HomeMy WebLinkAboutOC1968-1399 - ESTATE OF UNICEKAPPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN°THE NAME
OF A RESIDENT DEC EO-
APPLICAT
TOoTHE PENNSYLVANIA'DEPARTMENT OF REVENUE:~~~~~/ng;~~;:f:i~Applicatio~IS her~by made for censent to the tran~ang securities of a Pennsylvania
Corporation or a Nation~IBanking Association located in Pennsylvania:
COMMQNWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
o RCC-72 ~6-671
(a)JO (b)Federa.1 Resources (c}__CO_nmlO_n _
o(NOTE:In describing securities enterOin (a),abOle,either theOn~mber of shores of stock or the face amount of
registered bonds,ill (h),the n~me of the issuing company and in (c)the closs of stock or the stated interest rate
and maturity dote of registered bonds.)
(Date)
as of the dote of death of theodecedent,
ISSUED ON _3_1_6/_6_8 _-"-__I and having a TOTAL MARKET VA LUE OF $-'3~0:...l..7.:.::.0:...=.0 ____.:::::.._
Leon Unicek 1 on Sept.23,1968
(Name of Decedent)(Date of death)0
who was late of 40 Anchor Drive
(Street and Number)
Washington
(Post Office)
Washington
(County)
Pa.
(State)
The securities are registered as follows:~~~~~~o~n~~~i~c~ek~~~~~~~~~~~~~~~~~-
(Name or names in which certificates are registered)
(Name)
,.
ADMINISTRATOR):_--=N.:....::.o..:-ne-=--__'-----:-_
EXECUTOR )
COUNTY FILE NUMBER 1399-1968 ADDRESS OF APPLICANT 40 Anchor Drive,Wash.,Pa.
BUREAU FILE NUMBER Sam~SIGNATURE OF APPLICANT ;hd1fArd~
NOTICE:IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION,IT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES DAT~ct.24th.1968
I hereby consent to the transfer of the above securities now registered in the nameoof the aforesaid
r
Decedent and waive the filing of a certificate certifying to the payment of the transfer inheritance tax to which
the property of said Decedent is °made subject pursuant to the provisions of the Act of June 20,1919,po.L.521 ,
as ame~ded and the Act of June 15,1961,P.L.373,os amended.This is also in accordance with the provisions
of the Act of April 9,1929,P.L.343.
This Consent to Transfer the herein described property operates only in reference to the estate of the
above-named Decedent.
Washington
Signed for t oSecretoary of ~nue ..
By ~~~L o~$~<;n,/o/,
(Signature)Registe~of Wills
(Title)(County)