HomeMy WebLinkAbout06-07-78
RCC-72 1.9-138)
COMMONWEAL TN OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLlCA TlON 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 fallowing securities of a Pennsylvania
Corporation or a National Banking Association located in Pennsylvania:
DATE
June 7, 1973
(a) 15 (b) 3ational Central Fir..ancial Corporati~) common
(NOTE: In describing securities enter in (a), ab Oie, either the number of shares of stock or the face amount of
registered bands, in (b), the name of the issuing company and in (c) the class of stock or the stated interest rate
and maturity '!f}'7~7"f~iS:W2'1~'lf~~')
ISSUED ON 12/7 ~70, 2/l2/7~and having a TOTAL MARKET V A'lUE OF $ 360.00
~a7.1 Edn W 'Y F b ',I'l7"
as of the date of death of the decedent . a . .,ewcomer an e ..) "v
, ,
(Nome of Decedent) (Date of death)
who was late of
337 l? l~th St., New Cumberland. Cumberland County. Pennsylvania
(Street and Number) (Post Office) (County) (State)
The securities are registered as follows:
Edna H. [lewcorner
(Nome or names in which certificates are registered)
ADMINISTRA TOR)
EXECUTOR )
Nancy A. Newcomer and G. Robert
Newcomer
(Name)
NAME OF APPLICANT
337 W. 16th St.
;lew Cl1tl1berbmrl, PSI
(Address)
G. r-obert Newcoraer
COUNTY FILE NUMBER ,;Z (. '7 g.X d ADDRESS OF APPLICANT 337 W, 'h St., (~. (.., Pa.
BUREAU FILE NUMBER SIGNATURE OF APPLICANT V; tV-'1:'-tf>"~
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.
COMMONWEAL TH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES DATE Q", ~I \- /9?!
I heoeby consent to the transfer of the obove securities now registered in the name of t~said )
Decedent and waive the filing of a certificate certifying to the payment 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 t e estate of the
~,
~
above-named Decedent.