HomeMy WebLinkAbout12-06-79
REV-SI7 11-711
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERA TIONS
APPLlCA TION "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 COlsent to the transfer of the following securities of a Pennsylvania
Corporation or a National Banking Association located in Pennsylvania:
DATE December 6, 1979
(a) 100 Shares (b) Duquesne light Co. (c) Common Stock
(NOTE: In describing securities enter in (a), ab Ole, either the number of shares of stock or the face amount of
registered bOlds, 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 November 22, 1974 , and having a TOTAL MARKET V AILUE OF $ 1 ,375.00
(Date) Paul C. Moser October 6, 1978
as of the date of death of the decedent, Helen N. Moser , on December 11, 1978
(Name of Decedent) (Date of death)
who was late of 489 Country Club Road, Camp Hill, Cumberland, Pennsylvania 17011
(Street and Number)
(Post Office)
(County)
(State)
The securities are registered as follows: Paul C. & Helen N. Moser, Joint Tenants
(Name or names in which certificates are registered)
ADN.IUlSTRA TOR)
EXECUTOR )
John M. Moser, 2917 North Front Street, Harrisburg, Pennsylvania 17110
(Name) (Address)
John M. Moser
2917 North Front Street
COUNTY FILE NUMBER 10-206-4 ADDRESS OF APPLICANT Harrisburg, Pennsylvania 17110
21-78-699 ~"_
BUREAU FILE NUMBER 21-78-698 SIGNATURE OF APPLICANT .. M.~. ~~
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS AP. CA TION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
N/A
NAME OF APPLICANT
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES ~ n _ _ 1( ,
. DATE~_IIf~
I hereby consent to the transfer of the above securities now registered in the name of the aforesaid I'
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.
*'
REV-SI7 (8-78)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERA TIONS
APPLlCA TION 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 coosent to the transfer of the following securities of a Pennsylvania
Corporation or a National Banking Association located in Pennsylvania: (7~
(a) 50 Shares (b) U. G. I., Corporation (c) Ce"'FRen Stock *~..,.t"
(NOTE: In describing securities enter in (a), ab Ole, either the number of shares of stock or the face amount of
registered boods, 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.)
DATE December 6, 1979
ISSUED ON June 27, 1975 , and having a TOTAL MARKET VA1lUE OF $1,350.00
(Dote) Paul C. Moser October 6, 1978
as of the date of death of the decedent, Helen N. Moser , on December 11, 1978
(Nome of Decedent) (Dote of death)
who was late of 489 Country Club Road, Camp Hill, Cumberland, Pennsylvania 17011
(Street and Number)
(Post Office)
(County)
(State)
The securities are registered as follows: Paul C. & Helen N. Moser, Joint Tenants
(Nome or names in which certificates ore registered)
ADh',lNlSTRA TOR)
EXECUTOR )
John M. Moser, 2917 North Front Street, Harrisburg, Pennsylvania 17110
(Nome) (Address)
John M. Moser
2917 North Front Street
COUNTY FILE NUMBER 10-206-4 ADDRESS OF APPLICANT Harrisburg, Pennsylvania 17110
21-78-699 ~\_
BUREAU FILE NUMBER 21-78-698 SIGNATURE OF APPLICANT )9\.~. ~
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS A LICA TION, IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
N/A
NAME OF APPLICANT
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES DATE4<=- (~,..lqV)r
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.
Sig~Cretary of Revenue
By :g~~ ~~ __
(Signature) ~
~~~ iMk ~
l(Title~ 1..1 1 (County)