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HomeMy WebLinkAbout12-15-78 -'. .. " I,' ~ .'1< '.:; ~ATE ',Dee~r\lS.;1978' APPLICATION (MUST'BE'FI"'ED IN TRIPUCATE), "',:!, .,:', . \ TO niE PENNSYLVANIA'o'ERARTMENT,OF REVENUE: . . . <,:, ,', ' ! '.. . 'Applicrit:f6/iis I\etebymade far'cOlis'ent to tf,e transfe; oHhe following ~ecurifie~ "of a 'P~iinNi~~A'jb(,1 " i COiP'orciN,n~,<o',N.att~in~I'~ciJikin9' A.ssh~jqIJ~~I?cqfe.d ,iri~!,?n~yfviii;';:, .'~ I,; . ' ., .. , -:.. ,:;. ..... '::: ,'. I . .(a) ~fh:i2~~" ',:('S}~';";~}'~'~:;'''ilr-'tle~si~hco~ai:ior/: ,~:, . < ,f"I)' <iomm~~~;.i(J.,~:.nI41'~'!i "~I' l., . _ U,,' ..~~I . _ ",. ,.", Id' '/{^lIIfM ,'Iii _ ' ,C 1 l;; . _:,..,{~,,~":i :d"'_"~:."_'_' . I " (NOTE:'lndescribtn~sec4i:-ities enfer in (6).abOle, either th~",~di;',~(9'Jts~~res; of>st~ck,or th;.;foce a';;-Q~nt,of:' .' I " ; '. registereilYonds; in \!U,:,!heh';'e,~f.th'e'i~;i~li1~~~\'m'pb~'V'~~~~'.i~:K~':;f~~'cl;a&;s,ci,f, ~tdck ,ori~'~ 'Sf9;,~diri;ei,~;s.~ rate::: 'r and mafurlfy' date of. .r. egr stere~,'bonds ),', ,,' Hi",;'>;, ", I. " ".:.,J'.fl'" h "'W!il\I":iIIl','j.' "".f'.: "\".'" , 'I,,' I ' ,"" "" '''''..'', '1 . ',,'\.' .. 12"759' 11'). '6':J'''Z''16' 66 6 "1':)"'67' 2"'~69", I' 'h"""'; " ,;' I, '. ''''\ :'f:t,,'d ""s' . ,- -'-3~-10~!~ij'7~i}s'o"'1',,-,,~, :":l~ '~":,.;t"-l'~"';-;"""''t:.('.:~.,,: ,.'-""'-'-'."".. ;."tr ~~-,~:., i:~ ,1' S~~~j~i~~~~~~7~,i,i;~f5~nt.~s0i~, T0.T~h::,~1d~,~I ;\"At UI5 OF $ ,~; 5'25 :OO:''-."'<:~~:;::. ::.., ,', ;' i' a~ of ;h~d~;~ 'ofdeaihl;;ji~~~B~~~~~~t ,..~;,:,;'\ji1:.Ph~I1:8'~;tstiwe.r!,';":';', ~rii ',c ':ill!ld;J'i4~('::t~77: ..',) ~ ....~, .-......:",.~.i'-.~ :.:~;;Jl,~0~_r.~t;:',)/. -., ~, .;~. :-:. ......' :;~' :' ,l '. ;"; ,.:;-; -;'.:':':~"~~l' .', '.' ."~ h .. '_''<;.~:~''!.o,;r.''li _~ 4'" ' l (' ....JNome of Decedent,). f ,I I " . 1 '~ ,',(Dote.of deb;th),f~ 'L' I f'; ;,' ,i~Ii#"(~'~1-i",,;;;~ili~\1'11I~:: ~i '" u:ii,;'; ifF;,:: '':;\~~;:;'i i! c' ~~'j ~'~\;~f.~f.1t,\~ 'ijl:>t' i}f) r. 1~ 1 < 1l~~~~:"~'_~~i~\iP~};~1iiil.',~'.I~\ ,- J '~~... 'Whb,'W,os~I.6t~;iof,.:,<;..:~.;t,a:.9Q.':D~, . jBJC) .~ n..!, .} " i~Jg ~t 1r"! \ "I; 'jH 1':~ \' ~ I r alil.tI"tl~'~~i.~',~~" fJ1:, ,i.',~: . . ~ .'. :}'-:n~',~:~~XJ",. .~... _.-,{.-" '.":-''':I~C-.?'; ; .' ~ '. _.' ,,: ':.-"~ "'\1';;<!'\\\" _'-I;t,;'iliF ' '.':" _\ ~-- !"I 'i ~;~(~~./:~V i:'j ~_.;Jl-:.,'.>. .. , :'; -:'.:'. -"-..-,;'.':'I~.,.,~-~~",.,~.':;" '~'. " . I '. .~~ . 'f-~fJ,~/,~'.*.''i.' ~ . ._'''';' <~, (:~t!~et^ an_a,.'Nul'nber):~.: ;'/;; 'f...!~;,:,f..;~,~.~h~t..:. .,( p,o.st :P~f.i!=~,_.... ,"lf~.~;il.",-:'t"F~~t;'.. '.( County). ,.. ~;~', (\J;v~,(-St~te) '. ~!l.~\'.h i i" l-'~' I.. Ii; , "'; -. 'JJ:~Y;~~:, :;..~;~.:'~~~t:.,,~!~.:.:$t~I~'\*~'::~'.' .'~ ~,; :~: \~..::::::.:r,~~~~i_~~1i~'gi'!~f ~ ;'e: .: :-;f~"B' ~.,,~:,\; ': ';S"."."':~. -{','\LT~r~~:.; ,~'i.'s') - ") ,(D1' .'ei:r-:'.' li~;' ,t!iJ(;j:;,i:S.;~-t:J.1;zw~':(~": ";'EN' ~' Ih ..," . ,--. '.', ,'-I'~"'L1" 'If II' .." LJ .,.-..IiOJ',v, ..,..... 1;9" '~W,H"":&...- .,- -.Q v ' u.a.n.JIii;.~ II'Y,~r."!'''i "'&- -4. ". , ,.' , , e securI,fres ,.ere re.9,st,ereu,as.' Ii O'WS.:,.'!:;: :'~'!)i'~':;':, c... :'. " . ......','~..,...,..', ,...c';;...;' ",,, . . .'''', ."" """",:"" ' " ,'" . :;'-" ',./,'" > :'~,q '";- l':':'iPfi~t: "~lt."'lC-:::I:~.:;~~r';'J:" ,I \.\'~I"',J~''1~F~';1!Il\''('N'" 'J' 'I; 'j,"I~\"-'-h".l~'h.;;"".I"..'f:ll,~ l ~"'. d');f~'1.,",';:":".J'i';:;~./r,\' n. .. "".iI. I . ; 1 ..:t; H....-:~ ~... "';., . . ," ,",,~ . "Ct. 'lme or names In w IC cer I ICO.t:lS are reglstere Np... ,::,.'.' 'l"~~ ~1 \ \-,1,. , . ''''',,'''''11 Ii_ "",,,, -.. ',. i' It." - .,.. t"~~'''l'''.' ~ ,~. ~, ~ ""~". .," I~' , A"" " ... ;,,~, :~"Y<,~,..",:.., . ':}:Sank.' :H~l\')/~lti: Marb~':slir~ifj;~,;~~t.; Bil~~:' J~f~;~1i1ion~<,':'" ,\ ",J } ,.,' f !)~;:, ,'"~',.,. ,'.::'I,~:':"r~"~il:"":."'/".h:~-<-~-l";~~~:':", ".i' ':' 'Ji'.:-,~' " ~ [. ',EXECUTOR"",""'~"''',,,,.,>'(Name) ,'" ,...... ' . .. "",,',,1.',.'''' '~dd,~~,) .. ,',"'''' ,,1", : ',/1:~~ ~~.t<."t,~ ,~:: ;:~~:;i1:;>"~~'>>": " "~ fNA)('E!O!F"'APPIiICA1'f:t;\~~.r~\;'''nx', ,"9..I\-...~ :~,i-t~\l{:..,r~',}I:\' r ~. ~ ... ,*' I .... '( r ~ , I ' \. " ",t. . I ., .. ' . ."-.il'.'1.~ i?' \:,." r .'~:-' ."'"",~l" ;"'~1,' " I., . ," .:r:J,...~~.,p.'(Jl:."I~ '. " '''':'{):C:;;.:u;.(~,.,,,,' '~ , ","'" ", 1 ','" '. ,I ,,, '. ,....~ ''''''''~' "'~F~~ 4; ""'Q'1" ' . S'., . '''t'.'ll..~-'l"' ...., , "c' OU.'T',;(~;;IL' E' "<'UM<'H-i'-R' ''''~'':^''",,'1'')''\I'I:,I.',wD' R" '."SS":O'f'A' 'po p' ;,I....,.1I1ij;;-"W,\"'lIi '. ,t," ,'~~"""'L~"'~''''''' "'.. "'.... , ., .. .i!.r.... '., DC .Gl((~, ~,.;.oQ", rb.. ~ _, U . ~ L.. t.;;.#.\'N;111..:~\-' "'~c, ' I ., 'J~ 1. ..' L" 11 " '_:.J \," ',;,'-;':"~ ", " .....L~ + ':'(~ _" '1"~" I'J,!, ,..,\):i.,...:.., .," ,., (FI .( I rt1J'r',"f'.1 'I' ,. k, I . .'. . . I '..!:i'~--- 'l-1~ > . '~ .,', J<''''~:i''l,'f''~' " . 1-., ~<,fu,>';!>lt I'~~'-~. ~.,\,.".., ,...,.... ,\ li;'ltH-:\ir'{,J~'~~ln:(' ". '.. N~\V~,</ttjl.::-".' V ,.ASS.~.,'I\Y, rtClJt:. I:'es....&. ", BUREAU'fF,ILE',NUMBER:, .:,,,'" ", .::~ ":',SIOi'lAJ:OR'E OF' APpL'm;Jl!~JtT\. " ' :'.' "'.l.l!,.!,'~' ,":""""i'.c. ." ::. .;:; ',~ ~-'yVi-<'~-fj;r!-Jl",.~\"" 111~1;F'A!:t;:.t' "".;i.ll' ',I ~ '. .ftjl;.l~'I(';d tl,I.. .,., h' "Ft'I"':'" JJ) . !,~ ';'NOT!~,E: ~:~IFIY,ou .f,;4;,!!,\T.O:!:'~pP,~~'I,.;t]~!+~dl!l)A}.'!,jl;: ~OR.T!91>! O,F.:-:.I:!!,S,;b.P;~,~I. ,,!- I 9~, IT ,W~L~:~,9Ti.I!,E.~r ~:"" <"" .: ,~' :';.;,;;"..I,:?';4:i:,CO,!'lSID.~~~~'.C~M.PLETE .A:I\l.I?',Vi~L.L~B~:'RF'!,U~,,!ED, TO. y,\:lU'!q.R,C91Y\~~~T10~.. " .. \' ,.:~~~[~"i\-:.." ,- .': '. ':~iJi~~.i~~;~;L:,~'i6MMdNWEAL T~'.OF.~;'~~(;':~~~L VANIA- DE~A~~'M'EN1;J1Fs'R~VENii~ ': :~'~~1:.,:f~;iJ.;,~f{;\';':" ", .,~"" "'''' "l " , "s'''' II"" -. ."" ,." ,,,,,,,'" " "l '~\' , , , , ,j I .j" ,,''',''r i" ' " . I '~~;;,~'fri{1fl~'0H~; CI'1\V,~\1 <'f;I';' ".'iC:O~: ~~~~ ~\\Jr,(iJ.~r:r.Rl~NSFEt'(lSI:~ ~ ~)\Tie~l\r','~' ,~t ,:'.fl'I';~i 'f:?.lr(j.~t~~~f,\~'4qt~~'<\'" 1 ~ l~ ':I'I.';~:t4J(~~;):;(~r~jl(~,~:,ji':t~t-;r;t~.d'1 J~I~(o\l:.u\p,r~"L~~~~)frYf'\11: '~I."jlm~'~Hi'!l~~(.:!".Ir)r;:'~:. [)ATE.. 'f""'~;"J"~'_._' ,'1.. t " : '" ':.;.~';r.;~~(,coll:s,e."f',f.o, the transfer,ofi'the;'il~~l~~s~~urit:ies n<lY(,~,~.5'~jM,e~~d li,~ ,the np'1'e ?( ,th"~af?r,~~g,~~,,.t"~ . ..'~:, 't-'" : Yh,..., , .r.......,~. .."5'~',_~"" .... . '~"a:'~!' . ,.,.l.... ,....."iG'~ ""-"'.{~~~'\'r 'S. <, ~':f,..Ii.,(~j.-r!~:"'f':''' .~~,.\ ,. !>''''-~. - h t'.J'" ;'. '. (';'~.'.~",-""'!"''';'''.. ~".;:;:f, . ~ \' H' lfqr'~\(\'i.-j' .1"" ,,'( ~ 1 ~" . i :Dec~1j~~!'~p~ .w,o,!v,e, f,h.~-fj,l,in,?,of' 0 'cerfif~C'~tt\~~W!yi~g ,to, the. pa,y,~.':~t;?f <~~N,,:aiisfer .inherifance"tPn'!'.f,t1i,c~ ',' . [ . J< \.'.-'::".~ ,oj . ~.; '.)v-."t~r,.-( \ _ ,~- L 'f:\ ~-1\'':' _ , : 14 --1>'~.~ ,', ~ '- '. ~. fhe pro~p~rt~ of ~~i"d Dec~d'fi1f !,s rnd-d~'I~,~,bl',~'d ",~r:~l'a~t. to fh'e',pr~~isi?nS' ?f;th'e' Act of June, 20, rI9,1!9,j ,Pr,,6~' 521, .:, (~I,'r '..r'~\" .'i-;(_ ~\ I:," l," 1._, \t)\I'~ I:J11~t~\lll,'l\i-V~I\1.: <'I', ',',' .,' 1,::".J1'(ll1h\llf'I'''I' ..' ~, ,I, ;<""~I\';'\I',il!'t/ti" .,~~ ~, " ",. -I' ,U I,' 'l':! (. "'~ ., "\" '1 ,~\'1 \l1'.M as anie.;d~d a~d the Act:~flJ~'h'~' 15;; "96i,riR~tE::i'3i3;'as amended. Tliis:,ji1cilso j~ occordance with;"h~,p;~visi~ns '.: .~'<" { . "'.i<!tn, .\'ti'i,'I\~'''r .t,'.'1'11 '~'h' '. l ., ,", -.)l.i{.;.-. ~ " /','><-...1 L' ~'~i\..'.. 1.\_,' ,~1F,\.'.'" ":(.,=\1!"-Y\"I-;;.~:;n ]f.,,' ,.t ,. I ..'fl!(tl}n'](. ~ : ~ ~ - " ~,.. ~ '. ' ",' [ ~ ~ ~ I " - , . ." ,. . of fhe .Ad of Api! I 9 1J9'29f'P'\[' 343'1'.1"1""':1"'"',,", 'i' ,I' , . ,',"" "~ <~"" ,.';";'~'.,, ',' ; I'; ~.,,,,, '. "'1'," .t" , ,.. . "...I,~,'1"l~., ',"'1, "u, ...J....T'~f'.. , . "'~t'<"''l'''~'V~'1l~' ::- ~_h~ " . I ,~... ,.,,,,\.~ '..",'''~'..'','. ~ J"--.'!.,-' '-.'.~ll<:... "";f-<'I.,J ~,...1 ,I I'I'~" ;'~.f.i".t~v'''''. 'J" 11:,,:"" ." . ...'."'; \ ',," - '."i / ... ~ ...~ -, ~'\ ;; ~ . I ' . '., -"'''1.'. =- a'~. ..... . - .' . ' ( ,.' ~ '~l " ~\ . , .' " ". :tTht~ ',Cohs'e';,~:'6~Tta'ii~'f';r the~iii,.;l,.iW:dl~~Ir'].y,e~ :p'r,~~l;rty 'operot';s < o~ji', i n ';eferenc~ to th~ :e~i,~ti:,;f 'fh,,' ' ";' . (,:(',1 1.::'\'~1.:f1 q~".'~lllfi-( '. ~'!...;:..... r~ j '. :," .,./'~' ;',:..i~\~,\-:-:- i.._, ~ ~ ;' \ h [It'\"'f~,'t..../~, 'l')l . t. ' i ';:;',,!.: ""\I\'.\.:~(\,.J_~$,' . .,'.' 'i',I.)~'~l.'~',\::..~:~'r\,.-, ;''-~':<).' .,~' - "~~;~''':'~'_::'~''::'::'f-'~' ~!.. . -'.,~.'~\~'~'2..i~'~i_~~.'.. . "", ",,' ,1~~~;~ ,.~~~~c,:~~'" ',J; aDove..namea,Dec-edenh'-'~" ':'. .... - .. ('_.:,-.f"c.. - -. '-"'f'~""'."'\-.c.":""""",!\~~";"-~' ,.'.:. \.' ''f'.'' . " ..::./;n;.l~':\;;:~,N~: '.' t !.' . /:. ~::~:;<:,~:;;~~~.~:,i.}:::' ,<:."~ ':..." (~~ Js .o:""c', ~.:, ~_;;.... -1:.:):i1 .:~..\ .~.~..\:. .l,., '."" \ ")k ,.' J~'-;~. ~";.'~~'~;:-/ ~Ig~e_d :..fo. i~!;e Sec~etary _ of_ Revenue "") .:. "''''''''''''~., '*" Y" ~I""I"""1 .....-'~~~~ f,...'~.,.;..,...r ~.."''''''''''.' .'.,i: t\"'~"'("~'-' ~'~"'B"~' "F-r',;..:~..: ,,"".:.'. y" ~ .~_:.-,I:;"".:l..',...,;,.. . "d~'- .~~..~ ~ . :. ".: ,. t,. ) ,~.-~i:.l,?~~~ )\._~ c ~~':: ~ 't - '. J.!~:~ ,~ .ft#EGJ~~E;(~.~~~~) ,T. .': . , . '....~UMBERw: ~~~ '.j '.._~ (TItle) " '..-bt..~ r :~)\. APPLlCA irON' fOR AND CONSENT " TO TRANSfERSECURiTIES-....;~ REGISTERED IN THE NAME ,Of :A RE~IDENT DECEDENT '0 .......--',~ . " ". ";,,.......-~.~...~ \0 ' .~.~.'7..;7";J-:- .t"'-':""'""'~":': ',.);,,,..1, ~_.- ., ------.....~ ~__:1' . ~. "'1' . ,.., . .~,. "~'~:: j'~ '~:.,. ',_. .~ ~c~~~~~t~...~.:.:;>~~,:....~<~ .- COMMONWEALTH OF PEN~SYLVANIA !'DEPARTMENT OF RE':~NUE , ,BUREAU OF COUNTY COLLECTIONS ',':. .',. i _, ~ ~:, ", " I " .. i.".::' I' , , ! ~ ,. .<> ,~ ~r.,: r,: ~l ~., " ,. " ~.l ~. , ~ to: , (County) RC":.72 <9.66) . c~M6N~AL THOF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT *' . ~, . , .' !. "i ..,' DATE, ,I' , APPLICATION (MUST BE FILED IN TRIPLICATE) , Dt,:<;"'llll.J~L 15, 1978' I. TO,THE PENNSYLVANIA DEPARTMENT OF REVENUE: " Application is hereby mode for consent to the transfer of the following securities of 0 Penn'sylvonia ,,:I , Corporation or 0 Notional Bonking Association located in Pennsylv,ania:,:: "i~ I! ~ .' ,t t' \'1 (0) 464 (b) CCNR carpar;>!': ian (c) ('nmmn" , (NOTE: In describing securities enter in (0), ab CNe, either the number of sho'res of stock or the face amount of ., , registered bonds, in (b), the nome of the issuing company and in (c) the Closs of stock or the stated interest rote ", ' and maturity dote of registered bonds.)' '" ',' , ,,' ',~1'!':' ISSUED ON 3-26-70 & 7-U-7;I.and having 0 TOTAL MARKET V A'lUE OF $ (Date) os of the date of death of the decedent, Stephel'l Il. Sho'Jer (Name of Decedent) 6,148.00 ...,/;."" " . ~. . , , , on Dec. 14~ 1977 (Date of death) who was late of 146 South Enol3. Dr. (Street and Number) Eno1a (Post Office) Cumberland (Counfy) , , ,'.' ,'.: I'a. (State) : " The securities are registered as follows: Stephen B. Shover and E1verda E. Sho'Jer JTRS (Name or names in which certificotes CHe registered) ~CNB Sa~k. N.A.. 2'01 ~arket St.. Camp 'gill. Pa. (Name). (Address) NAME OF APPLICANT CC'!NR R"nk. N' ./1 COUNTY FILE NUMBER a,-')S'- It, ADDRESS OF APPLICANT " 17011 .; .. BUREAU FILE NUMBER SIGNATURE OF APPLICANT NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPL AT N, IT WILL NQ;!' tl'l!ust CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. " " "~.. Pa. ,17011 ' es.' Ofricer , .q .. -'.!. .-i: COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE ,': " ,CONSENT TO TRANSFER SECURITIES " ,~" )'3J';t;, ',': 'i: , , ' , DATE _~ I hereby consent to the transfer of the above securities now regist:red in the name of th aforesaid: Decedent and waive the filing of 0 certificate certifying to the payment of ihe 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: S21,,' ,': as amended and the Act of June 1S, 1961, P.L. 373, as amended. This is also in accordance with th7 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' .,.. . above.named Decedent. ':, " "1 : " B HAli~;glit,_J EGISTER' OF WilLS 'I CVMBERIAN!LCDIIMrr1 (Title) (County) ~ l " .... " .....+"""'".....,.....