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IIlV..1!ili I X I (J.1I0)
COMMONV'I~A~ Tli OF ,'oNNBVLVANIA
noMIITMeNT OF ReveNue
TI\ANSreRINHIIIITANOB TA)(
lleaID~NT DeorDBNT
SCHEDUl..E "F"
STATIlMftNT OP DEBTS
AND DEDUCTIONS
Estula 01 __J'MHX!1!Ui! \I:J:LJ" aWOU'l' _ DOlo of Ooolh....1L11101 FIlo No, 21-_8 ;1...478
WHEN Cl.AIMING THe PAMIl.V EXBMPTION;COMPl.fiTE THfi FOLLOWINGI
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None
~ DATe NAr>\B OF FA vue .' ReMARKS , AMOUNT
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I hereby certify tha\to the best of my knowledge and ballaf tho fllregolngls a lust and true stete,ment of debts, funeral
expensnand expenses Ilf admlnlstratllln submitted to ths state nded\,!ctlons for Inheritance Tax purposes,
l-0-: "'\i/UJ91
OA-Ii
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pEaTS AND oeDUCTIONs AREA'4LOWI!D IN THII BUM op .S'3::<'t:(' ~,
AT'
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% TAX ,RATE
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DATE
QeN~-BAL lliI:l!!RITANCe TAX INFORMATION
Un.atl.Ued liabllltlOllncurred by the decodent prior to hl./hor dOllth lira doductiblo agoln.t hl./hor to~able
..tot.. lil addlllon to debt. Incurred by the decodont or utoto, other 1t0,"1 ora clalmoblo Including tho co.t 01
admlnl.tratlon, attornoy I..., Ilduolary 1.01, lunoral and burial O~pOn'OI Including tho co.t 010 burlallot,tombltan.
or grovo marker o~d oth.r rolatod bu,rlal o~pon.'" '
All debt. being clalmod agalnlt on "toto oro .ubloot to tho approval 01 tho R.gllt.r 01 Will. wl,th whom th.
Inhorltano. Ta~ R.turn I,lIl.d. EvldilncOo lupport the deoedenj'I or tho Oltalo'I liability lor th. d.b" being
clalmod Ihould b. attachod to thl. .chedule.
A lamlly exemption may b. clalmod by a sPOUIO 01 a decodent who dl.d domlcllod In Penn.ylva~la. IIthero I.
no ,POulO, or II tho 'POUIO hal lor/olted hl./her right., thon any child 01 the docedont who I. 0 ",omber,ol th" lan10
hou.oholfoan claim the ox.mptlon.ln the ov.nt thero, I. no .uch 'POUIO or ohlld, the Olllrll1ptlO~ oon be clalm.d by
a pllr,"t or parenti who or. m.mber.of tho .ame houlOholda. tho decedo~t. Th,lamlly .xemptlonl. allo\"ablo only
agaln.t allot. whloh pall ~r 9w,I,1I or, by the p,nnaylvanla Intostatel,.aWI' '
NO,TEl Comp.nlatlon paid to an ..toto repr...ntatlvol namely, an e~ocutoror administrator, for IOrvlc..
perlorm.d In admlnl.terlng a,ne.t\1t. la, reportabl, lor Ponnlyl,val1lo Incoh," Ta~ purpa.... Thll,ta~abl. Incomo
"em .hould be repart'don lorm PA.40.lndlylduallncomoTa~ Relurn.
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INSTRUCTIONS f20R COMPLE'\'ItlG SCI:\!PUl.~"
II the family mmpflan \. b.lng clalmod, Indicate the cl,olmont'l nOmo, oddreu ond hl,th.r rolatlon.hlp to
the dooeden,,!!nter Ufamlly e~.mptlon" Inthe remark, column and the amount claimed In the \lmount column.
2. AUlgn con',ecutlve numbe'a ,to each Item listed. . '
3. Ent."l\ldaW on whlah eaeh d.~t was Incurred and/or paid.
4, Snt" the ~ain.. ofelleh payef. '
5. !'!Ovldell brle! nplanatlonln Ihe remarks column 1.9r each debt claimed.
6. E"I,er theat110unl 01 each debt b.lnoclalmed. , """.'
7. Thelorm mu8lbesloned by tho person wl\ohas auumed the reaponslbllllY for paying the dobt..
IF i'\OOtTtONAI. SpACE IS NECESSARY USE a%" ~ 11" SHEETS.
INPpAMAllIlli.
To lo.~rp propo, arodlllo Vour oCCOU01, Iho nomo 01 1110 .01010 ond Iilu numbor Ihould ~o clorirlv prlnl.
od 00 Ihl chook or monov oldor, '
TI,I. a..o..n'oOI II !"odo In, occordonoo wilh Bootlon 700 < 01 Iho Inhorlllooo ood EIIMO Tao AQl pf
1ge1 m p,s, 9 24SU,70ij),
To Ih' oolBnl Ih'l Inh8fI"no. lao la paid wl\l.110 Ihroo (31 monlha ollor Iho dOOlh of Iho dooodonl, ·
dlaooUnl of flvo (U) poroooll. 8110w8d 172 P,S, 9 ~480'7101,
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10horll,oolToo, olhor Ihnn 100 UO 0 futuro 1010rool, I. duo nttho dalo of Iho d009donl'. do~lh and bonomo.
d,lIoquonl I' tho ooplrotloo of nloo (81 monlh. .llor Ihe dooodenl" donth 172 P,8, 6 2480,71 \). 101l0,lllooe
ToM ooil fuluro Ir\teroll I. povobll wilhlf\ Ih,oo 131 monlhl nltor Iho tr8n.lo'tnk.. offool In po....oloo 8,od
, .njovmoot ,od i. doilnqulot Ihlr081(or (72 P,S, 6 2480,7121, Ooloulnlolnloroll.lrom'lho dolloquonl dolo .howo
on Iho f.oo of Ihll form,to Iho dOlo of odlual povmonl ualno Iho followrno IOloro.' toblo:
"
..__.........-.""'_.._...~...............,..-_........--.....-...._-- --..........----.... .....!-- - ....~...- - -...... ...........,-...-...'...- -_...- - -.. --
lmoolh ,000 4 moolh. ,020 7 monll18 ,036 10 monlhl ,080
2 moolhl ,ala 8 mOolhl .028 o f\,on\l.,. ,040 ' 11 moolhe ,088
3 niimlhe .018 o monlhl ,030 o montho ,040 12 month. ,oeo
--
I dive ,00017 11 dov. ,00186' 21 dOVI ,00302
2 <d.V' ,00034 12 daV. ,00203 ~2d.V' ,00389,
3 devo 00001 13 daV" ,00220 23 d.ve ,00390
4 d'V' ,oooe8 14 dov. ,00237 24 d.". ,00403
o d.V' ,00090 16 dave ,00260 20 dove : 00420
8 d.V' , ,00101 ,,10doV' ,00267 2e dave ,00437
7 dove ,00118 17 dava ,00284 ' ' 27 dl"e ,00484
Qdm <,00\30 18 'iJ.ye ,00301 2edBY' ,60411
e d.ve ,00182 10 dava ,00318 29 dav~ ,<lO489
10 d.ve ,001e9 20 dava ,00336 30 dBve ,00800
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,Anv patty In IntBroal, InolUdl09 Ih. CUrjl,monwoalth ond Ih9 ~mDonl ropreooollllV., I\o,l$allaf'ld wll~
the ......I11Bnt m.v obllot Ihatolo WllI!ln alMty (eOI dayli a!lor tooalpt of \hlll Notloa U ptoVldo~, bV alotlon
1001. oflhl Inh.rilanoO and Elllalo Tao ACI of 1961 In p,s, 6 2486,1001),
Maklloheck or \noney order payable to;
"Register pI Wills, Agent"
Mall to the addtess listed below;
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.
~~s~ WI~~ AND Tr.STNMmNTOF PAULINm M. HILL
I, t'auli\'\e M. Hill, ot the' TownshipotHAmpd~n, Qountyof.
Cumbel:'hnd And State ot pennsY~VAhh, being ot Bound and di!lpOllinq
,,\\ind, memol:'Y And undetBt'anding, do make, publish And declare this
tC) !;ll my last will and testament, hereby revoking and making void,
'all torme2i wills by me At llny time heretofore mil de .
~. I direot th~ payment of. all my just debts and funeral ex~
pens,s ~s !lOon as oonvenien~ly mAybe A~ter my decease.
2. All the re.t, residue and remainder of my estate, real,
patsolHl.l 'and mixed, whatsofilver and wheresoever situate, I give,de"
vise l\nd beq~Ela~h to my childrfiln, John E. FrUE!l2i, lie len Kathleen
a,tet18r, an~t' Harold M. ,Frl\Zer'l in equal IIhnell.
3.. Lastly, I nominate, CQlllltitute and appoint my 1I011, Harold
,M. ,FrucU,', to be the J!lxeoutor ot this my Ullt w:L;1.l cmd testament,
,It! he! should predeceaBel me' or to!:, any ,0 the I:' I:'eaeon be unahle'to aot'
as suoh !!lxeoutot, I appoint my lion, John E. Frazer, to be the l!lxeou-
tor ii'1 his ~laCle and IItead, likewise, if hfll Should also predecease
"
me, or fOl:'any other I:'eason be unAble to aot as, Exeoutor, I appoint
mY C\auqhter, Helen Ka~hleenStetle!:', to be thelllxeoutt'i)(of thi~mY
, '
last: wiil Mdtestamellt. I direct that none of them 'shall, bet'equh"
ad to fUll bOl\d or lIeoudty, il\the offioe of the ~egistlJr Qf Wills
in ord$r toqUalUy ae ExeOUtor' or Exe,oUtrix of my a"tata.
, ,~W!TNl!lSS WJtl!llU!lOF, I havahel:'lIunto se~' my hand aM ..al
I' 1 day Of lTanu~FY A.D, 1970., " ,I ., "
\"(-~C\;.tv-\Q \1'\ ,,\~ .
thie
(smALl
, , 94,qnlld, .ea~ed I published and deolal:'llcl by the above..named
Pauline M. HUl aB and for hel:' l~st will and telltllment, in the,
P2i..en98 ofU. who have hel:'lIunto subsotibed OUI:' nallleS at herra-
que.t 'al! wi tne.... thet'eto I in the pl:'ellle e of ,theUid te atdlt
and of eaoh othar.
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OAT" m'l-t;R!\ONAf, Rt;PRI(!\t;NTATIVK
COMMONWBA1.TH 01' PENNSYLVANIA SSI
COl,JNTY or CUMBERLAND
Berore me, the Reglsler for the Probllte of wills and grantlnll of Letters of AdmlnlstrallCln In ~nd for the County of
Cumberland, personallY callie
who, bel nil dilly sworn
Itfl,RQLD M. FMZER.
,do es
depose and SaY that as
E~eout:or
9f the last Will and Testament of
PAUL!NEM. IIILL. nee STOUT.
deceased
he will well and trllly adn,llnlster the,goodsand 9hallols, rights andorodlts \>f s"ld deoeased aOQ\>rdI118t\> law,And
also ,will dlllaentlY oomply wllh the provlsl\>ns of the law rolallng to Transfer Inherllanoes,'RWn1:'n and subsorlbedbeforo me,
1\ud~_lAt. ~ f
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UtteREE
Bo Uremember~dthat c>n the~.th_daY of
r~\>tded the last W\IIand TCs,tllment pf PAULI}lE
ehtrrql'/I\Shipol! \lIl\1lptle"t
I\UCTUSt:.
,,0\,0,,19
STOUT , '
81 , thero Was pt\>bll\ell and
lito of
M. ijILL. nee
Deoeased, Lellers-----1estamentary Were granted to
Wllnoss my hand and offlo'al seal the day and year aforesaid,
250
, CUlllberlandCollllty, PolItI~ylvanla,
IIAROLD M. FAAZr.R.
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'-7 -' Re;lster
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. PE~NSY.J"Y.I\tiJA~CE TAX GENERAL INf'ORMATIO~
l. PERSO S PO S BLE FOR RETURN
Section 701 of the Inluirllance and Eslate Tax Acl of 1961 provides thallhe I.ollowlnapersons shall prepare and file
a return:
I
~, The personal 'representative of the ostate of the decedont as to property of thede,cedenl administered by him
and suchilddltlonill property which Is or may be sublecllo Inherllance Tex 01 which he/she shall have or
acquire knowledge;
. b, .The transferee of properly upon the transfer ,01 which Inheritance TaX Is or may be Imposed by the 1961 Statute,
Including a trustee, of property Iran sf erred In Irust, provided thai no separale return need be made by the traasferee
of property InclUded In the return of a personal representative. ,
2, PLACE FOR FIld.tlll
The raturn Is to be filed In duplicate with Ihe Register 01 Wills of tile county wherein the decedenlreslded,
3. TIME FOR FILINQ
The return Is due nino 1I10nths.afler the decedent's dealh, Unless an exlenslon for filing has been applied for and
granlod by Ihe Secretary of Revenue wllhln the nlne.month period,
,-.1 "
4. RTO F LE R~ URN
Section 791 of the 1961 Stalule provides that II ",any person who wIIIIUlly lalla to file a .return brother report "
required of ~Im. . .s~all beperaonally liable, . .to a penelty 01 26% of the tax ultimately found to be due or $1,000
whichever Is the lesser to be recovered by the Department of Revenue as debls of 1,Ika ilmounl are recoVerable by
law."
,6. TAX ~Am
Inherunnce TaX Is payabl e, at the rate 01 6% on Iranslers to lineal descondant,s, s,UCh as father, mother,' husband" wife,
sOn, daughter, grandChildren, grendparent, son.ln'law anddaughter.ln.law anp at Ihe rate of 16% as to all others,
6,~
the lax assessed on the tra~sfer Of, property reported In the return I,S due 9 months aftet the decedent'sdeath,lnteresl
at the rale of 6% perannum a,ccrues thereafter ,untl I payment Ismade" All, paymenlsre,celve,d, a,re fltst applle,dto a, ny
Interest which may be due with any remainder applied to the tax. IF TAX IS PA,IDWITHIN3MONTHSAFn~ THE
DEOEDENT'S DEATH, A DISCOUNT OF 6% OF THE TAX P~YMENT IS AkLOWED,
~~~~~:~~:u6rg~l ~obfh~ '~nea f~1~I~I~a~n~~~lhs~eb~~arl~l:n ~ ~}h ~e~~~~~, wherel n the Qece,den t resl ~edan dat~
7, f,aI~~BEJOPAY ,
the ta,Xes Imposed, together with any Intetastlhat~n, are a Iienupon real pro,nerty,whlCh 1,I,en temelns IneUeet until
the .taxesand Interesthevebeen paid In lull. The taxes maybe sued lot agalnsl any real property In the decedent,'s
esla\e ot egalnsl,~ny properly belonging to ~transleree liable for the tax.
8~FILINGOF, FA~SE RE'fURN
Anypetson who will fully makes a lal!le return or renoll !llqul red of h 1m shall, In accord~nee wllh' Section 793 of the
1961Slattl\e, be guilty of a misdemeanor end, on convictiOn tl1eteof, shalL be sentenced 10 paye flnoMI exceeding
$l,OOOQJ undergo Imptlsonmootnol~xceedlng one YOAt olbolh.
Wi Componsa\lon paid to an estato representative; nalllolY,an executor of ndllllnlstrator, for servlceS~etformed
,In edrnlnlsterlng an eslatels tellortaplefor Pennsylvania Income Tax purposes. This taxable IncOme Item should be
reporlljdoriform P A.40~ln'dlvlduallncome Tax Return,
~OHEDULJLQP' l'IOUS~IiOL.D GOODjl
Total I
$ 20.00
1),00
5.00
1$.00
1.00
.. .0,0
10.00
2.00
15.00
,
4.00 ,
2.00
'1.00
5.00
4.00
6.00
10.00
$ 9$.00
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AE\I.4~3 '"'' (3.80)
COMMONWIAL TH Of PINNIVLVANIA
oePAATMINT Of AIveNIJI
TAANIPIA INHIAITANal TAX
A III DINT DlalDINT
SCHr:OU~f. "D"
peNSPIOIARIBS
*'
IInstflllltlOIl' on Rnvors" SIr/II)
Eltete of
II ~lJLlt'1~ M I nI'Lr.lQ~lQqfl'
BllNllPIOlARllIS AND ADPRESSBS RSLATIONSHIP BUIWIVep OATP. OP INTP.RSST OF Bi!Nl!PICIARV
OEOI!PIlNT PIRTH
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T~a aboYlI beneflclarlel ara lIylng at thll tlma except for the followlngl
NAMIl
PATS OF OEATH
-
WSTRUcTION~ FOR cOMP\.ETINa SCHEDU\.E "t:~
Sahaclule HIl" mustlnoluda ail property, roal end parsonol, owned by.tha dooqdont lolntly with ol\other
petty or pMtlOl 1810lnt tOl\antl with rlllht of survlvorahlp, Both tanglblo end Intangible property ora to be
InaIUdat.\;' l.;lIt real estato first.
" Desarlbeall roal property as Imllootod In tho 1118\ruotI0l'$ for SchadUla "A". Dosorlbe all personel property
allndloatedln,the Instruotlon8 (orSohodulo "B", Include tho mime, eddl'e88 ond l'oln\lonahlp to tho
decedaht qf, tha co-ownor (al end tha dato tho loln\ ownnruhlp W08 ostnbll8hed.
2';' lhdlcete the IOlal market value of thololn[ly ownod pl'oportv,
. G. ,Indloato the parcentng/! of thl! decedont's Intoro8t.
. 4,' Indlatito the markot value o( \hqtleoedant's Intel'os\.
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IlI'V-"", (1-181
COMMONWfiA~ TH OP PfiNNIV~VANIA
OfiPARTMfiNT OF RP.VfiNUfi
RURfiAU OP Plfi~P PFaRATloNS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTF.RED IN THE NAME
OF A RESIDENT DECEDENT
'*
~_.---~~--_.._._.----~~.._~~-_...._..- ~~.. ,...,-~~--'.
~ (MUST BE PILED IN TRIPLICATE)
TO THE PENNSYLVANfA DEPARTMENT OF REVENU~I .
Application Is h9teby made lor oQl,sent to tho Iransfor of Iho lollowlny soourltlos of 0 POllllsylvonlo
Corporation or a Notional Banking Aaaaolatlon ,Iocaled In P9nnsylvunhn
, certitioate ot aenafi-
(a)..J. Units (b)~ALIn,...Utl1\.8niL'.r.r.ullt_~FunL..... (oU'~I1.L9~Ju'.!'.h~PI--~ Pa.
(NOTE, In doscr1.plnil securities enlor In (0), ab O/e, ollher Iho numbot 01 shuroR ,61 slock or tho loco amaurtt o#ierie
registered bonds, In (b), the na,me of the Iuulng company and In (c) Iho closs 01 stock or tho stutod Intorost rata
and maturity data olteglstered bands,) , .
ISSUED ON Jun_ II, ~~_73_, and haYing a TOTAL MARKEr VA,LUE OF $.. .5.22&Q__..u_.__
(Pot.) .' ' .
as 01 the data 01 deoth 01 the decedont, Paulin__ M, lIil~J~Q!.l!<.., .,__.~ ,oll~u,".I:t~].~."~2..L 19 8t.._
IN,.mo of P.,.do"t) (Dot. .f dodth)
DATE. 99.llQ))!r:,,'L.L). 981
who was lole,ol Messiah Vill~qe ,21.Q1U1riiQgl:ulr.g.,,,jJ~t.t;J,q!'\c'l.QQ\m!;y.,.-~'-L,.,1.'O!l!5
. (5t,.., .nd ,HU"'~U') (Po" Offl'.) (Coun'Y) (Stat.)
T~e ncurltie., atoroglstotod as 10110WSl____.,_.__.J?J\t!~j:.tUL.I!:U_lttEl'l'QYW, ... .".......--.--.-.---
(Name or nann,. In whlc:h tGfllflcdtol c'tluttgl;ttorud)
~E 'T~) lIarold H. ,Frar.e~_L~O Ce\lt,rj\l.n.C)~;\.!Iy.~~Clt ._c;!\lJ!P_J:!,~, U,J'~,.J., .,...17011
ex CU OR (Nam.) " (I"ld,...)"
NAME OP ,APPLICANT _..-,~~~Ig~ii~!'n~~g~<f!i-M~~~e
COUNTY PILE NUMBI!R 21~al"470 AODRES~OP APPLICANL~l!.~~'l.~~Wl?~.\J'!H_!l!Hl...~.!96!5 -
BUREAU PILE NUMSI!,R 21wOlw470 SIGNATURE OP,APPLICANt.~.......,.::a.~\.)t...w..L~~~
HOTtelll.. IP YO,U PAIL TO PROPERLY PILL IH AHY PORTIOH OP THIS APPLICATION, ITIV([!.L HOT liE '
COHSIDBRBP COMPLI!TE AHP WILL III! RBTURNI!D TO YOU POR COMPLETION. '
-.----. _ __._..............._..___..~.....-',"~~._,rl".'.;._.____....,__.. , ...--,- _~. __..___~~.....___. _..,.'U",~._.~_..,__..,.'m_L
COMMONWEAL THOP PENNSYLVANIA - DEPARrMENT O,F REVENue
"CONS:NT TO TRANSPER s~.~~rmJES" . /fJi ,.it)..:; ld,,?1
, , . DATEea.._,_.~li
I hetoby consont to the tr~nsl.r 01 tho aboyo securities nowroglstoted Inlho nalno 6,1 thll olo~e&ald
Docedent ahd"walve the IllIhgol a certificate cortlfylng to tho (laymont of tho trollslor Inhoill<<nco tax to which
tho properly 01 sold Decedont Is mil do aubloctpursuonl to tho ptovlslons of tho Act 01 Juno 20,1919, P,L. 521,
as amonded and.th,. Act 01 Jun01S, 1961, P,L. 373, as umolldod, This Is also In accordanco wl,th Iho proYlslons
__.___________--,-.____.." --.c---."'.... 0-- _," - -..,~...",.~-- -----"" ..~--. ,>-.~-~-_._- .
of tho ,Act 01 Apill 9, 1929, P,L, 34,3,
Thla Consonl to Trahalot the horolh descrlbod property opo,atos ollly In rolorollco ,to tho eslate,of lhe
obo"e.na",edDecodent.
~~,;'
-~
Slgnod I,a,r tho Socrotaty 01 Ro,yonuo
ay___!!!Zl~~t..~ _a:.,~~,' ;;.d_
E) (51'~: ,/.- ,)'
~'/4) f ~
n ., w.~.(. "y ,a~/)?t'~~~u~-
P' (County)
11Iv-e," U-711)
COMMOMWEA~ TH OF peNNSVLVANIA
OEPARTMENT OF RBVBNUB
eUREAU OF m~a OFaRA TIONS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
'*'
~ (MUST ,BE FI~ED IN TRIPLICATE)
TO THE PENNSYL.VANIA DEPARTMENT OF REVENUEI
Application I.horeby mode for oCll1sont to Iho tratis/or of Iho followlny sOOlJrlllo& of aPotltuylvanla
Corpotallon or 0 Nallonal Bonking Alloclallon locatod In Ponnsy,lvcnllC1I '
DA TE.OotoDel'..?~I-4..J.9 01
(0) 1 0 0 Share. (b) " Duq\l..n.mLiuhtLc.omp.an:t.~"~"",,,~,u,-"'.-'n"__'" (c L.. C'nl1lJllon-Bt,Qok..._.--
(NOTEI In describing .,curltles ontor In (0), ah Ole, olther Iho numbor of shores of stock or tho foco ,amount of
regl.teted bond" In (b), the nome of the Issuing cOhlpony and In (0) ,Iho closs 0/ stock or tho stoted lIitoroBt rato
and maturity dot. of regl.tered bond.,) ,
ISSUED ON Juu,ll, 1973 ; and having a TOTAL MARKET VA'~UE OF $...l,~fii..t!HL.._._,
, ' (P.t.)
os of thll dote of death of the declldent, ,1'"ULINtl M. HILl:. .1l'1'OlJ'r __,.u...w_' on July ..nf.-_J.i.a~-
(H.m..f a...d.",) (D.'. .f d..'h)
170Ga
who wal late 01 Mouhh _ Vi~h~l..J:IesthllniQ@.put'I1L.9.wn""uJ.i\l'lg..QQ"ntY.L.~ttl..n1Y.~
(S"..t .nd Numb.,) (P." Offl..)' (C.un'v), (5'.,.)
The ncutltlol ore tegl.teted 01 followll.
p^l.!I1lNr:L.U;l;JJt!_~T.o.!J'1'~_. ".",.m__n
(Name ot nOmOI, In whlcl1corllflcntol (UO tngla'",vd) ,
~ llarolc1 7~.m~t'aUrl 20 ;'ol!tr~1.._n9.I1;~~~.I:'~(~d~~r-.1~gll.~P~..!.'!. 17011
NAMe.,OF APPL.ICANT .,,_.g~Qr'1.'- t1L..U_qy.glL,.____.._~
, COUNTY FILE NUMBeR '21~Olw478" ADDRess OFAPPLICANT""'~~,~'~~~~.~~tu~'~~~i,-n!655
BUREAU FILE NUMBeR 21~n~"7a SIGNATURE OF APPLIC^NT.~..:.:2X~~~kkL~ "J....
NOTICEI IP XOU PAIl- TO PROPlIRLY PII-LIN ANY PORTION OF"THIS APpLICATION, IT *~ NOT Ill!
CONSIPEREP COMPLlITE AND WILL ae RETURNED TO YO~ POR COMPLl!TION' ' .
. ....,.. ..__,"_ ,. ..,,__ .__~ ~_~ ~___~__._._".~ _.___ ____. .~. ,~_. _~n._"_"'__._"'''.' n
__".---'_,_"..n..~_"__"., _. .~~.~'n.",.~'.._'_____~__ _~_'"'___"'_'_~ '"~ C",,", __'~T _n"
COMMONWEALTH O~ PENNSYLVANIA - DEPARTMENT OF REVENUE
~NSENl' TOTRANSF.~B.JJ.:.~~..RJ.TIES tJATetld~~//
I hereby ccnlllnt to the tronMet of the abovo lo~urltl08n?w roglstored In the Mmo of tho of or os old
Deoedent and walve'the IIIlnool a ce(t1f1oale conl/ylng to tho paymontof thlltrol1sfar Il1lwltol1cotox .tbwhlch
the ptoperty of sold De<:edent 1,1 mode sublect PUtlU9nt to the pravlslol1s of Iho Act of JUI10 20, 19W, P,L" S21,
08 amended and the Act of June IS, H61, P,L, 373, os amendod, This Is also 111 accardanco with !Ill) provl,slonl
of tho Act 01 April 9, 1929, P,L.343.
Thls,Connnt to Transfer the,heroln desctlbod ptoporty oporotol only In rofotol1co to the Il$talOaf the
abave.t1on,ed Deoedent,
*
Sloned"f~,'~' e SJc, rotar,y Of"R'~,vo"nue, CA.'" ',',", , ",',
':-./.;0.. . /13 ", ;J
By_ -(5~~t-,~.,. .,~ ~
-~.._'<.d_~;f&,_'ft.~
HI-'V-&\7 11I-7ll1
COMMONWEII~ TH OF PEHHIHVIIHIII
DEPIIRTMEHT OF RaVEHua
BUREIIU OF FIELD opaRIITIONS
APPLICATION FOR AND CONSgNT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
*'
~~__~~___~___~_~._.___._.r~..~.
"
DATE n9Q1;Q!?U;b1.l-._19 81
~ (MUST BE FIL.ED I,N TRIPl.ICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUEI
App1l9atlon Is hereby ma~e for consent to Ihe tran!lfor oflhD followlnu 80Cllrltloo 0/ 1I Ponnsylvonla
Corporation or a Nallonal Banking Alloolatlon located In Ponnsylvunllll
(a)~ Share. (b) t>e.nn.UiV.I3nia_ Power i...1J.igh1LJ':O./!lPAny,m~_.'. (cU.!t"up.J:llfe".S:L~.---
(NOTEr In dOlcrlblng ncurltl", ontor In (a), ob ~o, allher Iha numbar of shoros of slor.k or tho focoanl'ount IIf
roglstered bllndl, ,In (b), the name of the luulng company and In (c) Iho c1os& of slock or tho stalod Intarost rato
and maturity date of registered blind,,) ,
ISSUED ON June L.J973 ,on~ having 0 TOTAL MARKET VA'LUE OF $....1,.070.0.0._.-...'-..~~,_.,
(00'0)
os of the date of doath of the decedont, Pa,uli.nLl!.t...ill..U".sioQUi;......"......_." on.....~.:r.ul~~,U,-.l9JU...-
(Horn. .f Do,."onll . (Dnlo .f dO.lh)
who was late of Massbh vt11A99.L~.t9.!Hmi,12p.blu'g,~.C1.\mbfu;lA1'l".CQuntY,...P.~.,_.1'lJlIU1-
(5tru' ond Humbo') (Po.' Offleo) (Counly) (5'0'0)
The securltle. ore reglstored as ,followsr
..m...X'J\Ur..:tlU:l..HXT.c~.aTOU'IL.. . ,.,_..,...
(N~mo 0; namOI In-which curtlflt.atol n;o rnglttt.red)
---'--'-+~+~-~"'----
~C U,T · ))-1lG.QJ..d....M..., "uur , ....2.Q....Cen.t1:a.1BQU1.Var.d,..Qll1lIP.Ui1.1.,~.P.~, .~~-11~O3,.l...-
Exe OR .(Nome) ,'. (Add....) , , , ,
, NAME OFAPPLICANT... .a:~ig'~a~.Lt~~~Cl~-dfi~~r.
COUNTY FIL.l; NUM, eeR :~:::, ::~:,. " ADDR, ESS OF,' APpLICANT -,,. .._lI.tQ~~C!lJ.);!l.lU'_,',~~~~O:B
BUREAU FIl.E NUMBER_,' , __" SIGNATURE OF APPLIC,ANT.__~," M<~,\!:--\..l./_..~_.t....t(-<j -
HOTICEr IF YOU FAIL TOPROPllRLY FII.I. IHAHY PORTIOH OF THIS APP~ICA TION, 11\.l)ILL HOT BE '
COHSIDEREDCOt.\PLETIl AHD WILl. .B.E R_~TURHI!~...!.~.Y~~~~.R~O~,p'L!_TI_O~...._...._,_...~,._._. .
.n~' ...__",.~'-..~_.n_~~~____~~.__'Hn~_~~__~.' ~._,___.,_~.~,__,_.T'___~~"._~" ~,.,~-,---'---'---~.~ . ~
COMMONWEA\:.THO,F PENNSYLVANIA - DltPARTMENT OF REVENUE
., " ,CONSENT TO TRAN~E~~~CUBITleS ,DATE.at'44Hr/
I hereby Gonsont to the trons/etof Ihe obove s~curltles nowteglsterod In tho nOlllo ofthoaforosald
Oecedent and,',wolve Ihe,fllln~ a/ a catllfleote certl/ying'to tho paymel1' 01 the Ironsfnr l,nhorllOl\co 'ox t9"whlc:h
, '
,he properly of 'ol~ Oece~enl Is mode subleGt ,pursuont to the provisions 01 tho Acraf JUIlO 20,,19,19, P,L: 521,
as amended and Iha Actllf June J5, 1961, P,l., 373, os amonded. this Is Illt;O in a,,=coldonco wllh Ihl1..praylslbnS
0/ the Act of April 9, 1929, P.L., 343,
Thl,s Consent to Ttans/or tho~ereln desctlbod proporty oporoles only inroferellce to tho es,ate of the
abllve'han'ed Dlcedento
'*
Slgnod f~t::~!Lo Secrotary ~f Revenue' ,
By._-'Yl~"rt'."t4:t,--,"~,'~'", ",',.; ~"
.,,/) (Sl(~ ,,' ~h~"
..,4~4~'~!"(~ft~~t.T_"~~~"-