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RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
Dale H. Dawson, Esq.
DAWSON, PASSAFUIME, BOWDEN & MARTINEZ
4665 Scotts Valley Drive
State Scotts Valley, CA 95066
SPACE ABOVE THIS LINE FOR RECORDER'S USE
Mail Tax Statements to:
RECEIVED 8/4/2006 at 10:37 AM
RECEIVING # 920953
BOOK: 629 PAGE: 54
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Gerald Channing Griffiths, Trustee
2611 Huntington Dr.
Aptos, CA 95003
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AFFIDAVIT - DEATH OF TRUSTEE
ACCEPTANCE OF SUCCESSOR TRUSTEE
GERALD CHANNING GRIFFITHS, of legal age, being first duly sworn, deposes and
says:
1. That RICHARD MANSEL GRIFFITHS, the decedent mentioned in the
attached certified copy of Certificate of Death, is the same person as RICHARD M.
GRIFFITHS named as the Trustee in that certain RICHARD GRIFFITHS 1999 TRUST,
executed June 11, 1999, and on that certain Grant Deed, executed June 11, 1999,
recorded as Document Number 859329, in the Official Records of Lincoln County
Wyoming, on June 17,1999, relating to the property situated in the County of Lincoln, State
of Wyoming, and more particularly described on Exhibit A attached hereto and incorporated
herein.
2. The undersigned, GERALD CHANNING GRIFFITHS, is the duly appointed
successor Trustee of the Trust referenced in the recorded document, and hereby indicates
his acceptance of the office of Trustee of the Trust referred to above.
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Ü3Z0S53
C00055
This Affidavit and Acceptance is executed this '2 vJ day of "itA ('/
2006, at Scotts Valley, California. . t1I ~0
.~~
~ERALD CHANNIN G IFFITHS
State of California )
) ss.
County of Santa Cruz )
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SUBSCRIBED AND SWORN TO before me this 2i day of /.(. 2006, by
GERALD CHANNING GRIFE ersonally known to me or pr vt: ¿n the basis of
satisfacto . e to b the person who appeared before me.
~~--~----~_....-
i) JANE L. DAWSON
- . '-". Commission 1111366799 ~
~ . -. Notary Public. California f
~ , Santa Cruz County -
My Comm. Expires Jul27, 2006
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CERTIFICATE OF DEATH
ST.<¡TE OF C.<¡LiFOANIA
USE BLACK INK ONLY I NO ERASURES. WHITEOUTS OR ALTERAT!ONS
\/S'11 REV 1:004
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3-2006-44-000690
Manse1
LOCAL REGISTRATION NUMBER
2. MIDDLE
õ' ::SOECE.DENT HISPANIClLATINO(A)rSPANlSH? III vn.... WQ.k5h..1 Ë::irNO
White
16. KIND o~ ",USINESS OR INDUSTRY (e.g.. grocery .Iore, roød construcLion, employment egencl'. etc.)
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28. NAME OF SURVIVING SPOUSE -
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31. UAME OF FATHER . FIRST
34. BIRTH STATE
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35. "'AME OF MOTHER - FIRST
CA
36. BIRTH STATE
39. DISPOSITION DATE mm/ddlccyl'
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06/16/2006
CA 95003
41. TYPE OF DISPO$ITION($)
43. LICENSE NUMBER
CR/RES
4-1. NAME OF
Santa Cruz
101. PLACE OF DEATH
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Residence
Santa Cruz
Scotts Va~~ey
107_ CAUSE OF DEATH
T1fT\.'lm.",.¡a1 a.lween 108. DEATH REPOATED TO CORONER?
'ohul and DUL'" [3f] YES D NO
R¡;:F¡;;RR~L NULH!EA
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IMMEDLATE CAUSE (AI
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In dGø.lh) (al
S~q....ønU...Uy.ljsl
1;:0ndiIJons. íl ¡ony
leading 10 cause
onLIne A. enfer
UNDERLYING
CAUSE (disease or
:~!~Z;~~~~ø eventl (0)
n.......U;ng in d....lh) LAST
109. BIOPSY PERFORMED?
DYES GfJ NO
110, AUTOPSY PERFORMED?
DYES ~NO
, ,. USED IN DETERMINING CAUSE?
DYES ~r~o
no
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114. L CERTIFY THAT TO THE BEST OF MY KNOWLEDGE DEATH OCCURRED
AT THE HOUR, DATE. AND PLAce STATED FROM THE CAuses STATED.
mmJddJccyy
Decedønt Lasl Seon Alive
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Dlic..d....1 A!landed Since
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119. I CERTIFY THAT IN MY OPIMON DEATH OCCURRED AT ,HE HOUR. DATE. AND PL.ACE STATED FROM THE CAUSES STATED
MANNER OF DEATH 0 Nøtural 0 Accídrmt D HomIcide 0 Suicide 0 ~~r:;iI7~.I¡DO 0 ;:t~I~~~:e
rnm/ddlccyY
11a. TYPE ATTENDING PHYSICIAN'S NAME. MAILING ADDRESS. ZIP CODE
04/16/01
2025 So ue1 Dr.,
Santa Cruz~
120. INJURED AT WORK?
DYES ONO DUNK
~ 123 PLACE OF INJUAV (..g., home. conslruCLI,.,n (¡jj",. wooded are.. SIC.)
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127. DATE rnmJddtccyy
12e. TYPE NAME. TITLE OF CORONER I DEPUTY CORONER
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STATE
REGISTRAR
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000713
FAX AUTH. M
CS~RTIFIED COPY OF VITAL R~C;;~061111111"11 ¡II¡I IIIIIIIIIIIIIIIII I IIII¡III¡¡"I
} DATE ISSUED J U N * 0 0 0 1 6 5 8 4 4 *
This isaî¡u~and exåct reproduction of the docume~t officially registered and
_. placed on file in the Vital Records Section, Santa Cruz County Public Health "i2.1. ~~
Department. ' . row. U
CHIEF PUBLIC HEALTH OFFICER
SANTA CRUZ, CALIFORNIA
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EXHIBIT "A"
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Lot 244 of the Lakeview Estates, Tract "A", a sUbdivision
of the S~SE~ of Section 29, T37N, Rl18W, 6th P.M. I
Wyoming, according to that p~at recorded 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.
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