HomeMy WebLinkAbout06-02-78
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,cCf,MMQNWflA't 111 or PP.NN5YI,VANIA
-,' ~'DEP^RTMENT 01' r~Evr;NUE
BUREAU'OF COUNTY COLLECTIONS
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APP.L1C^TION I'IW AND CONSENT
TO TRANSITfI SECURITIES
. .REGISl;ERED IN THE NAME
Or:;"A RESIDENT DECEDENT
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APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
, Application is hereby made lor consent to the transler 01 the lollowing securities 01 a Pennsylvania
Corporation or 0 National Banking Association located in Pennsylvania:
DATE
6- 2- 78
(a) 1 (b) CommoTI\'I~~!.th National ~~nk,__,_,___ (c), common
(NOTE: ,In describing securities enter in (a), ab Ole, either the number 01 shores 01 stock or the lace amount 01
registered bonds, in (b), t~e name 01 the issuing company "nd in (c) the class 01 stock or the stated intetest rate,
and maturity date 'of registered bonds.)
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the property 01 said Decedent is made subject pursuant to the provisions 01 the Act o-f June 20, 1919, P.L. 521,
(Address)
NAME OF APPLICANT Srrme As above
COUNTY FILE NUMBER ~1-'1 t- .;?<};t ADDRESS OF APPLICANT Same ,As Above // _ , '
BUREAU FILE NUMBER SIGNATURE OF APPLICANT 'f-~ 4~
HOT ICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE <,
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_ COHS~~ERED ~~MP~E~~EAND _w~~; B~,R=~~~~NE~.!~Y,~~~~~~~,~~M:~:~~~ION. ___ ,,' " .Jl;
, . COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE ~' ", " , ~i
, ", ,CONSENT TO TRANSFER SECURITIES " : ;,', ", :'.'. :j" i,';:,:
. . "', DATE ,", , ", ?~. ::~,
I hereby 'consent to the transler 01 the above securities now registered in the name 01 the laresaid ' ", ' ',', :;Jf~
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ISSUED ON
3~8-78 '
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,and having a TOTAL MARKET VAtUE OF $
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(Date)
as 01 the date 01 death 01 the decedent,
Barbarn /\L Reicl)ard
(Name of Decedent)
, on
5-4-78
(Date of death)
. (Streot and Numbor)
(Post Office)
Cumbesiand
(County)
pennsvivania
(Slafo)"
who was late 01
639 N. East Street
Carlisle
The securities are registe'red os lollaws:
l1arbara A. l1,eichard
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SOLE SIJRVIVOR/NEX:T' OF KIN/HUSl3AND
~JS:nM1r5J~ Lester l3. Reichard"
~19:rt:m ' )
(Nome or names in which certificates arc registered)
639 N. East Street, Carlisle, Pa.
17013
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Decedent and waive 'the Ii ling of a certilicate certilyi'ng to the payment 01 the transler inheritance tax tawhich '
as amended and the Act of June 15,1961, P.L. 373, as amended, This is also in accordance with the provisions "
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01 the Act 01 April 9, 1929; P,L. 343.
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This Consent to Tra'nsler the herein described property operates only in re{erence to the estate 01 the
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Siflnl'd lor the Secretory 01 Ravonue
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Rlt~ll.iID'\!J'AIroEllSllIl~~ V' T.,..., '>'.
REGISTER OF WllI.S ' ,
CUMBERiANDC.Q.UM':, ..... ........ ;l. 1..0
(Till,,) ~ (CUllnly) 1~' j .'
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above-named Decedent.
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Richart] r'. Anderson
Register. of 1'Iills, Cumberland C:ount)'
Cumberland Count,' Courthouse
Iligh 0, Ilanover Streets
Carlisle, Pennsylvania 17013
Dear ,.fr. Anderson:
Barbara A.. Reichard, died in the 1th da,' of nay, 197P., a resident of
Cumberland COllnty, owning one share of Conmlo11Hcalth National Bank Stock, the
only prohate assets in her Estate. If an)' Pennsylvania Inheritance Tax is
due on the transfer of the Security 1 isted thereon for \Chich a consent to transfer
is r,ranted, I do hereby personally 'l"arantee payment.
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Sol e Survivor/HlIshand of Oeceased
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S\"orn to and subscribed before
this -t1-/U day of fUAJE
1978
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:t'; ".;}'iota;Y"Publ:i.~
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:. - ..:,:;.Ca.t IS,~, Cumberland Co., Pa.
'.\ .,..:/:- . .::;;.V My q:tmmlssion expires Nov. 14, 1981
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