HomeMy WebLinkAbout12-05-78 (3)
RCC'72 (g~fi8)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT DF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLICATION 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 far consent to the transfer of the fallowing securities of a Pennsylvania
Corporation or a National Banking Association located in Pennsylvania:
DATE
Dec. 5, 1978
(a) 114 shares (b) CCNB Corporation (c) common
(NOTE: In describing securities enter in (a), ab Ofe, either the number of shares of stack or the face amount of
registered bands, in (b), the name of the issuing company and in (c) the class of stack or the stated interest rate
and maturity date of registered bands.)
ISSUED ON Awrust 6. lcn4
, and having a TOTAL MARKET V AILUE OF $1482.00
(Date)
as of the date of death of the decedent, Nellie May Nelson
(Name of Decedent)
, on January 7. 1978
(Date of death)
who was late of 533 Bridge St.
New Cumberland
Cumberland
(Street and Number)
(Post Office)
(County)
PennsYlvania
(State)
The securities are registered as fallows:
Nellie Nelson
(Name or names in which certificates are registered)
xy~J'I[ -tIIIIIrII)
'rhelma Ouistwhite 542 Bridge Street, New Cumberland, h.
(Name) (Address)
NAME OF APPLICANT Robert J. '!'race. Esq.
COUNTY FILE NUMBER ;)..1- 7~ . b''f ADDRESS OF APPLICANT 11]
Pro.
EXECUTOR
BUREAU FILE NUMBER SIGNATURE OF APPLICANT ~/~ S;,
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 COMPLET ON.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES ~ %
DATE 5 '9 '7
I hereby consent to the transfer of the above securities now registered in the name of the aforesaid
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 the estate of the
above-named Decedent.
Signed far the Secretary of Revenue
BY~ ,l~n..l,[ ~,~, ~~
(Signature)
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(T~fle)-"~'c;J (,VJdl ( (County)
RCC~72 (9-68)
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLlCA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
'*
APPLlCA TlON (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made far consent to the transfer of the fallowing securities of a Pennsylvania
Corporation or a National Banking Association located in Pennsylvania:
DA TE D.c. 5. 1978
(a) 120 shares (b) CCNB Corporation (c) Common
(NOTE: In describing securities enter in (a), ab eNe, either the number of shares of stock or the face omount of
registered bonds, in (b), the name of the issuing company and in (c) the class of stock or the stated interest rate
and maturity date of registered bonds.)
ISSUED ON March 26. 1970
,and having a TOTAL MARKET VA'LUE OF $ 1'560.00
(Date)
as of the date of death of the decedent, N.lli. MIq N.lson
(Name af Decedent)
,an Jan. 7. 1978
(Date of death)
who was late of 533 Bridge Str..t
(Street and Number)
N.w Cumberland
Cumb.rland
(Post Office)
(County)
P'Dna.
(State)
The securities are registered as fallows: N.lli. N.lson IUId M. Stanl.y Q. Shupp, Jr.
(Name or names in which certificates are registered)
~~
EXECUTOR )
fh.lIIa Ouistwhite
(Name)
542 Brid<<e Stre.t. N.w Cumb.rland, h.
(Address)
NAME OF APPLICANT Rl:'b.rt J. !IrK'. E'iq.
COUNTY FILE NUMBER ,),1 - 75' -If"f ADDRESS OF APPLICANT
111 Locust St.. H."M sbur<<, h.
~ ,
BUREAU FILE NUMBER SIGNATURE OF APPLICANT ' /..-<.-c /V"'-,J
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APpLICATIO ,IT WILL NOT E
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEAL TH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES 6((1 If
DATE ~ 5' 70'
I hereby consent to the transfer of the above securities now registered in the name of the aforesaid
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 mode 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, os 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 the estate of the
above-named Decedent.
'*~
Signed for the Secretary of Revenue
~'(": , r" ~~""'nI_1lI i
(S;9ria'"r~ .~ "'''''-''0''" ,
T, ".t,;? OF WiLJ...~
I ,.,':.);;"0'8- CDl,mTt '
(County)
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(Title)