HomeMy WebLinkAbout909710Affidavit Of Survivorship
I, Randall Jenkins, being of lawful age and duly sworn according to law,
upon my oath, depose and state:
That under the date of November 10, 1995, for valuable consideration,
Leisure Valley,. Inc., a Nevada Corporation, by deed of that date, which deed was
duly filed of record in the Office of the Lincoln County Clerk, on November 29,
1995, in Book 376 of Photostatic Records on Page 776, conveyed to Randall
Jenkins and Rosita Jenkins, as joint tenants, the following described property to-
wit:
RV P0xk
Lot 400 in Star Valley RanchVp'~'l as platted and recorded in the
official records of Lincoln County, Wyoming
That by reason of said conveyance aforesaid, the said Randall Jenkins
and Rostta Jenkins, husband and wife, became the owners of the above
described land, and title thereto vested in them continuously from the date of
conveyance described in said deed to the date of death of Rosita Jenkins, also
known as Rosa M.'Laracuente Garcez, on the 14th day of December, 1995.
That by mason of and upon the death of Rosita Jenkins, title to the above
described real property vested absolutely in Randall Jenkins, as the surviving
spouse and joint tenant.
Affiant avers and certifies that Rosita Jenkins, also known as Rosa M.
Laracuente Garcez, is the identical party named with Randall Jenkins in the
aforementioned deed whose death terminated her interest, title and estate in said
real property; and Affiant attaches hereto and makes a part of this affidavit, a
copy of the Official Certificate of Death of said decedent, duly certified by the
public authority in which said death certificate is a matter of record.
Datedthis ~.0. dayof ~)/t/~ ,2005.
~//~' Jenkins
Puerto Rico )
)SS.
Countyof~a roli n~ )
Subscribed and sworn to before me, a notaryj~blic in and for said County
and State, by Randall Jenkins, this ,~- 7 day of '-/ v' ~ P ,2005.
WITNESS myhandar~dofficialseal.Q/~~~~-~.~ht~c"~ ~'-~'-~'
~ ~ Nota ry'~'~(31ic~-- .
RECEIVED 6/30/2005 at 1:26 PM
RECEIVING # 909631
BOOK: 589 PAGE: 844
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
ODOD?IO
DEPARTAMENTO DE SALUD
(DEPARTMENT OF HEALTH)
REGISTRO DEMOGRAFICO
(DEMOGRAPHIC REGISTRY)
CERTIFICACION DE DEFUNCION
(CERTIFICATION OF DEATH)
NUMERO DE CERTIFICADO (CERTIFICATE'NUMBER)
152- 1995-01064-028570- 000000- 01527685
NOMBRE DEL FALLECIDO (DECEASED NAME)
ROSA M. LARACUENTE GARCEZ
SEGURO SOCIAL (SOCIAL sEcURITY')'
120-28-5203
ESTADO CIVIL (MARITAL STATUS
CASADA (MARRIED)
FECHA DEFUNCION (DEATH DATE)
14 DIC 1995
LUGAR DEFUNCION (DEATH PLACE)
CAROLINA, PUERTO RICO
CAUSA DE MUERTE (CAUSE OF DEATH)
MYOCARDIAL INFARCT
FECHA NACIMIENTO (BIRTH DATE)
18'SEP 1927
LUGAR NACIMIENTO (BIRTHPLACE)
SAN:GERMAN, PUERTO RICO
SEX6 (;
NOMBRE CONYUGE SPOUSE'S NAME)
RANDALL JENKINS
FECHA REGISTRO~i(REGISTRATION
19 DIC 1995~
FUE EMBALSAMA~ ~wAS'EM~ALMED!
SI FUE EMBALSAMADO~.(EMBALMED
EDAD (AGE)
68 A~OS
NOMBRE DEL PADRE (FATHER'S NAME)
JOSE MONSERRATELAR3~CUENTE
FECHA~EXPEDICION (DATE ISSUED)
13 JUN 2005
NOMBRE DE LA
ROSA
ESTE ES UN ABSTRACTO DEL CERTIFICADO DE
DEFUNCION OFICIALMENTE IN~SCRITO EN EL '.
REGISTRO DEMOGRAFICO DE PUERTO RICO BAJO
LA AUTORIDAD CQNFERIDA POR LA LEY 24 DEL
22 DE ABR[L DE 1931
DIRECTOR REGISTRO DEMOGRAFICO
(STATE REGISTRAR)
ADVERTENCIA:. CUalq
THIS IS AN ABSTRACT OF:THE RECORD
FILED IN THE DEMOGRAPHIC REGISTRY OF
PUERTO RICO ISSUED UNDER THE
AUTHORITY OF LAW 24, APRIL 22, 1931
DEPARTAMEN~o.D¥
SALUD
6n ~o bor~adura ¢