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THE STATE OF WYOMING
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RECEIVED 1/6/2006 at 10:18 AM
RECEIVING # 915008
BOOK: 609 PAGE: 73
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
COUNTY OF LINCOLN
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AFFIDAVIT TERMINA TING ESTATE AS JOINT TENANTS
I, THELMA G. DANA, being first duly sworn, upon my oath depose and says:
1. That I am of adult age, a resident of Thayne, Wyoming, and the Affiant
herein.
2. By warranty deed dated December 3, 1996, and recorded June 13, 1997, in
Book 398 PR on Page 265, Instrument Number 0839168, in the office of the Ex-Officio Register
of Deeds for Lincoln County, Wyoming, Van H. Dana and Thelma G. Dana, as husband and
') wife, conveyed unto Van H. Dana and Thelma G. Dana, as husband and wife as joint tenants
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l with a right of survivorship and not as tenants in common the following described property
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situate in Lincoln County and State of Wyoming, to-wit:
See Exhibit A, the property being described in the Lincoln County Records on
June 13, 1977, in Book 398 PR Page 265, Instrument No. 0839168.
3. Said Van H. Dana died on June 21, 2000, at Eastern Idaho Regional
Medical Center, Bonneville County, State ofIdaho, and a copy of the official certificate
of his death, certified to as true and correct by the public authority in which the original
of said certificate is a matter of record, is attached hereto as Exhibit "B".
4. By reason of the death of said V an H. Dana, his interest and title
in said warranty deed has terminated and title to the real property conveyed thereby has
vested in Thelma G. Dana, wife of Van H. Dana.
Dalla Termillatillg Affidavit Page 1 of 2
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0315008
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FURTHER AFFIANT SA YTH NOT.
Dated this & -f1-., day of December, 2005.
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THELMA G. DANA
THE STATE OF WYOMING )
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COUNTY OF LINCOLN )
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The foregoing instrument was acknowledged before me this ~ day of
December, 2005, by THELMA G. DANA.
WITNESS my hand and official seal.
CHRISTINA K. ALLRED - NOTARY PUBLIC
COUNTY OF STATE OF
LINCOLN WYOMING
MY COMMISSION EXPIRES 04/30/2009
CJv~~~ 7<. !1OJ~
NOTARY PUBLIC
My Commission Expires: 4 - 3l.")-{)ot
Dalla Termillatillg Affidavit Page 2 of 2
WARRANTY DEED'-':'FORM NO. 9
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WARRANTY DEED 1,·Ui. L .,;),
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EXHI81T
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.' '.... -- ~-.. -.. -.... . ... ...--.-. -. _.. . .._. ----.,... .-..---.-----.. .. - - --_._--_._.~.._.._. - --- -. -. . .. ---- -_..- -.-----......, ...
. ....-. _,__" _·'·.u· ___.._.. ._..__. .._...... _..... __.._..__.__..___._____...________... ..__.____. __.____..__..__.... _... _.. _. .
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VAN H. DANA and THELM4 .r.. DANA . ....
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-------~-----------------------------------~---------------------------------------------r~----______~~-----__________
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gran tor _:R_, of -----~-'12~~x~~__º.9_~~_t_~y________________1.!!}2_~j..!!.__________~________:__~__________.:.__ Coun ty, and Sta te
of_____l?~QwJ_~~________________~_, for and In consideration ot___________________----~~_.~-~-~--------------------____
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.. - - - - - - ~ ~-~ - ~~~ __c:~,!1_:.~__':~!.~~!>_~~_ -~~!:~~~«:E~~~_~ ~---:-.-=-'--.:: __-=-__'_.::...:_ .::.__.:-___c:..;._~~---:.----:.- _ _'- __.::_ _DO LLA RS
in hand paid, receipt whereot Is hereby acknowledged, CONVEY AND WARRANT TO....-..-:..--::!-.-~-_---------_~_.___ï-..----
-.. .... .. - -.. - .. - - -- Y. ~-!l-~-!?A~A.__~_r.!ª__'!:!.l~~t1AJ:~.:_ J?A~A _._ þJ!.§ Þ1!.TIfLª!lJL KH.S!....._.â.~_ j.Qi.n.t_J:.enanbLIolÍ th.______
right of survivorship, and not as tenants in common.
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j¡'nm Wð - ~- ,Whüi>ð adW:t /l1! i s--!l3.P__U1.!lcldy__SJ:.~j..P..ß...RQ £lA..;.. :rba.y..u~;..~QI1i.i..u6;..B3.12J_____;.._;..;....;..__..__;.. ..~_ ;._~ ..._..._ _'_'0
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the [olIowing described real estate, situate In-.:r-~~y-~~--Ç9~I'!!=EY_.?_..!:~_l!.L___I:J_.!!.c.:9_lJ;L___.._____________County and State
ot Wyoming, hereby releasing and waiving all rights under and by virtue ot the homestead exemption laws of the State, to-wit:
In Section 1B, Township 34,.N. ,Range lIB West of the 6th P.M. Lincoln
County, Wyoming. COMMENCING at a point 200 feet North of the SW Corner
of the (N~S~) of said Section 1B, and running thence North along the East
edge of the Muddy String Lincoln County Road # 117 a distance of 655 feet.
thence East 765 feet; thence South B55 feet, thence West 480 feet, thence
North 200 feet, thence West 2B5 feet to the point of beginning.
Together with water & Water-rights and ditch rights and all improvements.
Containing a net area of approximately 13.71 acres.
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In o~~·?,q Q fR n...:ge ') b~ "\";rflfl' .."J " ' ,:.,'
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"(0 ....Q.l~..~.!..þ.ª,.....................Marsha MOE:, ~i~ h
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WITNESS,..______________ h.nd,S_____ thl._~_~y .if~--N:--15~.L--.
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State of
County of ~
WYOMING
}ss.
Lincoln
The foregoing instrument was acknowledged "before me by
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My Commission Expireš: ' IV - /} r '
VAN H. DANA
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