HomeMy WebLinkAbout08-17-78
I
APPLICATION FOR AND CONSENT
1 TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
*'
R(:r: ,12 (9~btd
C:OMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
3UREAU OF COUNTY COLLECTIONS
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APPLICATION (MUST BE FILE[J IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Applicatian is hereby made lar cansent ta the transler al the fallawing securities af a Pennsylvania
Carporation or a National Banking Association located in Pennsylvania:
(a) 100 shares (b) P. P. & L. Company__(c) 4 1/2 % Preferred
(NOTE: In describing securities enter in (0), ab we, either the number of shares af stock or the face amount 01
registered bands, in (b), the name of the issuing campany and in (c) the class af stock ar the stated interest rate
and maturity date 01 registered bonds.)
ISSUED ON see over
,and having a TOTAL MARKET VA'LUE OF $ $5..200.00
(Date)
as 01 the date al death 01 the decedent, Frederick R. Demain
(Name of Decedent)
, on January 18. 1 q7R
(Date of death)
who was late of 14 South 17th Street Camp Hill, Cumberland,
(Str.et and Number)
Pennsylvania
(Post Office)
(Coul)ty)
(State)
. '. Frederick R. Demain a.k.a. Fred R. pemain
The secun"es are regIstered as lollows:
(Nome or names in which certificates are registered)
ADMINISTRATOR) Edith Demain, 14 South 17th St. Camp Hill, Pennsylyania 17011
EXECUTOR) (Name) (Add,...)
NAME OF APPLICANT Edith Demain
COUNTY FILE NUMBER21-78-79
ADDRESS OF APPLICANT 14
Pa.
BUREAU FILE NUMBER SIGNATURE OF APPLICANT
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILl! N
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYL VANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES ~ ;;>
DATE < I
I hereby consent to the transler al the above securities naw registered in the name 01 the afor said
f97f{
Decedent and waive the liling of a certificate certifying ta the payment 01 the transler inheritance tax to which
the property 01 said Decedent is made subject pursuant to the provisians of the Act of June 20, 1919, P.L. 521,
as amended and the Act al 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 Cansent to Transler the herein described property operates only in relerence ta the estate 01 the
above-named Decedent.
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Signed lar ~he Secretary oARevenue
BY~ [. iJv,.,JV1D~",!_ f~
R'cH~~l!''hl<llfMe..l ,,-- f' \
'1EGISTER OF WIllS'
r"''''bArI9 GBUfflt'
(Title) (Caunty)
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DATES OF ISSUE OF SHARES
Date
8/17/1949
4/20/1966
7/28/1966
8/6/1969
8/6/1969
Number of Shares
10
20
20
11
19