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HomeMy WebLinkAbout911428, ,00276 AFFIDAVIT OF SURVIVORSHIP THE STATE OF WYOMING ) )SS. COUNTY OF LINCOLN ) RECEIVED 9/1/2005 at 10:19 AM RECEIVING # 911428 BOOK: 596 PAGE: 276 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY MARVIN LEE SCHWAB, being first duly sworn upon his oath, deposes and states as follows: 1. On or about the 23ra day of December, 2004, my wife, Terri Lynn Schwab, died as is evidenced by the official certificate of death attached hereto as "Exhibit A"and incorporated herein by this reference. 2. At the time of her death she jointly owned an interest in certain real property with me, said real property being located in the County of Lincoln, State of Wyoming, and more particularly described as follows: Lot 4 of Twin Cliff Subdivision, Lincoln County, Wyoming, according to that plat of record in the Office of the Lincoln County Clerk. Subject to reservations and restrictions contained in the United States Patent and to easements and rights-of-way of record or in use. Together with all improvements and appurtenances thereon. 3. Said real property interest was originally conveyed to Marvin Lee Schwab and Terri Lynn Schwab, husband and wife, as tenants by the entireties, wi~h right of survivorship, by a Quitclaim Deed dated June 20, 1996, and recorded July 1, 1996, in the Office of the Lincoln County Clerk and Ex-Officio Register of Deeds in Book 385 of P.R., Page 55, Instrument No. 822221. 4. By reason of my wife's death, I am entitled to sole ownership of the interest in and to the above-mentioned real property. DATED this "~ day of $~~, 2005. Bowers & Associates Law Offices, PC P.O. Box 1550 Afion, Wyoming 83110 307-885-2266 ~1~ LEE 00277 STATE OF WYOMING ) ) SS. COUNTY OF LINCOLN ) The foregoing instrument was acknowledged before me by MARVIN LEE SCHWAB this 'b f~ day of.e~"*^*-~,~ 2oo5. WITNESS my hand and official seal. My commission expires: ~- t~ ~o~ NOTARY PUBLI(~ Bowers & Associates Law Offices, PC P.O. Box 1550 Afion, l'Vyoming 83110 307-885-2266 2 ........ STATE OFW:YOM!NG.?,. "oo " DEPARTMENT oF HEA~:TH" i:i ./: ........ . ..... . LOCAL FILE NUMBER CERTIFICATE OF DEATH STATE FILE NUMBER 4 ~CiAL SEC~RIT~ NUMBE~ '"' ' ' 5&..~GE -- Le.s~ i~(l~ay ~.'UNDE~ 'J ~R ~ '~R I D~ .... '~ DATE ~ B ~TH {M~ay~r '~ '"'"" 'J ....... 520-82-4109 45 [~ ~RCH 25, 1959 '~:;~. : .'" ':::]'. :~ :~] :[~:. :~:: "[; .::: '~:; '~{ "::: 7I~C~OFOEAT~k~ ';:::.. :~] "]~ ":]~:: :::' ".~ .::' '":: ": '::: ':::~ ':]:~... IFDE~THOC~0RR~NAH~P~A~ :~.~ iFDE~TH~RRE~'S~EWHE~OTHERT~Ug$~IT~=: ~',;'::: ~.] ~] ::~ ~ ':;~ '[] ::[ ..;]': ~:~:' 353 TWIN CLIFFS. <:"-. .... ~; '". ~. "~ :::::~:.,'i::..:'(-~Y~:AFTON ~:~ ...... " [ LINCOLN ::' :' :': : :': /~ .~ ':~; ~,' .. ':h ::' ~:~:~ '~ 54' :~:~ -'- ~::L.f, , ::~ .~- ~: ::~ ,~::,~(~ f~ .. ~:, ~:L :~: :~. ' :' Om 353 .T~IN C~1~FS RO~ .... ' ' '<, ...... 831 O: ~ ':{" ~ ' ~ ' xS8~,,., .... :'-'O~;,~;. ~;~ D~;~,~ ::..~:'-~ ::.AFTON.~CEM~.~?,, '.. '-::c : :i:i ~ ~ ~ ~: ~ ~' ~ · ~: ~ .' ' ~- ~ .~'~,~ ' ~:::~ ;:~:: ~ : t · ~ ~ ...... ~:: ~ ' " "'" ....... '"'-~"i~ · ' ':-'~ ~ ~".~ ~ ~ '~ ~ ~:~: ~ %'":~ ' ~ ~"~'si~":'~:" ::' :: ~' "~~-~C::: .' ~;' ~ ..... ' ........... "~' "~ .... ......... .... ~<.:~:? '.~ ................................. -,,, /~ ::~' .~....~:~ ~ :: :: .:: :: : :: ~-~:,:::- :~ ...... r' ,' ,; " :6:'1 :':. 6' .: . ....'.' . . ".'. '".V-~: '' ::: ..... I ":' '; :': '" :':' ~I ::~ ': .::~ ::~: :~: .:~: .%, .. :: ~. :~,' '..:. ~Z~:, ~:~:.;Lt'~l ''~? ~;?"~*':~'':h~: '::: : '~ '':~ ::~ ::' '~: ::' ::~'" '::: ' 'h' "~( ' ':~. ~,O~EOFI~UURY~M~.~, ]~: ~:[ 3, Ti~EOF~URY ~ ....... ~P~CEOFi~U~*~Vu~,~..'~ ~ 331~RY~TWO~.";' ' : .......... ..' ...... ! - ' , :. : , %.] ~D~,/~.~,~ ~: .::: :~: '.:% ::~::: .'~ ;:.: .. :% .~,. ./ '~::. '~:: .... ::~:-.~::. ~, ":::?:?":"::::;~:. ~:~:~ ':::-...: ~ S,~.~C.~'::L;' ...:" ~. ~:....v :< .:-':: ::~:.: ".::::.' .~, '~'' ' ~,:~~'.:~ ~, 7::::~,- - "~:. A~:~:' :~ ~ ,':::"~ :, t~::.. :~ ~""~'~"'~'~: ..... ~': ....... ::: ':~:" ':L...:~:: ' .::~;~ .... ~::~L..::' ' ':~ .......... ; ::~:.......:~' ~... ~: ~ "~,~"*~(~?~:' ~::. ::::~. This is a true and exadt reproduction of the document on file in the office of Vital .ecords Services Cheyenne Wyoming. :DATE,:ISSUED: i~ dAN ::::'< 3 ...... Deputy:State Registrar This copy is not va]id unless prepared on paper with an engraved border displaying the date sea{ and signature of the Depu y Sta e Reg strar