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HomeMy WebLinkAbout909569THE STATE OF WYOMING THE COUNTY OF LINCOLN SS. RECEIVED 6/28/2005 at 4:14 PM RECEIVING # 909569 BOOK: 589 PAGE: 576 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER VVY AFFIDAVIT TERMINATING ESTATE BY THE ENTIRETIES I, Dean J. Merritt, being of lawful age and first duly sworn according to law, upon my oath, depose and state: That I am of adult age, a resident of Lincoln County, Wyoming, and the Affiant herein. That by virtue of the conveyance which is recorded in the office of the County Clerk for Lincoln County, Wyoming, located at Kemmerer, Wyoming in Book 322PR on page 565 is recorded a Quit Claim Deed. The Quit Claim Deed, dated the 11th day of March, 1971 conveys unto Joseph M. Merritt and Lera B. Merritt, as Husband and Wife, as an estate by the entireties the following described property, to-wit: A portion of Lot 2 of Section 19, T34N R118W of the 6th P.M., Lincoln County, Wyoming being more particularly described as follows' BEGINNING at a point which is the southwest corner of said Lot 2 and running thence East 225 feet; thence North 150 feet; thence West 225 feet; thence South 150 feet to the POINT OF BEGINNING. That said Joseph Marvin Merritt died on the 17th day of July, 1995, and a copy of the original certificate of death, certified to as true an correct by public authority in which the original of said certificate is a matter of record, is attached hereto as Exhibit "A". ~ That by reason of death of said Joseph Marvin Merritt and by reason of §2-9-102 W.S. (1980), the decedents interest and title in said conveyance has terminated and title to the real property conveyed thereby has vested absolutely in Lera B. Merritt continuously since the death of the said decedent. FURTHER AFFIANT SAYETH NOT. Dated: Dean J. Merritt State of Wyoming ) )ss County of Lincoln ) ~_T.h_e f~o,/regoing insl:_r, pm~. t was subscribe~2005.and sworn to me by Dean J. Merritt thi s~::::~~ day o ~-~~- Witness my hand and official seal. My Commission Expires: NOTARY PUSUG '<J'~'~'-~"' ....' SALT LAKE CITY - COUNTY HEALTH DEPARTMENT .................. z:..:- DIVISION OF VITAL STATISTICS -. 0 0 5 7 ^cc.. ,. ~.,..,..,,~, o.STATF, OF UTAH - DF. PA RTM ENT OF HEALTH ....... e ....... , CERTIFICATE OF DEATH .I and R ..... LOCAL FILE NUMSER 18- 2789 STATE FILE NUMBER I. NAME OF DECEDENT FIRST MIDDLE LAST I 2. SEX 3a. DATE OF DEATH (Mo. Oar. Y0 j~b. TIME OF DEATH ~24 ~w. clock) JOSEPH HARTM . MERRITT~ Male July 17, 1995 / 2127 4. BATE OF BIRTH ¢~. Der. V, t/ 5. AGE.r:a,~ ~*~r~ lC u*~OEn ~ YEAR I~ Ue~OER 2~ HOURS 8. BIRIHPLACE tC~ 4 $t,~, ~ Fme~ c~ri [ 7. S~IAL SECURITY NUMBER March 22, 190 89 Y,. I o.y, H .... [M,.o,.. Fai~iew, Wy~-g 520-42-4213 ~a. PLACE OF D~ATH (Check only omB} 8b MANE OF HOSPITAL. NURSING HOME OR OTHER ~ACILI~ (If ~tsida a facility. Salt Lake City Salt Lake Lera Bar~. ~ 1537 - east of ~a~e ~ayne L~co~ Wy~tng 13e. INSIDE Ct~ 13L ZfP CODE LIMITS? ~4. WAS DECEDENT OF H SPANIC ORIGIN~ ~ Yes ~ NO 15. RACE - Bla~. ~,e. ~. Indian 16. EDUCATION ¢5pe~ only highesl g¢ade (11 yes. sp~ify) ' (Tri~ may ~ enterS). Ja~anese. ~mp/et~) Elemenla~ elc. (S~/ {0-1~)-Co~ege (13-16 or t7 PARENTS George W~lli~ Merritt Martha Nora ~chaelson iNFORMANT SON - De~ MerriLL / Box 425 / ~a~e, .Wyo~g 83127 Bedford Lincoln County - mSPOSlTION ~,., ~c,.~,,o. ~ ..... , July 21. 1995 C~ete~ Bedford, -A~ENDED BY CERTI~ING PHYSICIAN 25. II ~, c..,fled by m. ~cal .... , ....... death rep0.. ,0 M.~.? D Ye, ~ N;1 CERTIFIER 27a. CERTIFIER~ ~ CER~F~ING PHYSICIAN ' ~ MEDICAL EXAMINER I LAW ENFORCEMENT OFFICIA~ ~.. On lhe bas~s ol exam ual on ancot investigation ~h ~ op nion dee h oc~ned al the lime dalet place and due ~27b. SIGN~R E AND ~ OF~RTIFIER ' ' ~7c. L~ENSE NUMBER I~ Ihe27d.CaUSe(g}DATE SIGNEDa~d ma~ner(Mo.. ~ay.aS Yr.}Slated' Brett Troye~ M.D., 50 North_Medical Drive, Salt Lake City, Utah 8~132 , ~, ~o,,~o~ REGI~TRAH ; 3 t ~[~.?~[~E~:.~S. ~~S tHAt CAUSEO TH6 dEZtH. ~ NOr ENTER rile UOOE OF DYING, SUCH AS CARO~AC If any, leading Io Immediate DUE 70 ion xs A C~SE~ENCE OF): I cause. Enter UNDERLYIHG CAUSE (disease or inju~ DEATtt in death) ~ST ~ ,_ 34. MANNER OF OEATH 35a, DATE OF INJUnY ~ 35~. TIME OF iNJURY I 3~. iNJURY AT WORK? 3~. P~CE OF INJUnY-AI hem., latin. Thomas L.(S')ch Jl ker, MD '--~ information on file in this office. This certified copy is issued under authority of Section 26-15-26 of the Utah Code Annotated, 1953 as amended. Date Issued :1.67458 JUL 1 9 1995 Director of Health