HomeMy WebLinkAbout10-20-78
RCC-89
COAruONWEALTH OF PENNSYLVANIA
Department of Revenue
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ENTRY INTO SAFE DEPOSIT BOX
TO REMOVE A WILL OR CEMETERY DEED
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Ortohpr ?Ol lq7R
(Date of Entry)
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1. Name of Florence M. Rafael
de ceden t :
2. 304 S. Filbert St., Mechanicsburg, Pa. , 17055
Address of decedent:
3. Date of death: 10-01-78
4. Name and address of person who requested the opening of the box:
Joseph P. Alexa, 16 S. Market St., Mechanicsburg, Pa., 17055
5. Name and address of the financial institution where the safe deposit box is
located:
The Commonwealth National Bank, Main & Market Sts., P. O. Box 320,
Mechanicsburg, Pa., 17055
6. Number of box: 452
7. Title under which box is registered:
Emil Raf~~l (rl~rp~,prl) or Florpncp M. Rafael
8. Was there a will in the box? (Yes or No) no
9. 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:
And now this 20tA day of OctBB8r , 19 78 , I hereby
certify under penalty of perjury that the above record is correct and complete
to the best of my knowledge and belief.
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Signature
Anna L. Rankin, Personal Loan Officer
Print Name and Title