Oumberland, I'll. 17010
(l>Iom.) ,(Add....)
. NAME OF APPL.ICANT _, Mlrlnm H, Ma.ohor
COUNTY FILE NUMBER~L:.i'<J .~~. ADDRESS OF. APPLICANT 41S PArk Ave. ,New Cumberland I
. . . pa. 17070 . /1
BUREAU FILE NUMBER . . ,SIGNATURE OF APPLICANT 7'&1;,.';"1. (rf'f(~Ie:.?:'7'Y/
HOTICEI IP VOUPAIL.TO PROPeRLY FILL IN AH.VPORTION OF THIS APPLICATI6H, IT WILL HOT B'
CONSID.BRED COMPLBTE AHD WILL BE RETURHED TQ you pOR COMPLIITION,
~ ,- --
J.OMl+lI&:rR^~'
eXECUTOR' .-
COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE
, . CONSENT TO T~ANSFER seCURITIES DATE ~.., $''''7 +-
I horoby conlUnt to tho tr~n8/or 0/ the aboyo securities now reglitored In the nome. 0/ the a/oruuld
Docodent ~nd wolve tho /lIlng 0/ a cor"/,Ic~to ~ertlfylng to tho p~ymonto/ the !tonI/or Inher.ltance'ax 10 which
tho proportyo/ laid Docodent 18 madOlubloct purlu~nt '0 tho ptcvlllcn8 of the Act 0/ June 20, 1919, P,L, 521,
CI amendedond the Act 0/ Juno 15,1961, P.L, 373, os amended" Thl. 18 ~IIO In ~ccordcnce with thop'royl_lona
0/ tho Act 0/ April 9, 1929, P,L, 343,
This Conlon.t toTranl/or thohoroln delcrlbed ptoperfy opotclol only In re/eronce to tho ut~to 0/ tho
~boYo.n~mod Decodont,
*'
By_
"'!I
,'II! "~
,:,'Jt!iLl'(.{J~rH'(
--. '''('''iiT~)~---~--n-(COunty) ,.-----------~---
H('C-12 (&I-hilI
APPl.ICA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDI:NT DECEDENT
'*
CpMMONWEAl. TH OF PENNSYl.VANIA
flEPARTMENT OF REVeNue
wReAU OF COUNTY co~~eCTloNS
__~__"..__" _~,,__~_ ._..,_" .____.. ~ _~-.__._.."_..F.. ..._~~L~'____.~----->__.' ~ _ ~~_,u,.,~____,.,.<< ~n._.______'_' ,.,..
U".___.~__..~ _._____________.............._,,_.~___.______ ._.~.__..----
DATE ~..22.~L.
~ (MUST BE ,FILED IN TRIPl.ICATE)
TO THEPENNSYL."ANIA DEPARTMENT. OF ReVENUEI
Application II hereby made lor canaent tc the tranllet 01.11'0 fcllowlng "curltln 01 c Pennlylvanlc
Corporation or a Natlcncl Banking A..oclatlan located In Ponnlylvcnlai
(0) 850 ___jb)_._._...._ 001'41 Q.qrpor~_t1on .._~~______ (c) OOlllll\on
(NOTE I In ducrlblng lacurltlOl onter In (a), ab Ole, elthar tho numbor 01 Ihcre. 01 Itock cr the Icce amount 01
reglltered bonds, In (b), the. nome 01 the I.sulng ccmpany and In (c) tho cia.. cf Itock or tho Itatod Interest rate
cnd maturity dato 01 rool:tt,rod bonds,)
ISSUeD ON_~71, 7/13/71, and having a TOTAL MARKET VA'LUE OF $ 10,200.
(D.t.)
0101 tho dolO cl death cl tho decedent Wilbur N. Ml\OIvor
,,' ,
, on
4..25.79 '
(H.m. .1 D...donl)
(P.t. .1 d..th)
who was lata of 415 '"t'k Ave., New O\,Ul\berland
(Str..t .nd Humb..) (P..t Olflao)
Oumberlund
(C.unty)
,.\. 17070
(5t.I.),
The 10curlll0l ctO registered as follcwll.. Wl,~bu~_.H... M.I~IvoX' &: Miriflln E. It\llOIvot', TIB
IH.m. .. n.m., In which ...IIfI..I.. ... ,.gl.I...d)
A9Mltl+r..'fAIIr~l:_~lrium B. MlIcIvor , 41!l~.I.~.!LAvIl . , NeW OUllI'\)erlilnd, fa. 17070
EXECUTOR) (Horn.). . (t\ddr...)'
.'. . NAME OF APPl.ICANT Mir1n\l\ s. MaoXvol'
...:J'IL . '--ij:I"'5-Pi"u:'k live,
COUNTY FILE NUMBER ~I. '/'7'~- ADDRESS OF APPL.ICANT N8wj}umbet'1I\nd. .~a, 17070
~ ' _' ,_ ,'...J
BUREAU FIL.E NUMBER --:,_~SIGNATURE OF APPL.ICANT '1Ji,;'wra. r:f; d),l,;', IJ7N/
NOTICEI IF YOI,lFAIL TO PROPPRLY FILL IN ANY PORTION OP THIS APPL'lc.TION, IT WILL NO'f.BII ..'
CONSIDERED COMPLETE AND WILLBII RBTURNIID 'TO YOU .POR COMPLETIOM,
',. - ~
COMMONWEALTH OF PENNSYL.VANIA - OEPARi'MENT OF REVENUE
CONS.ENT TO TRANSFER SECURITIES. DATE ~.... S' "Y\4
I heroby conlOnt to the. transler of tho abovo ae~urltlol now registered In the name of theafornald
Detedent and wolve the filing cl a certificate ~ertilYlng to. tho pcymont cl the tranaler Inheritance tal< to whl~h
thll.proporty cf acid Decodontll. made subjoct pursuont tctho prcvlalona 6/ the A~t of June 20, 1919, P,L, 521,
as amended cnd the'A~t 01 June 15, 1961, P.L. 373, as omondod, This II olso In accordance with the pro~lllonl
,.
of tho A~t 01 April 9, 1929/ P.L.. 343,
This Consent tc Transfor theheroll1 descrlbod property oporctes chiy In reference.to tho.eatote 01 the
abovo.namod Docedent.
*'
Slgne
By
H'~l,..itf;j-" ..__...nfc.u,;;;;)'---'--~-'~--
CPMM~NWEAL TH 0" PENNSYI VANIA L' APPLICA TION FOR AND CONSENT
D~PARTM~NT OF REveNUE TO TRANSFER SECURITIES
BUReAU OP COUNTY COl.LECTIONS REGISTERED IN THE NAME .
OF A RESIL>ENT DECEDENT
-~..~-~~..._._~,-...._,.~~~">,,-.-+-~..~.-...............~ ---.--....-.-,-__.~.___._..T~~____ ."_L_.~"__-;~.__"~..-.........__....___. ---.__-._.......______.....------.....___
DATE-'...:.:~2..7!) __
~ (MUST BE FILED IN TRIPLICATE)
TO THe PENNSYLVANIA oePARTMENT OF REVENUE:
Application la hereby made for acnaent tc.thu tranafer 01 tho lollcwlngaeaurlllu cf c Penn.ylvanlo
COtporctlon ora National Banking Anoalcllon located In PennsylvanlOf
(aL-llL_(b) P'W8)'lvanla lower '~h:l1.~ Oomp.lln;y _(c) Oomlll.
(NOTel Indo.~tlblng socutlll.. onter In (a),ab Ole, ollhor the number of aharu of Itock.or the.lac. omourll of
regllt.red bond., In (p), tho name cf the Inulng company ond In (c) tho cia.. cf atcak or the Itatedlnt'!,lt rcte
and mcturlty doto of rogllter.ed bond.,) .
".26.. 70
ISSUEO ON ,9..?;a"1o _, ond having a TOTAL MARKeT VAWEOF $
(Do,.)
a. cf the date of decth 01 the decedent, WUbur N. MaoIvor
'*
who was late ai~' Park Ave.. _ "". OUlllblll'1ft~
(S...., and Numb.,) ,. (Palt O(lle.)
(Nom., or D..adant)
~1$9.,o
, on 4.2".79
CJUMberlf1l'\cS
(County)
(Dot. ~f d.ath)
Pal
(Stat,)
The uourlllea or. roglstered as followsl.)i1bur N ,_..!!oIVor .. 1!11rl"IlS. MfloXVor , J ...If. B,
(Nama a, nom.. In.whl.h .."III.at.. are revlll.,.d) ,.
JIOMoItol~
EXECUTOR )
MlrlRa I. Maolvor
41..S-.fill'k Avo.. Now OumQ8t-l"nd I PI!. 17070
(Add,...)
NAME OF APPLICANT JUMilm B. Maolvnt'
..:3'/1." . .
COUNTY FI.!..E NUMBER ~/. ?~. ~ . AOORESS OF APPLICANT 41 S Pl\rk h, ..NewOu..bf.lt-J.lt,nd .Pa.
. . . . .~' I ,.~ h 17070
BUREAU FILE NUMBER '. _-SIGNATURE OF APPLICANT "U(/I'V(.. . <1' .J Z/.
~OTICSI IP YO~ PAIL TO PROPSRLY PILL I~ ANY PORTION OP THI~ AP' ICATION,' WILL Notas
CONSIDSRED COMPLEn AND WILL BS ReTURNeD TO YOU .FQR COMPLSTION. .
(Nom.)
COMMONWEAL TH OF PENNSYLVANIA - DEPARTM'ENT OF REVENUE
CONSENT TO TRAhlSFER SECURITIES DAfIL4L:J - ?ot.
I hereby c~nsonttc..the tran.ler of the abcve secUtlfloBnow reglBtere~ In'the ncme olth. aforesaid
Decl'~'nHi"U wolve the Illlng cl a cortlflaate aorlllylng to the payment of the transler Inherltcnee tOK to which
'(\I't. j:: ... . . d', ,. _,
the prgpe'i,Wicif .sald Decedont.ls ma,de suble~t pursuant tc tho provlslcns of the A.ct cf June 20, 19iiJ, P,l., 521,
os cmended and the Aat cf Jun1&'15; 1961, P,L,' 3731 cs amendod, This Is also In,~ccordance with the provisions
I
of the Aat of April 9,1929, P.L, 343,
above.named Decedent,
..
Thl,s Consent to Transfor Iho horeln doscrlbod ptoporty oporates only In teferenee to the estate of the
,t~
~
(5IanQtul") NWJ:Vitl. t'~Nn!ri',!!.
11!!:htlti tJ/ \'111'1
~- ~~".......~_._--_...~--_~...._..JJL'Lui..m.lir,'J_ f(iU'jlr
(Till.) (County)
'*'
-~
Hr,C;"'2 la-6tH
,
APPLICA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDeNT
'*
CpMMONWEAl TII or PENNSYLVANIA
i)EPl\llTMENT OF ReVENue
Bu~eAU OF COUNTY CO~I.ECTIONS
~~'-.............._--,------,~~.._~.--'----~~......._--
,_____~_._..L.~_ .__..__~~_______,____,_.~............._
-.....-....................-
~ (MUSTBE FIl.ED IN TRIPLICATE) DATE '-~~"1P
TO THE PENNSYL V AI:ofIA DEPARTMENT OF REVENUEI . ,
Apr11ICiat/on.ls hereby modo for.oQ1lOnt to tho fransf.r of tho followlngs.eurltln of c P'nnsylvonla
Corpcratlcn cr a National Banking Alloelallon loect.d In P.nnsylvanlal
!~OTE~O~n dOlCti~~~g s~~rl~"~ ~n~~IlI~~a~~::~~lth;Ttho~~mber of sha;;~(~f sto:ko:r~~: faee amount;;-
reglster'd bonds, In (b), th. nom. of the IlIulng company and In (e) the clall of stock (lr tho stated Inter..t rat.
and maturity data cf reglster.d b(lnds,) .
ISSUED ON 11/9/~h-!aL~'l, and having a TOTAL MARKET VAWE OF $ 1519,00
(D~I.)
as of the dot. of doathof tho dee.d.nt, Wilbur N, M6\01vor , cn '+..2$.79
(N~m. .f O....d.nl) (D~" 01 d'oth)
who was lat. of ~1$ P~r.k Ave., New OUm~_~!lflnd~~~!.llblll:'lnnd 00., PI\t
(SI..~1 ~nd Numb..) (Po.t OHlco) (C.unty) (5101.)
Th. IOcurltl.. or. registered os followsl_ Wnbu:t" N'__~IlIJIvo_r , Mlrlnm I,MItOIv~r, JT!B
'. (N~..o 0' no..o. In "hlch c"f1"~ot., Oil ..gIOl,"d)
AOMIH+&f~).. M1t:.!!(m B. MllliIvor, 415 Purk A!.~~ New Oumbllrll4ndJa. 17010
EXECUTOR )(N~m.) . (Addr...)
NAME OF APPLICANL_.M~rlam B, Mao.~vor
<,::f'I'/ 41.5' Park Ayr.I~ ..
COUNTY FILE NUMBER.QU. 7q,,~ ADDRESS OF APPLICANT New Oumberlilnd.' Pa. '11070
BUREAU FILE NUMBER ,-,-SIGNA TURE OF APPLICANT QU.:I'~.}'IiI' /!, "J-');~" J?:t":t/
NOTICEI IF. YOU FAIL TO PROPIlRL Y FIL.L. IN ANY PQRTION OF. 'tHIS APPi.I~TION, IT WIL-L'f-lOT B~
CONSIDER 110 COMPLIlTE AND WIL.L B~ Rlll'URHED TO YOU FOR COMPL~TIOH,
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
, . CONSENT TO TRANSFER SECURITIES DATE ~ "'S - tl-
I hereby conaent to the transfer of thc abovo securlt/es ncw teglst.red In tho ncme cf tho aforOald
Decedent cndwalv. the filing of a certlllecte certifying tc the paymont of the.trunefer Inheritance taK tcwhlch
the property cf sold Decedel\t Is mad. s~blect pu"uant to the provisions cf the Act of June 20, 1919, P.L, 521,
os amended and the Act of Juno 15,1961, P,L, 373, ca amended, This I. also In cccordanee with tho prOvisions
cl tho Act of April 9, 1929, P.L, 343.
This Consent. to Transf.r th~ horeln doscrlbod proporty cperatos only In rofetonce to tho estate of t.he
abo.ve.namod Dec.dont.
'* By
-'("-,il,3 '-"~--'--(c'.;unl'Yl'-'-'~----
'lr c.'" I,IHI II ,
CRMM~NWEAL 1Ii OP PENNSV~VANIA 1. APPLICA TION FOR AND CONSENT
pef'AATMUNT OF REVENUe TO TRANSFER SECURITIES
nUREAU OF COUNTY co~~ecTloNs REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
I....--.._~~.._-_.....,--~_.- . .._......~.___m__'__u__. pAre -.. ,..22"'79 __
~ (~UST BE FILED IN TRIPLICATE)
TO THE peNN$YI.VANIA DEPARTMeNT OF REVENUE, .
Applleatlon 'shoraby made for ocnunt'to the transfer of the following aocurltle, of a P.nnaylvanlo
Corporation or 0 Nalloncl Bonklno Allcelallo.n locat.d In P.nnaylvanlcl '
(a) 85 (b)_A!':.!'_nUo Rlohtldd OOIlPl\n~_____(e) OOlllmon
(NOTE, In duct/bing securities entet In (a), ab Die, either the numbet of ahates of aloek or the fact amount cf
reglatered benda, In (b), the name of the ISlulng company and In (c) Ihe cia.. of atock or tho stct.d 'nl.rest ral.
cnd maturity ;i~,~~~I'~)lb&*6) .
ISSUED 0N9. 1 , 5/d/', , and havino a TOTAL MARKET VAWE OF S "83.6,
(D.,.) ""lb .. M "V" ,. 211 ..,
ca of the dct. of death of tho decedent, "10 ur n. UCl~ 0.. , on .. 01" r
'*
(Nom. .1 !l.ud.M')
(D.'. ./ d.ath)
who waalato of..!l' Pn"lc /In. Hew Ouabll'lnnd OWllbll'lunct PfI, 11010
(St..., .Md Numb..) (1'.., OHI..) (C.UM'Y) ($,.,.)
Th. IOcurltl.. are registered as (ollow,,_~l1bUl" N!' MtlOIVox: a. Mll"l.UI, lI" "lIoIval', .nil
(No... or M.m., 1M which cc.II/I.o,.. .rc ..gltl...d) .
ADMINISTRATOR) Mlrll\11 Je. ""olval", 41.5 .pm,'lk /Iv..., Njj~ OUMber-lllnd, Pn, 11010
EXECUTOR) (Nom.) Mll"llfiddfl:')MaoIVOl"
.3f'l NAME OF APPLICANT. 41' I'ftrk Ave,
COUNTY FILe NUMBER ..:l/. n.at#1;. ADDRess OF APPLICANT N.w O\llllbflil"l'lncS, Pal 11010
BUREAU FILE N(JMB~RSIGNATURE OF APPLICANT.'$~~(er.ta~ C;!,J;;?'I':'-/?-""('/
NOTIClll IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF TI'f1SAPPLICATION, IT WILL NOT BE, .
CONSIDERll.D COMPLllTll AND WILL BE RETURNED TO YOU FOR COMPLETION,
~
COMMONWEAL..TH OF PENNSYLVANIA -DEPARTMENT OF REveNUE
CONSENT TO TRANSFER SS.CURITIES DATE ~ - S...1 L
I her.byconsent IQ the Iransler of the abcvesecurltJes.now registered In Ihe nllme of the afore~~td
Decedent a~d wolve tho llling of II cerl/f1cate cortJfylng tc the paymont of the trcnsfer Inherltcnce IlIX 10 which
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tho proporty.ol sold Decedent la mad.,ubiect pursuant to the pro.vlslcns cf the Acl.of June 20,1919, p,l., 521,
as amonded and tllOAct of June 15,1961, P.L.., 373,01 cmended. Thll.Is ulso In' accordance with the provision,
01 tho Act cf April 9, 1929, P.l.. 343,
This Consent to Transfer the heroin doscrlbed property oporotes only In reference to the eslote 01 the
. above"named D~cedont.
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