HomeMy WebLinkAbout916706
G00482
THE STATE OF WYOMING )
)SS
THE COUNTY OF SWEETWATER )
RECEIVED 3/16/2006 at 10:58 AM
RECEIVING # 916706
BOOK: 614 PAGE: 482
JEANNE WAGNER
____:'_NCOLN COUNTY CLERK, KEMMERER, WY
AFFIDA VIT TERMINA TlNC ESTA TE BY
JOINT TENANCY
David L. Garetto, being of lawful age and first duly sworn according to law, upon my oath,
depose and state:
1. That James B. Garetto died on October 2, 2005 in Reliance, Wyoming.
2. That on March 7, 1991 for valuable consideration James B. Garetto by his Quit Claim
Deed of that date, which deed was duly filed for record in the Office of the Lincoln County Clerk
on March 14, 1991 in Book 294PR on page 602, conveyed unto James B. Garetto, David L. Garetto
and Dorothy F. Garetto, as joint tenants with full rights of survivorship, the following described real
property, to wit:
Lot 86 of Star Valley Ranch Plat 9, Lincoln County, Wyoming as described on the official plat
thereof.
3. That by reason of the said conveyance, James B. Garetto, David L. Garetto and
Dorothy F. Garetto 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 Quit Claim Deed, until the
date of death of James B. Garetto on October 2, 2005 at which time title to the above described real
property vested absolutely in David L. Garetto and Dorothy F. Garetto in accordance with the
provisions of §2-9-102, W.S. (1980).
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 ffYH'('Ì\
.2006.
12-
Jf~;,l rJt.Jii-
CÀ David L. Garetto
State of Wyoming
County of SWQ€!t'llatcrl~rt.o\f\
\( _ The fore~~nsnment was subscribed and sworn to me by David L. Garetto this
[) day of ' '((' , 2006.
Witness my hand and official seal.
My Commission Expires: ~- ß- 'Ö
Notary Public
LINDSEY KRAll ~NÕTfr~ý'P~~;'
-;
COUNTY OF STATE or ;:
LINCOlN ....'YOM:NG i
My Commissi~n Expires f)~ \~... 1.0 ~
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~.·00483
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
LOCAL FILE NUMBER 137
" DECEDENrS LEGAL NAME (1ncIud. AKA'I W ony) (Arst, ~, LaII)
JAMES BATI$TA GARETTO
STATE FILE NUMBER
3. DATE OF DEATH (M l/DaylY') (SpoW Manlll)
October 2, 2005
2. Sf)(
Male
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II)
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~g
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~~
..0
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Sweetwater
4, SOCIAl SECÙRITY NUMBER
6. DATE OF BIRTH (Mo/P.ylY,)
520-14.,.9150
September 13, 1919
IF DEATH OCCURRED IN A HOSPITAL:
OOther S )
7d, COUNTY OF DEATH
1200 Main Street
Reliance
6. BIRTHPlACE (City .od otal. or loreign counlty)
9. MARITAL STATUS AT TIME OF DEATH
o ~ 0 Married, bul_rated
o Dlvon:ed 0 Never Married
121>, COUNTY
10. SURVIVING SPOUSE (II wite, give name prior 10 first marrieg.)
Clinton, Indiana
~Idowod
o Unknown
11. EVER IN U,S.
ARMED FORCES?
YES ONO
12d. STREET AND NUMBER
12.. RESIDENCE -, STATE
12e. CITY, TOWN OR LOCATION
Wyoming
Sweetwater
Reliance
121, INSIDE CITY LIMITS?
12., ZIP CODE
1200 Main Street
82943
YES
ONO
13, FATHER'S NAME (First, MiddIe,lall)
Lawrance Garetto
14, MOTHER'S NAME PRIOR TO FIRST MARRIAGE (Arol MiddIe,lesI)
Mary Elizabeth Delaurante
1 s.. INFORMANrs NAME
150. RELATIONSHIP TO DECEDENT
150, MAILING ADDRESS (St,.e' ond Number, City, State, q, Cod.)
Dave Garetto
Son
338 I Street, Rock Springs, Wyoming 82901
17~,J'V.CE OF DI~P.pSITION IN""",,,I d 17b.LOCATION CITY OR TOWN AND STATE
esr,.t1taveltoM!ilmOr al uar ens
o Remavll Irom Wyomirig
Rock Springs, Wyoming ,
19a. NAME OF FACILITY 19b. ADDRESS OF FACILITY
'154 Elk Street
Vase Funeral Home Rock Springs, Wyoming 82901
22. TIME PRONOUNCED DEAD 23, WAS CORONER CONTACTED?
Abt. 2100
October' 3, 2005
1108
~YES
ONO
CAUSE OF DEATH
24. PART I. Enter lIIe chain 01 evenlo - dlseasel, InjurIeI or COß'9IIcaIlonl - thel dlreclly caused the delth. DO NOT onler terminal ....onll such is Of"file '
an8st. ,espiratory arresl, Of ventricular rlbriUaUon wlthoullhowing the .UoIog)'. DO NOT ABBREVIATE. Ent., only one cause on a tine. Add IddiUonaJ linea
if necH&aIY.
Approxlmal. Inlotval:
OoS8110 death
IMMEDIATE CAUSE (Final dlso..e Of
condition ,elUlllng In delth)
a,Acute Congestive Heart Failure
DUE TO (Of II . consoquonco 01):
Minutes
Sequenltaiy UsI condIlIons, . any,
leading 10 the CIUse li$ted on Une L
Enler the UNDERLYING CAUSE
(dl..... or Injury that Inlllaled the
evenls '.Iulling In death) LAST.
b. Coronary. Sclerotic Artery Disease
DUE TO (or .. a consaquence 01):
Years
e,
'DUE TO (or II . consequonce 01):
d.
>.
II)
'io:
"w
.!!¡¡:
Co ::
50:
ow
Q O
IJ
~
PART U. Enter other sign¡rlCan~ condiUons contributing to death but nol resulting in the underlying cause given in Patti.
25. WAS AN AUTOPSY
PERFORM EO?
o YES NO
26, WERE AUTOPSV FINDiNGS AVAIlABLE TO COMPLETE THE CAUSE OF DEATH?
27, DID TOBACCO USE CONTRIBUTE TO DEATH?
DYES ONO
26, IF FEMAlE AGED 10-64
o No' pr.gnant within past year
o Pi~nl allime of death
o Nol pregnant. bul pregnanl wkhln 42 day. of death
DYES
o PRoBAeLV
29, MANNER OF DEATH
~Nalutal
o AccIdOnt
o Suicide
ONO
ÖNKNOWN
o NoI pregnant, bul prognanl 43 daY110 1 year belore dealll
o Unknown . p'Ögnanl within the pas' yoar
o Homicide
o Peodlng Inv..tlgation '
LJ Could not be detennlnod
30, DATE OF INJURY (MoIDaylYr)
31, TIME OF INJURV
32, PlACE OF INJURY (Dee.dent'. home, conllruction .Ita, lor.ol, ele,)
33, INJURY AT WORK?
DYES ONO
:¡.c, LOCATION OF INJURY (S"oeland nUmbe', CII)' or Town, State) 35. IF TRANSPORTATION ACCIDENT, SPECIFY:
o Driver I Ope,ator 0 P_striari
o P.... er 0 OllIe, (
36. DESCRIBE HOW INJURV OCCURRED, AND IF TRANSPORTATION INJURY, THE TYPE(S) OF VEHICLE(S) INVOLVED (Au_Ie, pickup, motOfcycle, ATV, blcycte, ele,)
37a, CERTIFIER (Chock only one)
o PHYSICIAN - To !he be.1 01 my ~Iedge, death occurred at the time, data.od piece, ond due 10 the caUSojl) ond ';'m.r ltolod.
0{ CORONER - On the ba.I., of examination, and/or Inve.ilgello my opinion, death occurred althe Iim., da'e ond place, Ired due 10 the caUse(l) and, inanner staled.
Signal",. 01, Ce_
37b. DATE CERTIFIED (MoIDay/Vr)
October 6,2005
Travis R.Sanders, Deputy Coroner, 421 "B" St., Rock Springs, WY. 82901
38b. DATE RECEIVED BY REGISTRAR (Mo/Day/V~
OctQber 6, 2005
ÚA TE ISSUED October 6, 2005
THIS J~J~é) eERrTIFY THAT this is a true correct confonned reproduction of the original
cop;),\' ,~'th~.qeatli:}]ertificate completed by the VASE FUNERAL HOME and submitted
tq, ~t.~PJ..IDS SERVICES, Wyoming Department of Health and Social Services,
I?·:.;"~~(ofß.ñaTtb..~a~.Medical Services at Cheyenne, Wyoming.
i, .!' . ,,: 0 \, ~ STATE OF WYOMING)
" ' ss
COUNTY OF SWEETWATER
Subscribed and sworn to before me a Notary Public
~ 6t~ ~ of October 2Q05
-I. 0
My commission expires on
April 21, 2006