HomeMy WebLinkAbout04-07-78 (2)
RCCM72 (9-68)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLlCA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
*
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for consent to the transfer of the following securities of a Pennsylvonio
Corporation or a Notionol Bonking Association located in Pennsylvania:
DATE May 22, 1978
(a) 50 shares (b) Hall's Motor Transit (c) Common
(NOTE: In describing securities enter in (a), ab (J{e, either the number of shares of stock or the foce amount of
registered bonds, in (b), the name of the issuing company ond in (c) the class of stack or the stated interest rate
and maturity date of registered bands.)
June 23, 1972 and
ISSUED ON June 18. 1971 ,and having a TOTAL MARKET VA>LUE OF $ 275.00
(OClte)
as of the date of death of the decedent~bert Charles Fest, >Jr.
(Name of Decedent)
, on
Feb. 11, 1978
(Dote of death)
(Post Office)
Cumberland,
(County)
Pa.
who was late of
Box 93
Grantham,
(Street and Number)
(State)
The securities ore registered as follows: Robert C. Fest, 3rd & Robert C. Fest, Jr. J/T
(Name or names in which certificCltes are registered)
NAME OF APPLICANT
Grantham, Pa. 17027
(Add,ess)
John A.R. Welsh
DOONl:~
EXECUTOR )
Dorothy Nolen Fest, Box 93,
(Name)
COUNTY FILE NUMBER 21-78-177 ADDRESS OF APPLICANT Mifflintown, Pa. 17059
BUREAU FILE NUMBER 21-78-177 SIGNATURE OF APPLICANT J~ /J IJfItt
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES ~
DA TE ~ b
I hereby consent to the transfer of the above securities now registered in the name of th oforesoid
t~7Y
Decedent and waive the filing of a certificate certifying to the poyment of the transfer inheritance tax to which
the property of said Decedent is made subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521,
as amended and the Act of June 15, 1961, P.L. 373, as amended. This is also in accordance with the provisions
of the Act of April 9, 1929, P.L. 343.
This Consent to Transfer the herein described property operates only in reference to the estate of the
abave-nomed Decedent.
*~
Signed for the Secretary of Revenue
B~ 2 > ~ri<W11h1 ~
(Signature) \J
RICHI,RD E. ANOERSOIl'1
~!:,::~~:r~ IJF \Nil I ~ ',:
(T;t!~tBERIANU GOumf,'!County)