HomeMy WebLinkAbout03-08-78 (2)
RC C~3 11-67)
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER tNHERITANCE TAX
(Act of May 28,1956, P.L. 1757, and Act of June 15,1961,
P.L. 373, as amended)
.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
,UREAU OF COUNTY COLLECTIONS
Application is hereby filed for the approval of an exemption from Pennsylvania Transfer Inheritance Tax on the transfer of
the property described below:
1. E state of
ANNABELLE M. GRISSINGER
of
Cumherlanil
County
2. County File #
21-78-0046
3. Bureau Fi Ie #
4. Date of Death Jan. 26. 1978
5. The Commonwealth's appraised value of the property for which an exemption is claimed is $ 1,000.00
(Nate: Where the property is other than a specified amount of cash, the exemption cannot be approved until the value of
the property has been established by approisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected ond submit 0 copy of the document authorizing the transfer, unless
such material has been previously filed.
WILL ;K;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTH ER 0;
(If ather, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
Immanuel Chur~h nf f-h~ C'hri,::ti;o" & '4ic::c::jonary Alliance
ADDRESS
800 South Market Street. Mechanicsburg, Pp.nnsylvania, 17055
8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
Signature of Applicant
i :tif. I /"
I 'i~r/. -- -'~~
U
Address of Applicant
417 East Lisburn Road, Mp.chani~sburq, Pa
1705'1
Official Title
EXp.~l1f-nr
Date
March 8. 1978
This form must be completed in triplicate and all three copies delivered to the Register of Wills for the County in which the decedent
resided, or in which letters were issued for a non-resident decedent's estate. If the decedent was a non.resident of Pennsylvania and
letters were not issued by a Pennsylvania Register of Wills, deliver 011 three copies to the Director, Bureau of County Collections,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Pa.
Do not write below this line - For Official Use Only
Approved: F or the Secretary of Revenue
Referred to Bureau Headquarters
Approved 0
For Secretary of Revenue
f tw..
Denied* 0
(Signature of Register of Wil
-",;' 1'_ '.NDEllilOlI
fii1 OF WILLS
:,F,J LuUWr,
(County)
'ft)~ ~ 1'171
(Date of Approval)
(Initials of Register of Wills)
(Authori zed Si gnature)
(County)
(Title)
(Date of Referral)
(Date of Action)
* See reverse side for reasons