HomeMy WebLinkAbout913096
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THE STATE OF WYOMING )
) 55.
THE COUNTY OF LINCOLN)
RECEIVED 10/24/2005 at 4:17 PM
RECEIVING # 913096
BOOK 602 PAGE: 343
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
AFFIDAVIT TERMINATING ESTATE BY
JOINT TENANCY
Opal I. Vieths, being of lawful age and first duly sworn according to law, upon my oath,
depose and state:
1. That Ralph R. Vieths died on November 9, 1988 in Salt Lake City, Utah.
2. That on August 5, 1976 for valuable consideration Strawberry Creek Ranches, Inc.
by their Warranty Deed of that date, which deed was duly filed for record in the Office of the
Lincoln County Clerk on August 11, 1976 in Book 129PR on page 482, conveyed unto Ralph R.
Vieths and Opal I. Vieths, as joint tenants with full rights of survivorship, the following described
real property, to wit:
Lot 68 of the Amended Plat Bridger Forest Ranch Subdivision, Lincoln County, Wyoming as
described on the official plat thereof.
3. That by reason of the said conveyance, Ralph R. Vieths and Opal I. Vieths became
the owners of the real property as joint tenants and title thereto vested in them continuously from
said date of conveyance as described in said Warranty Deed, until the date of death of Ralph R.
Vieths on November 9, 1988 at which time title to the above described real property vested
absolutely in Opal I. Vieths in accordance with the provisions of 552-9-102, W.S. (1977).
4. Affiant avers and certifies that deceased is the identical party named with Affiant in
the aforementioned deed whose death terminated his interest, title and estate in the said real
property; and Affiant attaches hereto and makes a part of this Affidavit a copy of the official
certificate of death of decedent, duly certified by the public authority in which said death certificate
is a matter of record.
Dated this L of
o;J-
, 2001.
~~j? ~\
G-J ~~tr
Opal I. Vieths
State of Wyoming
County of Lincoln
The foregoing instrument was acknowledged before me by Opal I. Vieths this ,,;] I'\Þ_ day
of 1\r.::)\J~ v0.h__t^-. , 2001.
Witness mv hé1nrl ---~ N··
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Notary rtGTic
My Commission Expires: =:J'~\.9' ·~o:::JS
-_.-,-~--~ ,
FIRST "'DDLE
SALT LAKE CITY COUNTY HEALTH DEPARTMENT
DIVISION OF VITAL STATISTICS
,r__-
~_.__._-----~.__.._---------
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LOCAL FILE NU"BER
NA"E OF DECEOENT
18-4018
CERTIFICATE OF DEATH
STATE OF UTAH - DEPARTMENT OF HEALTH
LAST
STATE FILE NU"BER
DATE OF DEATH (Month,Day, Year
I, 8,
USUAL OCCUPATION (Give kind of work done during mosl 01
working IHe, even if retired.)
'30, Repairman
NAME OF FATHER
10. Divorced 0
I KIND OF BUSINESS OR INDUSTRY
I
"3b Refrigeration
..AlDEN NAME OF ..OTHER
1988
Ralph
Reed
VIEnIS
11.
I WAS DECEDENT OF SPANISH ORIGIN? YES NO II ye3, Indicate type;
Me);ic..ano Puerto RicanO Cuban 0 O1her 0 (II olher, specify)
..
BIRTHPLACE (S181e or foreIgn country)
I. July 26,
Mlnute.s
CITIZEN of whal country
South Dakota
U.S.A.
il
o Never Married
Manied Widowed
548-07-5384
Opal Irene Daniels
".
Rudolph A.
Vieths
'I,
Florence Reed
~
18.1,
CITY OR TOWH
ln
17, YES NO
~INSIDE CITY LIMITS? NAME, RELATIONSHIP AND MAILING ADDP.ESS OF INFORMANT
· YES NO
:'Ob CJ Opal I. Vieths wife
STATEANOZIPCODE Box 132
I -
',Iloo W o. 83112 ,.Bedf ord, Wyoming
83112
USUAL RESIDENCE (Slreel addrE'iS or localinnl
Box
132
,Be
NAME 01 haspil;il, nursing home or other institulion where dBalh occurred.
(II aul~jde an insHlulian, give SIrBe_1 addrt:ss or l()Çalion.)
20a LDS Hospital
MEDICAL EXAMINER: I hereby cer1ily that 10 Ihe best 01 my know,ledge the dealh occuned al Ihe hour,
dale and place slated above from Ihe causes stated below based on uamination 01 Ihe body Cind/ar
imestiOCilion 01 lhe circumstances
211. Decedenl was fonaunced dead at: HOUR:
P Y IN: I hereby ceni y Ihal 10 the be~1 01 my knowledge Ihe dealh occurred 81
Ihe hour, date and place slated above lrom the causes staled below, Ihatl aHended I e
decedent, and Ilasl saw Ihe ent alive on:
21d. month day year
If not cenitied by medical examIner, was dulh reporled 10 Ii m? YES 0 N )Q
II yes, enler the dale and hour reported: M.E. c.- No. (\..,
æ Inpalienl
o E.D. palienl
o OOA
I CITY OR TOWN
:~alt Lake City,
UT
Lake
clock)
HOUR:
Burial 0
Removal 0
MO, DAY
EnlombmenlO DATE
C'em"óon IXJI Nav 10 1988
Other 123i..'·'
NAME AND LOCATION OF CE..ETERY OR CRE"ATORY
Lake Hills Crematory,
26,
PART I. DEATH WAS CAUSED BY:
CON0lT10NS IF ANY
WHICH GA.VE RISE TO
THE IMMEDIATE CAUSE
(A). STATING THE UN·
DERl YING CAUSE LAST.
29.
PART II, OTHER SIGNIFICANT CONDlTION.-CONTRIBUTlNG TO DEATH, BUT NOT RELATEO TO THE
I....EDIATE CAUSE GIVEN IN PART I.
30,
AUTOPSY
YES NO
T'M~ OF INJU~,Y
r (2" Hour Clock)
I
~. ~,
IDistance tram place 01 Injury to
rusual re:!lidence (lIem 18)
~. ~ M_
DESCRIBE HOW INJURY OCCURRED (.."..- Nq\HÞf1Ce 01 ...-.rIll wf1kh ,...ult.clln Injury, NATURE OF INJURY
SHOULD BE ENTERED IN rTEM 28)
Accident 0 PendIng In~ligallon 0 DA of Injury H:'omh,D2y,Year)
Suicide 0 Undetermined II Injured
32. Homicide 0 AccldflnUy or PurpoMlly 0 J3a.
LOCATION OF INJURY-STREET AND NU"BER OR LOCATION AND CITY OR TOWN,
39.
.-~.._--~---~----~~---'~._---
This is to certify that this is a true copy of the informa-
tion 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.
eMn. .~.aUM'~~~
~~b~~~-~P,H,
Director of Health
NOV 11 1988
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II Ii (/ ~u(/ REGIST~1-=/7
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