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Home My WebLink About03-19-07 PETITION FOR PROBATE AND GRANT OF LETTERS ~ Uriht1)uncL COUNTY, PENNSYLVANIA REGISTER OF WILLS OF File Number c9/,c9(XJ7 ,~S~ Estate of )).,"c1} ILU A "10 '('C( n dl>--- also known as . , Deceased Social Security Number 5IS-80- 2,77 9 o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is I are the last Will of the Decedent dated and codicil(s) dated ,~~ ,",-0 ~l~p . -'~ "" I - :~I ~- ~=~:~ ~ <:::::> --.I Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) --S-f... ::t":b ~amedirlthe." t... _J ' ___;' ~:2 >cc'; ~, : (State relevant circumstances, e.g., renunciation, death of executor, etc.) :f1 -... ,,:,i -.,., -:::, u:) :,' Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution~tthe instrum~s) offe~ed"': for probate, was not the victim of a killing and was never adjudicated an incapacitated person: -..J c:(B. Grant of Letters of Administration (If applicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c. t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete /ist of heirs.) Residence I q Z. q,ij..J.k &00 j,...{(fl €- )...l (l(h . ~ 4.nt.A- ~a..rt..L ~ County, Pennsylvania with his I her last principal re idence at A 170 oYiyofL 1"'W6h . Decedent, then LJ) years of age, died on lZ/ J l.4 } D~ at ~r "~JfL ::if D.Pf Ion ce-t .I~e...c1.J c. J. ~ Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in P A) Personal property in Pennsylvania (If not domiciled in P A) Personal property in County Value of real estate in Pennsylvania $ 1 ~o ~ $ $ $ situated as follows: I' Wherefore, Petitioner(s} respectfully request(s} the probate of the last Will and Codicil(s} presented with this Petition and the grant of Letters in the appropriate form to the undersigned: J~ Ju.-h(l. A. ULdow Ln. M.i.J). -fA L 705~ Form RW-02 . rev. 10.13.06 Page 1 of2 ~ 6r;r~5~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and beliefofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me the \ q4A- day of ()~ VI -.I Signature of Personal Representative Signature of Personal Representative File Number: dl ... ~ -c?~ Estate of~ ~ Kcrl1rYiL Social Security Number: 6'5 - ?:JJ- aln ,q , Deceased :J)~/~~f, AND NOW, having been presente~~r' IT IS rCREflx~ers are hereby granted to f,. .. MOJch Date of Death: in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as FEES CJ ~ Letters ............... S...(u, tv Short Certificate( s) . .5'. . $ "...;(). Renttn~;r;' f (s) .......... $ ,-l~ -/, ... $ /(1 7P ...$ Sa .. . $ .. . $ .. . $ . .. $ .. . $ . .. $ ...$ cV TOTAL. . . .. ... .... .. $ c? if S.. ~ , Attorney Signature: Atto11ley Name: Supreme Court J.D. No.: Address: Telephone: Form RW-02 rev. 10.13.06 Page 2 of2 nOS.80S REV 1/0S This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as , Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ()lr{}8t WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 lJ~ ~. ~ p 13215490 Date \) eeetY16e cl" .l Cf l ~ cS)(g ~ Local Registrar No. tll05 144 REV 0212006 TYPE 1 PRINT .. =:;T #30-412 ,. ...... 01 DocodonI (Firsl. middle. Iasl ....) Michael COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH . VITAL RECORDS CERTIFICATE OF DEATH (CORONER) E".) <::::> c:.::::;, --J ~ :;:~ ::.;0 \.0 ~, \.0 c.n -.J Koranda STATE FILE NUMBER 4 0. 0I1lI1II (1oIonIl. da't. rearl December 16. 2006 192 Meadc:M Lane Mechani.csbur , PA 17055 II. f....... N_(Fnl, lIliddIo.lIII. 06) K~ith G. Koranda 201. ..........,...... (T"," 1 Print) Julie A. Koranda 21a. MetIOd 01 DispoIiIion D erom-. D DonaIion ctBunal 0 Remo.a1lrom SIaIo . _ ~ or ~ AuIllofIM D 0Il0r. ~ : ..,_Eunnrleor-? Il:cad::a:' 4!>, ~ Gate of Heaven Cemetery Upper Allen Twp. PA ~ 22a SognaIlnolF::-SeMr:e~(<lrf*l'l"dngassucll) 22c. ......Il1dAddoessolFaciIiIy 8 Market Plaza Way . ~ . ~<<- J.f.- Malpezzi Funeral Hane Mechanicsburg, PA 17055 ~ llllms 23K only""" To lie besl 01 my knowledge. de.... ClCCUf1Wd at lie lime. daIo Il1d place _.(Signan.... lilIo) 2311, Licenoe Numllor 23c. 0. SIgned (ManIh. da't. JNfI p.y-. . not_ at lime 01 cleaIIlo cMly cause 01 cleaII ..... 24-26 _ be aIfIljlloted by pelIOlI llIlollfOllOUl1C8S de.... A 5 Ago (Uslllilllda'tl 41 VI> ., CGunly oIllIaII 6. 0.0I1liil ........ . ....-.. ctober 5, 1965 Victorville 8d FaciIiIy Name (f not inslUon. uNo....1l1d runlIer) moaIoI lie Do not_1Wlir8d I<illI 01 auso-llrWUy Carlisle Regional Medical Center 12 Was Doc:edent .... in lie 13. lloctdenrI EcIucIIion (SpeciIy only NgIInl wade CllftIllIelodI US AImed Fon:es? EIeIlltIUy I SeoonlIIry (0-12) CoIIlge (1-4 Clf 56) Dves GINo 5+ ~~ 17a SIaIe Pennsylvania Ilb. CGunly Cunber land 17.11 Ves.DocodonILNodin Monroe 17dD ~~oILNod- 21b. Dale 01 DiIpoUion (ManIh. da't. ,.., 19 MoIlt(s NaIIlt (fill. 1IIiddII. IIlIiden IUIIlnIj Celia Garcia Sanchez 201>. ~ Mailing Addoess (Shot...., 11own. _. q. oodel 192 Meadc:M Lane Mechanicsbur 21. PIact 0I1lispoIiion (Name 0I...-y. """"*y" _ place) TlIP Cilr 1l1ooo PA 17055 21d l.oeIliClIl (~IIown. _. ZIP oode) ~ 3 17055 <If Oan*ln? 25. Ollel'lllnounald iliad (MnI. dar. JNfI 7: 45 A M December 16, 2006 CAUSE Of IlEA TH ,...InehCtl_ ..... ...........) IIem 27 PART I E'*" IleQ\ilJllIftIlII-clstases.~, ..CllIllpkalions-ll1aIdreefr caused llecleall. DO NOT ...... _._ suc/l aseardiae lmlSl. lIlSjliraoy lmlSl, 01 _ ibriIIalion wiI10ul shcMolg lie ttioIogr. Usl only one cause on eaeh line ::::~t=~~ Atherosclertotic Cardiovascular Disease Duo II> lor... "'"_ 01) ApprolIimaIe inler<aI: Onset 10 llIaII ParlN: Enltr__...-..._Io_ but not reUIing in lie uncloftring tauIt gMn in Port I. =1iII~.~anr.. 10..... _ 00 ine . Enltr UIIDERI. Y1IIG CAUSe (~..~Il1aINaIodIllt _~lIde""ILA5T. Duo 10 (or... "'"_ 01) Due to (or _ . c.oneequeno. of) :llIo Was.. AiJIopoy Petformod? :n. w... Adlapsr f'1Ildingt Av_ Prior 10 Compeloan 01 c..... oIlloilh? Pff Yes 0 No 31. ....... oIllIaII ~ Nalurol D- o _I 0 Pending lIMIlIgoIion 3211 Time 01 "*'" o Suicide 0 Could NoI be Determnod P!I Yes 0 No 3211. loealion 01 "*'" Is-, ..., 11own. -I u ffi ~ i Da. CelIIllIr 1- only one) . ~:":::==:~:='::=..~~~~~~_-:~3)n_nn_nnnnnlJ ~ . =:=:'=~=~":::::::=::~_HIlMl'ln_____n _n _n__lJ . IIoodUl b_ ,Car_ On.... _ 01_ _, or InVftlivollon.1n "" OfIInion. _ _umd..... _. _. _...... and duo 10.... eauH(1) __ II -fll. _ Chief Deputy Coroner 33d Dale SIgned (MnI. dar. rearl December 18, 2006 34 Name and __ 01 Penon Who Completed Cause oIllIaII (111m 27) T"," I Print Todd C. Eckenrode. Chief Deputy Coroner 6375 Basehore Roadr Suite HI Me hani bur PA 7050 ;~' rr~ (See instruction. and p'xample. on reve,.e) 28. DilITollacalUle~lolllall? D v.. 0 ~ ONoDUnMowft 29. lFemaII' DNotfl'Ollllll1l-poIIre- o .....,.... at lime 01 cleaII o Not ~ but JlItlP*1I- 42 dars oIde.... o NotIOllflllll. butlOllflllll43 dap II> I rea' ai_ D llnknoMl ~ ...... _lie poll,.. ~. Plow 01 "*'" Home. F..... s.., f....,. Olb Building. lie ISI>>aI>II