HomeMy WebLinkAbout09-21-07
~ -'.. Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of William James Allen Kimmel No. ;7. I - 0 l - 0<&.0 \
also known as
, Deceased
Social Security No. 175-62-1373c;
(tr
Petitioner, Jean L. Kimmel, who is/are 18 years of age older apply(ies) for:
(COMPLETE "At OR "B" BELOW:)
[ ] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the executor/executrix named in the
last Will ofthe Decedent dated ,.;
I Not Applicable c.
(State relevant circumstances, e.g. renunciation, death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after the execution of the
documents offered for robate, was not the victim of a killin and was never ad'udicated incom etent:
Not Applicable
[ X ] B. Grant of Letters of Administration (~.uo i Ii
(d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (ifany)
and heirs:
Name Relationship Residence
Jean L. Kimmel Mother 30 Kim Acres Drive
Mechanicsburg, PA 17055
Robert A. Kimmel Father 30 Kim Acres Drive
Mechanicsburg, PA 17055
Decedent was domiciled at death in Cumberland Coun , Penns Ivania, with his/her last famil home or
30 Kim Acres Drive, Mechanisburg, Upper Allen Township, PA 17055
(List street, number and municipality)
al residence at:
Decedent, then 27
years of age, died September 2 , 2007, at Harrisburg, Dauphin County. Pennsylvania
(Location)
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 PA) Personal property in County ..................
Value of Real Estate in Pennsylvania...........................................................
Total ............................................................................................................
$ 2,000.00
$
$
$ 80.000.00
$ 82,000.00
Wherefore, petitioner(s) respectfully request(s) the probate ofthe Last Will and Codicil(s) presented with this petition and the grant
of letters in the a ro riate form to the undersi ned:
Typed or Printed Name and Address
Jean L. Kimmel
30 Kim Acres Drive, Mechanicsburg, PA 17055
I
OATH OF PERSONAL REPRESENTATIVE
I ( ~~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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 belief of Petitioner (s) and that as personal representative( s) of the Decedent,
Petitioner(s) will well and truly administer the estate acc9 . g to law.
f'"''''
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JeanX immel
L.ql<
Sworn to or affirmed ~ subscribed
before me this (;LI 6 day of
~.pb:...I~~^- ,2007
~~.< PJ.~ MuJ L~'^1I
, Fore RegIster \j
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No. 2J-O\-O~l.ol c'
Estate of William James Allen Kimmel, Deceased
Social Security Number: 175-62-1373 Date of Death: September 2. 2007
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DECREE FOR PROBATE AND GRANT OF LETTERS ,....
co
AND NOW, ~{Xi'\"l\..~ ^- ~\ ,2007, in consideration of the Petition on the reverse side hereof, satisfactory proof
having been presented before me,
IT IS DECREED that Letters [] Testamentary [X] Of Administration
d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate
are hereby granted to Jean L. Kimmel in the above estate and that the instrument dated , described in
the Petition be admitted to probate and filed of record as the Last Will of the Decedent.
Fees
Letters ...............................$ Z \0 - C0
Short Certificate(s).............$ ZL\ -00
Renunciation......................$ S CD
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Affidavit ( )........................$
Extra pages ( )....................$
Cod i c i I................................ $
JCP Fee...............................$ \ 0 ()()
Mtorney:
to. No.:
\,
Diane G. Radcliff. Esqu~re
32112
Address:
3448 Trindle Road
Inventory.......................... ..$
Automation Fee..................$ 5 00
Other...l\:!..I.\J..................$ IS-, 00
TOT AL.................$ ZSq 00
Telephone:
Camp Hilt PA 17011
(717) 737-0100
RENUNCIATION
In Re Estate of William James Allen Kimmel, deceased
To the Register of Wills of York County, Pennsylvania.
The undersigned, Robert A. Kimmel, father of the above decedent, hereby renounces the
right to administer the estate and respectfully asks that Letters of Administration be
issued to Jean L. Kimmel.
WITNESS my hand and seal this /t/1Ir day ot);U~)' 2007.
AJa~
Robert A. Kimmel
'-'.".]
Subscribed and sworn to
b;t:e me this Pf!!:day
of ~~1/0 ,20crp.
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dl<h211<k 0) ~
Notary Public
i '~J
C:J
TH OF P!NNSYL VANIA
Notarial Seal
DebonIh L Donley, Notary PublIc
Camp HI Boro. CumbeI1andCount)'
My CommIssIon E>cpnI Sept. 23. 2011
Member. Pennsylvania As.ocIatlon of NotIIIl..
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING. It IS illegal to duplicate this copy by photostat or photograph.
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TYPE I PRINT IN
PfRMAN(NT
BLACK INK
1 NitTlloIOllcedwlllFwst, ri.11e, !asl, SliII);)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See Instructions and examples on reverse) STATE FILE NUMBER
2. $e. 3 SoclaI SectM'i1y NtXnber
5 Age(las1 Bitttdily)
7.~(C" andscateor
14. Maldal SIalus: },tallied, Nevilr Uarlied.
Widowed, OevOICed (~
Never Married
Dauphin
tember 22 1979 Camp Hill, Pennsylvania
8d Fdty Name (II ~ ioillllbon, gillS 5t/_ and ntIT'bef)
Harrisburg Hospital
27 v"
8b County of Death
mosl ol-.. ~Ie 00 nol5law rBlir
Kind 01 &iliiness IlndllSUy
12. Wili ~eden1S116f in the
U.S. ^Jmed FOIces1
DV6. ~
Oecedenh
ktual Residence Ha ~te
PA
Cid Decedenl
Uvelna
Township?
17e, 'B YIS, DecedWlllived II
lId 0 No,OecQdQnallved'Mthi'l
Acluallimll$ol
Upper Allen
T"!l
- 16 Decedinrs Maikllg Address (Slreet, City / town, s"'la, l4> code)
30 Kim Acres Drive
16 Falhar's Name (fnl, rnilXIe,la.sl, slAbl
17b Courlty
C':lImberland
City/Bora
19. Molt!6(s Name (AIs!, midlJe, maiden liUll"laI1l8)
A. Kimmel
Jean L Buffington
2(1). Intomlanl's Maililg Ackifess (Streel, cty I town, stall, ~ cadi)
30 Kim Acres Drive Mechanicsburg, PA 17055
20a Intormanfs. Name (Type I Prinl,
21c. Place ol Disposition (Name 01 carnalary, crtmilo:y or ohl place)
Conolite Crematory
21d location (City J klwn, stale, ~ code)
Schaefferstown, Pa. 17088
221:. Name and M:iress ot Fdty
Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
23b Ucenw Numbar' 23c Dale Signed (Uoolh. day, )'Nt)
hems 24-26 mu:.t be compI&ted by perwn
.ho p1ooouoces deash
24 Tlffi80l 08alh
25 Oitii Pronouoc8d Dead (Month, day, year)
11 :51 PM September 2, 2007
26. Was Ctie Relerred 10 MeOcal E.wnirIer J Coroner lor a Reason Oihef than Clemalion or Donation?
ooV6. DNo
,_ CAUSE OF DEATH (See InalrucUon. and .xample.)
IICl1Tl 21. Par1 t Enid the ~~ - diseases, l~~li, or complicclhOllS-lhat lirecUy caused Ihti death 00 NOT enter terminal evenls &llCh as Ci.rtiilc arrlils.l.
respil4tory elrelit, Of lIenlf\(;wr Itlfllalion wilholi showing the etiology I i5t only one cause on each line
ooV" 0 No
32d TimeollnjiJf)l
ApprOllima11l inlllrval: Part U: Enler other r.ilrilir.ant condihons conlrhilir'lo to dealn 28 Old Tobacx:o U1i6 ~.IO Dealh1
Onset 10 Death bul not /esiJling tlthe lIldel1y~ cause g1"en tl Part I 0 Yet 0 Pr~bIy
[] No 0 Uo""",,"
2lI . Female
o Nolpr~t~n~~(
o P'egnanlilllmeofdeath
ONolpre~,b\Apregnanlwttt\ln42daY'
ol_
D Not prllglilOl. btA Pfllgr.-nl 43 dilplo 1 yoW
bet(ll'efNalh
o Unknown iI jl:/egoant wlChln the pasl year
32c:. Place of ~ury: HomI. Farm, Street, fadOry
Wl\l'la~~~J~~eedway
320. locabon oIlnju'y {Street, ciy J Iown, stale)
=~~~s~ ~h~~::"
. Traumatic Brain Injury
Du4t 10 (or as. a COf\SQqueoca 01)
"
Sequelllla1v I~ condlllOll!>. II any
t~,: $:~I~~~~ a
L=~~lJ~~~IIt:,,~rmt~
Due 10 (Of as S consequellCe of)
Due to jor ill a consequence of)
JOa Was an Autops~
Par!oonlld?
:JOb Were A.UlOpSy fmdlf'lQS
A"aLiblOl Pliorlo CompletlOO
oICaU$iloto..alh1
IXI y" [] No
31 MaMe/ of Oealh
o N.t.lural r-J Hormade
~ACCldeIll OPel'.OOgln"esllg8tion
[J SUlc!l:le 0 Could Not be Dehllffilf\8d
ala [k,fe ollrpy (Month, day, YeaI) 321). Oescnbe How loIJry Occu/Jed
September 2,2007 Sprint car racer Into wall at 120mph.
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Patty J. Garber, Chief Deputy
33dOaleSi!1J6dlMootJ,"Y,Y""J
September 4, 2007
10:15 Pu
Mechanicsburg, PA 17055
'"
33a Certltll/ (Clk1do. ooIy onel
CeoirYIrlg phYUcian jPhyslClill C8t1lty1ll'il cause 01 death whan anoth8r ph~lClan has plOf"lOUOCed d6alh and corJl>ItlllKlllam 231
To the beal ot my know~, ctuth ocwrrtd duttoltll t.uM(s) &nd NO,.,." allied... _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ __ __ _ _ _ _ _ _ _ _ []
~;Q::~~,~ :=hJ:~~"~~~~::~ :::"~~::t~ ~n~~'tl~::~~a: mlrWlef II atllecL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
:=~:~':~~:= and I or inveslig.Lion, 1n my opINon, dulh o<;curred illlhe lime, dale, and piate, .nd due 10 the ul.lae(al and mlnne, as llaled_ IKl
34. Name and Addren of Pelson Who Conl>IeI8d Cause 01 Dealh tllem 21) Type I Prl'll
Patty J Garber
1271 South 28th Street
Harrisbur PA 17111
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