HomeMy WebLinkAbout910864THE STATE OF WYOMING )
)
THE (~OUNTY OF LINCOLN )
SS.
002'55
AFFIDAVIT TERMINATING ESTATE BY THE ENTIRETIES
I, Leslie Burris, 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 Kemmerer, 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 364PR on page 675 is recorded a Quitclaim Deed. The
Quitclaim Deed, dated the 9th day of February, 1995 conveys unto
Steve Podlesnik, Robin Smith, Leslie Burris and Tiffany Atwood as joint
tenants with rights of survivorship the following described property, to-
wit:
Lot 5 of Block 57 of the Second Addition to the Town of Kemmerer,
Lincoln County, Wy..oming.
That said Steve Podlesnik died on the 31st day of January, 1999, 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 Steve Podlesnik and by reason of S 34-6-
102 of the Wyoming Statutes (amended 1977), the decedents interest
and title in said conveyance has terminated and title to the real property
conveyed thereby has vested absolutely in Robin Smith, Leslie Burris and
Tiffany Atwoon continuously since the death of the said decedent.
FURTHER AFFIANT SAYETH NOT.
Dated:
State of Wyoming
County of Lincoln
)
)ss
)
Leslie Burris
The foregoing instrument was acknowledged before me by Leslie Burris this
day of August, 2005.
Witness my hand and official seal.
NANCY STAFFORD~ NOTARY PUBLIC ~
My Commission Expires:
Public
RECEIVED 8/11/2005 at 4:20 PM
RECEIVING # 910864
BOOK: 594 PAGE: 255
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
o,u o eA
LOCAL FtLE NUMBER
/ 1. DECEDENT-NAME FkqST
.e.,.~m Steve
~ 4. SOCI~,L SECURJTY NUMBER
· FOR
~mUC~ONS 520-03=2527
i Yes
STATE OF WYOMING
DEPARTMENTOFHEALTH
t: 0.025
1005
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH ST^~NUMKR
Podlesnik ! Male i] JanUary 31!~
~a/.;~ Mo,.h. o., ~"' ..... 2 2
· J .J J 'J J December ,
1911
South Lincoln Medical'~:~en'te~ · K er in
. Wyomin9 ~;~ Widowed' ' --~--~ ...... :2 .... ~ ...... ~--~- .... ~::~-~
No ~ Electrician .:. _..
t~. ReSiDeNCE - ~ATE~ ,. . · 13b. COUNTY 1 ~. CffY. ~N OR L~T~N 1 ~ STREET ~D N~ER :
W~°mi ~-' ~incoln ~ D ia mo ndVille 1 6~ Gom~r
~ ~x~.~o R~, Etc.} (~) ~ ": E~ry/~. O-12~b~
~ v,, ~ r~ White 12 J 0
':~:~ Podlesnikr '~ Stefanila ~? ?:: Budna
ul,ane/~twoo~ ::'::":':: , :: ,~: .Daug..e, .~: .~:.-.~;
I P.O. Box 530 Diamondville Wyominq
[ 2~. ~r~l, O~n R~,I 12Ob. DATE (~ my. W.)J2~. CE~TERY OR C~MATO~-~E :., ~ J2~ m~ * 'Cay O~ ~N ~ATE
.... :Burial :::~: J Febi:.4, 1999 I Kemmere~ Cemetery I Kemmerer: Wyomino
. .[~~/~/~/~Cr~dall'FUneral Home 28 806 Pine Avenue, Kemmerer
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· Dr. Christopher G..Krell, 711 Onyxt Kemmerer~ Wyominfl 83101 ......
: ::::: :~,, "'~:~~' '::':': ':'~":"~ :~'" ;': February 8, 1999::~::: :::::~?:: ':'~' ~:~:
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~:!: This i$':~ ~t'ue and exad~ reproduction Of the doi~ument on file in the office of Vital
Records Services, Cheyenne, Wyommo.
CA~E ISSUED!' FEB I I:': 1999
Thii copy is :not valid Unless prepared On paper with an engraved border d
Lucinda McC a~rey':://~!i:
Deputy State Re~ist~:;~r