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RCC-89
COMMONWEALTH OF PENNSYLVANIA
Department of Revenue
ENTRY INTO SAFE DEPOSIT BOX
TO REMOVE A WILL OR CEMETERY DEED
1-24-78
(Date of Entry)
1. Name of decedent: Ravmond W. Rife. Sr.
2. Address of decedent: 1 05 HngP~+'o"m Rn., M",~h~ni ~",hll~g, P",., 1 7055
3. Date of death:
T"'nll~'7 ?1, 197P.
4. Name and address of person who requested the opening of the box:
Earl W. Rife and Raymond W. Rife, Jr.
5. Name and address of the financial institution where the safe deposit box is
Commonwealth National Bank, Mechanicsburg, Fa., 17055
located:
6. Number of box:
109tl
7. Title under which box is registered:
Raymond W. Rife
8. Was there a will in the box? (Yes or No)
yes
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:
September 27, 1971, Earl W. Rife and Raymond W. Rife, J1:, Executors
Attorney--Samue1 S. Wenger.
Mechanicsburg Cemetery Association lot #15 & 16, Row N, Section 12
And now this 24ta day of TaR"a-~
certify under penalty of perjury that the above
to the best of my knowledge and belief.
, 19 7~ , I hereby
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Signature
Annabel Enck, Ass't. Cashier
Print Name and Title