HomeMy WebLinkAboutOC1971-0896 - ESTATE OF FISHERRCC-72 (9-68)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN TH E NAME
OF A RESIDENT DECEDENT
J
DATEMarch 29th.1971
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for consent to the transfer of the following securities of a Pennsylvania
Cor~~iba .....jl !i.~ng Assoc~~~.ca;;islc:t:ylvania:Commoa
(a)(b)(c)_
(NOTE:In describing securities enter in (a),ab Ole,either the number of shares of stock or the face amount of
registered bonds,in (b),the name of the issuing company and in (c)the class of stock or the stated interest rate
and ma.turity date of registered bonds.).
./c;1S,v:.:;ISSUED ON ,and having a TOTAL MARKET VAilUE OF $..);::.........<L~._0 --'--_
(Date)..JOhn w.nell..August 23,1910
as of the date of death of the decedent,,on _
12l!1l ,...~.'.'"(.NciQ;le_of De.cedent)(Date of death)
iii wa~n OX.""..I'....1'01 washington,!'eus,lv.lda
who was late of _
(Name)
(Street and Number)(Post Office)(County)(State)
John W.Fishe#and Cbaxo lotte E.F1shGI',)auabaUd and
The securities are registered as follows:~---------------------·_'Ilw~i~·~!'lI!.~•.XXXXXXlOCXxxx (Name or names in which certificates are registered)~hUlotte s.Fishell.13$craveQ.DJ:.,Cbac1ef:oi,h.15023
ADMINISTRATOR)---'-_
EXECUTOR )
COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES A 0DATEug.3 the
I hereby consent to the transfer of the above securities now registered in the n'ame of the aforesaid
1971
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 descri~ed property operates only in reference to the estate of the
above-named Decedent.
Washington
(Signature)
Register of Wills'
(Title)(County)