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HomeMy WebLinkAbout909461STATE OF WYOMING COUNTY OF LINCOLN ) ) ) SS~ RECEIVED 6/23/2005 at 10:43 AM RECEIVING# 909461 BOOK: 589 PAGE: 205 JEANNE WA(~;NER LINCOLN COUNTY CLERK KEMMERER, WY MAXINE J. SANDERSON, being first duly sworn upon her oath, deposes and states as follows: 1. On or about the 21s' day of November, 2003, my husband, WILLIAM MAX SANDERSON, died, as is evidenced by the official certificate of death attached hereto and incorporated herein by this reference. 2. At the time of his death my husband jointly owned certain real property with me, said real property being located in the County of Lincoln, State of Wyoming, and more particularly described as follows: Beginning at a point on the Creamery County Road 1/12-111, said point being the SW corner of the NW1/4SE1/4 of Section 4, Township 35 North, Range 119 West 6th P.M., Lincoln County, Wyoming, and running thence West 450 feet, thence North 330 feet, thence East 3090 feet, thence South 330 feet, thence West 2640 feet to the point of beginning. TOGETHER with all improvements and appurtenances thereon situate or in anywise appertaining thereunto. SUBJECT, HOWEVER, to all reservations, restrictions, exceptions, easements and right- of-ways of record or in use. Said real property was originally conveyed to WILLIAM MAX SANDERSON and MAXINE J. SANDERSON, husband and wife, as tenants by the entireties, by Quit Claim Deed dated August 10, 2000, and recorded in the Office of the Lincoln County Clerk and Ex-Officio Register of Deeds on September 7, 2000, in Book 451 at Page 620. Affidavit of Survivorship I of 2 3. By reason of my husband's death, I am entitled to sole ownership of the above-mentioned real proPerty. DATED this -day of June, 2005. Mt ,A/XINE J. ~/A'N~ERsO~ SUBSCRIBED AND SWORN to and acknowledged before me this ]5 "-day of June, 2005, by MAXINE J. SANDERSON. WITNESS my hand and official seal. Notary Public My Commission Expires: Affidavit of Survivorship 2 of 2 TAT E O F...WYO M IN G DEPARTMENT OF HEALTH: STATE OF WYOMING DEPARTMENT OF HEALTH toc~ F,L~ ~,=~. CERTIFICATE OF DEATH WILLIAM MAX. SANDERSON MALE. I NOVEMBER 21, 2003 4. SOCIAL SEC UP, IT¥ NU~BE FI ~ AGE -La~ I~da-/ 9 5b ~ ~Y~ :' ~UN~R 520-38-7845 78 "I I I :" { '= {OCtOBeR 6, Z925 i '"4326~--~STATE" ' ~"~LINE ~ ..... ROAD-114. '"[:~:" ~:~: ': ?::' FR~ED6H LIN ~:OLN .:. - :. ,, ,. >: · . .::; : "";"/:;:'WILLI~ DELOS "' SANDERSON' I": '"""'' "" ALTX:':~ ~';~" BRowER ~~.~l . . :,;r ~ .' ":'" ''.. '"/m~'~ '~0~ I 4326: STATE LINE"ROAD 114  ~ b~-~. ~s~e~j :. '[ I NO | NO / · I Is~ U VR2-89 ~ .H~: i' ~'~''~ 11/99 15M This is a true and exact reproduction of the document on file in the office of Vital Records Services. Cheyenne, Wyoming DATE ISSUED: DEC ~:;§':' 2003::~:: ':::;:: ii::!" ':!i: :::'" IS not vaJid unless prepared on paper with an engraved border dis Luclnoa McCaffrey :. / Deputy State Regts[rar signature o£the Deputy StaLe Regtstrar