HomeMy WebLinkAbout06-02-78
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1. Name of decedent:
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Address of decedent:
2.
3. Date of death:
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CO~lMONWEALTH OF PENNSYLVANIA
Department of Revenue
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ENTRY INTO SAFE DEPOSIT BOX
TO REMOVE A WILL OR CEMETERY DEED
June 2, 1978
(Date of Entry)
RnhAT't S. Clark
9 Bighorn Avenue, Mechanicsburg, PA
17055
.Tune 1. 1978
4. Name and address of person who requested the opening of the box:
Caryn Clark - 9 Bighorn Ave.. Mechanicsburg. PA
170SS
5. Name and address of the financial institution where the safe deposit box is
First Rank ~ ~nlst Comnany
Main & Market sts., Mechanicsburg, PA
located:
6. Number of box: 1 S22
17055
7. Title under which box is registered:
Robert fl. ClaT'k
8. Was there a will in the box? (Yes or No) YAP.
~. If yes, state date of will, name and address of personal representative, if
named in the will, and name and address of attorney, if any: October 1.
~nnn R~kpT' - Executor - 101 S. Walnut st., Mechanicsburg, PA
1976
17055
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And now this ?",rl day of .Tune
certify under penalty of perjury that the
to the best ,of my knowledge and belief.
above
, 19 78 . I hereby
record is correct and complete
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~ Signature
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Print Name and Title
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