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RCC-89
COlWONWEALTH OF PENNSYLVANIA
Department of Revenue
ENTRY INTO SAFE DEPOSIT BOX
TO REMOVE A WILL OR CEMETERY DEED
February 13, 1978
(Date 'of Entry)
1. Name of decedent: R. C. Fest, Jr.
2. Address of decedent: P. O. Box 93"Grantham, Penna. 17027
3 . Date of death: February 11, 1978
4. Name and address of person who requested the opening of the box: Dorothy N. Fest.
P.O. Box 93, Grantham; andR. C. Fest, III, 615 Washington Avenue,
Mifflintown, Penna.
5. Name and address of the financial institution where the safe deposit box is
located:
Commonwealth National Bank, 4S. Baltimore Street,
Dil1sbur~, Penna. 17019
6. Number of box:
986
7.
Title under which box is registered:
R.C. Fest, Jr., Dorothy N. Fest
R. C. Fest, III.
(Yes or No) No
or
8.
Was there a will in the box?
9. If yes, state date of will, name and address of personal representative, if
named in the will, and name and address of attorney, if any:
And now this 3r-d day, l April
certify under penalty of perjury that the above
to the best of my knowledge and belief.
, 19'~ 78 , I hereby
record is correct and complete
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Samuel J. Stone - Vice President
Print Name and Title