HomeMy WebLinkAbout919247
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Affidavit of Distribut.ee for
Transfer of Wyoming Corti'ftcato of Title
r, ittl, <I Elk ~ ,being fu,t doly swn>n and opon my o,m, SlAt, dte rnUowing:
, tM'" Afkd~ Zðòþ
1. TbnttlH~ dMcden§' /.-4 T2di ~tLVI1 /::;dðn ,died olUllo :Jay ¡~, Z3' 2tJ£JS
of ~. 20__-r-' (Il ccrtlfic:d copy of dCIlÚl cr.rtificlltc must he 3ttJ\~htd to this form) /
2.
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3, Tllil[ the valuo of tho cntír~e61l\re ofthc decedent, whcnwer located, less liMS and cncurnbrances,
docs not exceed One hundred fif1y~thouslu\(1 (150,000.00).
4. Thafmorc than tlrirty (30) day~ bave elapsed since the dnte of the decedent's òealh.
5. ~ Thllt po application for appointment. of n }lcrsonal rcprcsentll:tlvc is pc:ndiJlß or has been granted in ¡my
juri6(l!clion.
G. 'l'bat the abOVe-llJlnltd djgltlbntec(s) is/are entitled to pOYJI\ent or òc:llve1Y oftho deceQ/!;llts property
and tbero Ilrc not other dl¡;lributocs of the decedent llaving Il right to succeed to tho propc[[)' \mdcr
proù:ttc procccdiI1I~g·
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7. ï, hat t underslgned¡/: ues[ thatJhc fol1owlllg described propert)' be transferred
ro:' I uí. (namcl:(s)] as
s~g
[rclhtlómhip(s) öf sard deallwF, Il,ud tbat rilles {(1 sni!l motar vehicles be trar1Gfarrcd into said nn.rno.
(lide npplication must be tlUC¡{ out)
8. Propcrty descrlprion:
Y car, n, '\11\.kelStyJu l Color
19~9 "- he. ve C.e e.he~-I r' C~ I!. A ï
. 20þ r.e
Vehicle IdcnUficat10IJ Number ¡{I 0 C" I .,....
Iß/AvJc:;.$tRh rpfó.3;;> v
DATED this
da)' of
SlGNA.TURE(S) Ol~ DISTRJ.ßUTIĆ(S)
øt//~ ¿~ cf{~ 't~
St¡lt~ of Wyoming) l,
CO\1ntyof l; (\CO\~ )
Bl'!.forc mc personally appea.red ~fll1 OrJ [110 HeJxJön
:J I IJcing first duly swom by
~ou ¡is/her oath says that Ù1C facts alleged ;1\ tho foregoing in!!tnuncnt are ffilC. Witness my haud and
. .
CHRISTINA K. ALLRED· NOTARY PUBLIC
~eabOUNTY OF" STATE OF
LINCOLN WYOMING
MY COMMISSIÖN EXPIRES 04/30/2009
7<
Notnry l'nùllt or Aisjgt~nt CO\lllt~r Clod,
RECEIVED 6/12/2006 at 2:28 PM
RECEIVING # 919247
BOOK: 622 PAGE: 869
:::::::;::::f:::::~:::::., JEANNE WAGNER ,;;~:;«'j_'.;i:;:;;!:r:!;
::,::;::::::::::~t::::: _ ~;~,¡~>r"1;>:;-¡!~¡i;W
. - LINCOLN COUNTY CLERK, KEMM"::j\:2't'(:;:'WY
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