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Home My WebLink About12-03-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of MICHAEL S. KILLINGER also known as File Number 21 07 \ \ \") d- , Deceased Social Security Number 200-60-0096 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW:) o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the last Will of the Decedent dated and codicil(s) dated named in the o ~ (State relevant circumstances, e.g., renunciation, death of executor, etc.) >~ ~ ~::::, ILt,; ":1 ::. I ", , , ) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of~r:n}trum~s) offe~d:'z~ for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ' :' [2::3 ! r' ,'! '-.:; -' ;'3-' VJ : " C:::'-~J [Z] B. Grant of Letters of Administration -0 (lfapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; duraffm,minoritate "C; ~ ':?. fTl Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following-~pouse (if anY1-&nd hefrs:'ar! Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) W' , I Name Relationshin Residence I 146 GRAHAMS WOODS ROAD CHERYL A. KILLINGER SPOUSE CARLISLE PA 17015 146 GRAHAMS WOODS ROAD HOLLY KILLINGER MINOR CHILD CARLISLE PA 17015 146 GRAHAMS WOODS ROAD DANIEL KILLINGER MINOR CHILD CARLISLE PA 17015 (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in Cumberland Woods Road Carlisle (List street address, town/city, township, county, state, zip code) County, Pennsylvania, with his / her last principal residence at 146 Grahams P A 170 15 West Pennsboro Two Decedent, then 41 503 North 21 st Street years of age, died on 3/21/2006 at Holv Spirit Hospital Camp Hill PA 17011 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 $ $ $ $ 0.00 0.00 situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant ofl-etters in the appropriate form to the undersigned: Typed or printed name and residence Cheryl A. Killinger 146 Grahams Woods Road Carlisle 717-245-0174 PA 17015 Form RW-02 rev. 10.13.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTYOFCUMBERLAND The Petitioner(s) above-named swear(s) or affmn(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. before me the day of €J Sworn to or affirmed and subscribed Signature of Personal Representative Signature of Personal Representative File Number: 21 1b -'\ \, \\ ').. CJ So :::u -', :,~:f.~ -' ;::.~ ;;-~ r--.> = = --' CJ rrl \) , W ::-,-) :~3 - - ";J::J 1 \,,;J fTi;T J T:CJ =-'.(.J C'-) r-~) ..C)::C:=; -0 Estate of MICHAEL S. KILLINGER Deceasea :::1: ___~ W _U Social Securi?\Nu~ber: 200-60-0096 Date of Death: 3/21/2006 J:>- AND NOW, ~ ~ ~ , ;Jif) 7 , in consideration of the foregoing Petition, satisfact~ proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to Cheryl A. Killinger Executrix in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will_ ( nd Codicil(s)) FEES $ ~() gister of Wills Letters ............................. (2;z~ Short Certificate(s) .....1...... $ L./ Attorney Signature: ( ~ Renunciation(s) ................ $ JCP $ 10 Attorney Name: Christopher E. Rice. Esquire _Au+o $ 5 Supreme Court J.D. No.: 90916 $ $ Address: 10 East High Street $ Carlisle $ $ PA 17013 $ 717-243-3341 $ Telephone: TOTAL ............................. $ 39 Form RW-02 rev. /0.13.06 Page 2 of2 H105.805 REV 1/05 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. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~~. ~PH ~-t;~-bS'~ Local Registrar ~ Fee for this certificate, $6.00 p 12270480 MAR 2 S 2006 Date o C:;O ::0..11 ~*~ ~ -~.j - (j) 7~ !'-.) = = -...l o ,,, C"? I W ?,;j (-") .;s \._.J nl l:::J (0.) 1- "'.~.I Tl :.=s ! 'II ::'~-:: (~) ~ C) .'n ~. '33 -i -0 :::I: 'i! (,J) (~ w I ~ H105.144 Rev. 01Kl6 TYPE,Il)RINTIN PERMANENT BLACK INK 1/30-201 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (CORONER) STATE FILE NUMBER ~\ 0\ \ \ (:) 'd- I- Z W o w u w o u. o ~ z 1 Name 0' Deced8fl1 (Fir$l. middle,lest) I~:ie 3. Social Security Nunber I 4. D"'" D..~ IM'",h, da" ''''I Michael S Killinger 200 - 60 - 0096 March 21, 2006 5 ....Ilas1""hda~ 6. Under 1 year Under 1 da 1. Dale 01 Binh Month, cia . ear 8. Birth e C' and slate 01 101 CO" 88. Place of Death Check on. 41 I Monlhs D." Hours I Minutes I Yiay 20, 1964 I Danville, NJ I ~srn~:tien, "EPJOulDlltienl o DCA I ~h~~rSint1 Home Vrs. o Resklence o Other. SMcifv; ~ Bb. County or Dealh 8c.City,~IDealh 18d~:~;'~(~:;;:";:::7:::" 9. Was DQCed$n1 01 Hispanic Origin? 10, Race: American Indian, Black, 'NMe, etc. :XI No o Yes (If yes, specify Cuban, (- Cumberland East Pennsboro Mexican, Puerto Ran, etc.) White . 11, Decedent's Usual Occ lion Kindolworkdonedorin most or workin Mfe; do not stale retired 12, Was Oecedenl ever in IheUS 13. Decedenl's Educalion S ion h. esl da .. 14 Marilal Status: Married, Never rrerried, 1S. SUlVivilg Spouse (II wife, give rreklen name)" Group &l~'m.nator I Kind 01 Busine$Sllnduslry Armed Forces? I E;"2ntarylSecorKlary(Q.12) I CoRege (1-40r 5+) Ma~~~I- Cheryl A. Smith Exel Inc. DYes IX N, . 16. Decedenrs Mailing Address (Stree!. clyllown, state, ziJI code) Decedenl's PA OklDecedent Pe..nnRooro 146 Grahams Woods Road AclualResidence 17a. Stale live in a 17c. tx Yes, OececIent Lived in WeRt T.,r. Township? . Cumberland 17d.O No, Oecedenl Liv9d wilhin Carlisle, PA 17013 17b. County Actual LiriIs of CIy.... \8 Father's Name (FIf$I, niddle, IBsQ 19, Molher's Name (First, middle, maiden surname) Ray E. Killinger Valerie J. Mechall 208. Inloorent's Name (T ypelprinl) 2Ob. Inlormanrs Maiing Address (Slreet, cityllown, slate, zip code) Cheryl A. Killinger 146 Grahams Woods Rd., Carlisle, PA 17013 21a. Method 01 Disposkion 21 b. Dale 01 Disposition (Monlh, day, year) 21c. Place 01 Disposition (Neme 01 cemetery, cremelory or OIher place) l21d.LocaI"'ICIy-'slal"Zi>cod'l . XI 8<l1iel o Cremeoon o Removel from Slale o Donation 3/25/2006 ~estminster Marorial Gardens Carlisle, PA 17013 o Olh...SDBCify, ~ D"~~N""-'/';"~Z~ I ~L<'~; N;;~3 L !:j N.me"",,,,,,,...,I',,.., ing Brothers Funeral Hare, Inc. , Carlisle, PA 17013 ~23a<ont(whencertilying 231. To !he best of my kno~e, de81h OCCUlTed allhe lime, dale and place staled. (Signalure and 1iI1e) 23b. Ucense Nuntler 23c. Dale Signed (Monlh, day, year) pltysEian is not8Vllilable al lime of death to certily cause ofdelllh. . 1lems2H6muslbecorrpetedbyperson ", Tme 01 Death 125. 0.1. Pronoo""" D..d I"""~, da" ''''I 26 Wu Case Referred to a Medal ExaminerlCoroner? who pfooounclS deeth. 10:54 A. March 21, 2006 ;J.. Yes M. ONo CAUSE OF DEATH (See InslruCtlonl.nd eXlmf*ts) Approxirre.leinlerval: Part It Enter olher 5Imbnl condlllons alIllrbulino to death, 28, Ok! Tobao:o Use Contrbule to Death? lemV. ParI I: EnI8flhe~ - diseases, in~ries,orCOfl1)licaOOns -thai dWectIy caused Ihedealh. DO NOT enlerleminat events such as cardiac arrest, anset to death bUl not resulting In the underlying cause giYen In Part 1. DYes o_bIy respiratory lITes!. Of v~ulBr lbrillation wilheUl showilg!he etiology. DO NOT abbreviate. Enter ant( one cause on a lIIle. o No o Unknown IllMEDlAn: CAUSE (Fill! disease or Occlusive Coronary Artery Disease NIDDM, Exogenous 29, II Female: condlIonresullingindealh) -7 ., D Not pregnanl within past year Due to {Of as a consequence oQ: Obesity, D Pregnant at time 01 death Sequ."'ial, is! _lions, i '''Y, b. o Nolpr8l,1\8nl,bulpregnantwilhin42days - leadingtolhe cause Iisled on Unea. Due to (or as a consequence oQ: ofclealh Enler the UNDERlYJNG CAUSE Hypercholesterolemia . (diseaseorln~rylhatinlliatedlhe o. o Not pregnant. but pregnant 43 days 10 1 year evenls resuting in death) lAST. Due 10 (or as a consequence oQ: beloredealh d, o Unknown if pregnenl within the past year 308. Was.n Autopsy n. Were Autopsy Findings 31, Manner 01 Dealh 32a. Dale of Injury (Month, day, year) 32b. Describe how Injury Occurred: 32c. PIece of Injury: Home, Farm, Street, Flc1ory, Office -, AvaIlBble POOr to ConJIIttion It NaO"., o Homicide &liIdintl,ek:.(_ of Cause 01 Deelh7 o Yes ;'No DYes oNo D_ O PInlf1rlOtnv8SligBtion 321. II Transporlalion Injury (SpeciM 320. Location (Streel, elyAown, stale) 32d. Time 01 Injury 1320. I,~'Y'\ Wolk? o Suicile o CouIdNotBeOelermined o Yes 0 No o Driver,o()peralor 0 Pusenger M. o _rio, .DAft.u.".."" 33&. CerUfter (check only one) ;;?71 Certifying ptty.1tian (PhyH::i&n Ctrlifylng cause 01 death when anolher phystcien has pronounced dealh and conl)leted lIem 23) Coroner To the belt of mr knowIedgll, d.ua ocelJrTld du. to the etUH(.) and ~. _led.. .----. ..-.-----....-... ....-.-.-... ..--..--.. ,,0 Prvnounclng and ctr1lfylng pttyslcliln (Physician both pronouncing death and cer1Itflng 10 cause of dealh) 33c. licenseNulTtltr 33d. Dale SVred (Month, day, year) To the bat of my knowIedgt, duth.occl.l"l'ed II the lime. dIte, and place, and dill to the CIUH(.) and mliInnet' as .181ed..__......._._......_...._.._....R.._....._._RO March 22, 2006 lledk:alex.smlnerlcoroner On lite basis of uaninetion andie, InveItlgltion, In my opinion, death occurred at the time, date, and place,'nd due to the C3use(S) and mliInner as stated_')it 34, Name end Address 01 Person Who CotrfJleted Cause of Death (Item 27) ryp.'Pml Michael L. Norris, Coroner 35)t~7~~~~: ~~~~>.J Id. I I d,11 10 ~'(~;~~'~~ 6375 Basehore Road, Suite #1 I I Mechanicsburg, PA 17050 '" o w en :;:) en ... ~ (See Instructions and examples on reverse)