HomeMy WebLinkAbout10-23-78
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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLlCA TlON FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME I
OF A RESIDENT DECEDENT
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APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Applicatian is hereby made for consent to the transfer of the following securities of a Pennsylvania
Corporation or a Notional Banking Association located in Pennsylvania:
DATE 2} O~t 197d
(0) 5 Shares (b) ,'emU!l ."OIVer and Light Co. (c) Id'':,jr~t'i1rr9d
(NOTE: In describing securities enter in (a), ab rye, either the number of shares of stock or the foce omount of
registered bonds, in (b), the name of the issuing company and in (c) the class of stock or the stated interest rate
ond maturity date of registered bonds.)
ISSUED ON 1 '1 Nov 1 ~<64
, and having a TOTAL MARKET V AtUE OF $ 257. '),j
(Date)
as of the date of death of the decedent,
I ""on" D. >1 L'er
(Name of Decedent)
, on 2 f~Qr :U:7b
(Date of d'~ath)
who was late of
1(:.9 hig .:.ilJl"'itl!: AVA.
(Street and Number)
"ewv111e
(Post Office)
1"lFIberlanli
(County)
j..!a.
(State)
The securities are registered as follows:
Kathr~n lEea~ ~~or
(Nome or names in whlc certificates ore registered)
ADMINISTRA TOR)
EXECUTOR )
Harriet t .'. ilrenneman .:ihil"ley LAne <<.I) 1 ooili n6[ SPis Pa..
(Name) (Address)
NAME OF APPLICANT ti&rriett .'. .tirenl.18,,,,n
COUNTY FILE NUMBER 21-7k-13(' ADDRESS OF APPLICANT "M rloy [ IW~ iW 1 9911u.g :>pgs.
BUREAU FILE NUMBER SIGNA TURE OF APPLlCANtt.f/'AAJ;d '/';f;", //C'vV///>;V dA:~_
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.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES It:. -J _ .,
DATE~ eX?
I hereby consent to the transfer of the obove securities now registered in the name of the afor~said
ICl7f
Decedent and waive the filing of a certificate certifying to the poyment of the tronsfer 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 omended ond 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
obove-named Decedent.
.~
Signed for the Secretary of Revenue
~~f:'
~~~
E: ,'.:' ~i~nl!'. tYl~rtS:.!R
~~:;nER OF WILLS
_____ r;, '",A~V GOUii!L-
:Title) (County)
/
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RQ C-~lL' i9--e81
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLlCA TION FOR AND CONSENT '*'
TO TRANSFER SECURITIES i "'",
REGISTERED IN THE NAME I "
OF A RESIDENT Df:CEDE_~~_L______n
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 Associalion located in Pennsylvania:
DATE ,; ".t li7i:
(a),~ ;i~ar8!.i (b) "OllYl:.!: :.ii. (c) COlt :cJn
(NoT: n describing securities enter in (a), ab Ole, either the number of shares of stock or the face amount 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 i '.' '."lOt" , and having a TOTAL MARKET V A<LUE OF $ 31.
(Date)
as of the date of death of the decedent, .it ''(~Q D."i'lElJ' , on
(Name of Decedent)
;..;: '''If'.l' 1 (f?:.
(Dote of death)
who wos late of
I <;~: .'..:::'J:' i,.'.. .p < q.:", ;~VCj.
(Street and Number)
r;f:'''\:i 1 t~
(Post Office)
i.lt<jOt:~\'j ~~;:l...l
..l.
(County)
(State)
The securities are registered as follows:
:;""';~"-I'l:~:Yr' T'I'-"'/'Hl~~ <l..F,'.
(Nome or names in which certificates are registered)
ADMINISTRA TOR)
EXECUTOR )
1;I~J"~1'~ (N~m:)'.. ;.t.;:"(","""'(' '],," ;~r-irl('r:d~r~~!~~' ;..)dl l~')-;:"J Qg' &"p~e ."'a
NAME OF APPLICANT iun'l'i ..t.t ,-'. ...<,,"eJ]n'ww'1
COUNTY FILE NUMBEIe 1-f'-) }i: ADDRESS OF APPLICANT .., i .~ i'C" .". 1 "'Ii,; rog '''11gB
BUREAU FILE NUMBER SIGNATURE OF APPLICANT 'tx:a:..ii-<--<,A (~I1~,.z-<" ,'0"'" ,,,a_-'
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.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES d\\ --l Ie') ~.,
DATE ,,-,!-cC(\ ';;'1 I 0
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.
.'.
. t~ ~ t\
. :'~~>
Sign:d f~r. the Secretary of tenue
B(:-"~{ (J~~__~ €: -- .~ ~
-- "1'AJ-0
(Signature) '-J
h:' ",'T1 !:.. f.rm!RSOI
-----,.- "~iHlF-WlI.U-~-------____
(Title) C'~:",;',",~j,j\M) C~r1ty)