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Home My WebLink About922646 r-'ff , -... .--..v'-'J ruo--" .----- ..., I 13õ3Ñ-F~;;.;t.Ä~; , :5 . S . #=111 Lookout Mtn. 'IN 37350 "f,1...;tS'-S"Q31 ...::. XTO ENERGY INC. - OWNER #: 41967 AFFIDAVIT OF HEIRSHIP , 000357 For: JOHN T. FORT (Deceased) Re: SEE EXHIBIT A (Well/Property) LEGAL SEE EXHIBIT A DESCRIPTION RECEIVED 9/21/2006 at 10:40 AM RECEIVING # 922646 BOOK: 634 PAGE: 357 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY County/State: MAJOR COUNTY, OK LINCOLN COUNTY, OK w· BRaDLEY W ~E= /,5 (Name of Affiant) , residing at 3 DS No~ TH .pf) R. REST A.J.L. (Address) L OOUW hlt. (City) ¡IV (State) S735'o being first duly sworn, on oath deposes and says that the answers and other statements hereinafter set out are true and correct. 1. How long and how well were you "0 (J OÅI"L< I ""' 1_ c 1-'1 g ; 0 L J.. ()}.S ;#/ r:.,' "'h ' _ acquainted with the decedent? -' ~. ~v I ur- "1- f J..µ ".t- Œ Co- as 2. If related to decedent, state in what way. NOT 'R.cLLa1i.d , 3. When and where did decedent die? S !t3/ (J' J 3 0.3 IV tJ1,'f1.v -Fe; R:R l.::sf A if I- 00 tow- frrr.) -r N . 4. Where was decedent's permanent residence at the time of hislher death? ~:?03 IV~TIf HRRf33T AU-, L-aJ~ /nf) It(. 5. How many times was decedent married? t'JN C E 6. Name and address of surviving spouse (if any). -3 AN E 13. -Fð ~ T residing at ...303 N. -ÇORRE5T Aú) LnoktJll.f trrr)TN 7. If decedent was ever married, list in the following table each such marriage, indicating in each instance the date of marriage, the name of spouse, whether such marriage was terminated by death or divorce, the date of termination of the marriage, the address of each spouse now living, and (if dead) whether or not such spouse left a will: Date of Name of S~ouse Marriage - Marriage Date of Address if Living Terminated Termination by Death or ~3 IV, FoRREST,q Divorce If dead, did such spouse eave a Will 1 .' .' . . ;.~ '.;. 'i~; , . ',:;';r,,;f,.;:,: ""+ :"·f .~;.":"JA,~'::-;:;J ;7,7:<':".~(~-t.·,V)f.:::,:;;, '.....~.Vi.."i!,¡!fy;.;~.- .. -;- -.,;; - ;-,:~~,;V;"""-; ~f:"~;~'!i';'t.;¡tj' :',,¡r,';Yi"i'.',',"·'\.', (m~~~ili!~illm:: 'ú ~:~:'~.~X':rll~~¡"':':::.·(I~,·.·-u.ê.v.~~.;.·,rr'¡1::J·Ð'\·;,,>,.. ¡. .~¡ _.' . '-.'....,.:';,.-:~~.... . ·'·-~.'<"~'~'~'~:þ>:,=I:r;'i '~;;¡,:ù:~";~l.",:.t·~···..¡J~;\!.:'~~¡!;'¡':;:r.1t~:":',~. '..: ~"]'(;;'::~~~':~:~\' 's :: :,::,.>,.;~;«:¡..;"'Ä~¡'~:: /,09Z264G / I // (¡)003S8 8. (a) When was the property described at the beginning of the affidavit acquired by decedent? 11 H Ie n DWN (b) Was it acquired by gift, devise, inheritance or purchase? (State which) 1'U~ E'J.I~E£ (c) If by Durchase give the foBowing information: (1) Where did decedent reside (the State in which decedent had his/her permanent residence will suffice) when property was acquired? (2) Was the decedent married when such property was acquired? y /::5 If so, give the name of decedenrs husband or wife. SA N E 'B. -Fó 12, If such husband or wife is now deceased, did such party leave a Will? 9. Did Decedent leave a Will? No If so, (a) was the Will probated? If the will was admitted to probate, name all counties and states in which it has been probated and give the name and address of the executor or administrator. (b) Has there been any contest of the Will or appeal from the order admitting it to probate? To your knowledge, is any such contest or appeal contemplated? 10. If decedent did not leave a Will, was any administration had on decedent's estate? /\)0 If so, name the counties and states in which administration was had and give the name and address of the administrator. 11. To your knowledge are there any debts or Federal estate or state inheritance taxes still owing by decedenfs estate? N () If so, will decedenrs personal estate be sufficient, in your opinion, to pay such debts and taxes? What is the estimated net value of the entire estate? :$ S-O~ Œf}!:!.. + 12. Ust in the following table the name of all children born to or adopted by decedent, whether living or dead, giving all other information called for in the table below. Any adopted children should be designated as such if decedent had no children so state. Name of Child Name of Child's Other Parent fi If Dead, Give Date of Death 2 ~;'.;:U;:llií:~3] i¡Iiii~~~i~~~l~?;! ::::;::::::,:,::Y: ~;~~~~~~ffig¡ ¡::::¡:::;::::;';:""': ·,:;·,:.s:,;,:,,';. ; '~;.·~·IN·¡·'·j·j"..l·i!h:i'¡". :_~. -'·'.'l::!.!.,: - , - ..';'~'~i!;'~I": .. -:.......' ;~~~{.::~ ' , .....:.. ' .: .:.:. ~.:;;. ; -. , . '.', ':':«';':>.' U922646 000359 13. Give information called for in the following table concerning descendants of any deceased child of decedent (whether natural or adopted). If no descendants, so state, Name of Deceased Child Descendants Birth !Address Living or If Dead, Give NIl\, Date Dead Date of Death I " . 14. If decedent left swviving no child or descendant of a child, then list names of decedent's parents and brothers and sisters and give information called for in the following tables. If half brother or sisters, state whether matemal or parental. Name Address Living or If Dead, Give Dead Date of Death Father Mother Brother Brother Sister Sister Descendants of deceased brothers and sister. If none, so state. Name of Deceased Descendants Address Age Living If Dead, Brother or Sister or Dead Give Date of Death 15. If decedent left no children or their descendants, or father or mother, or brothers or sisters or their descendants, then aive the information called for in the followina tables: Name Address Living If Dead, or Give Dead Date of Death Paternal Grandfather Patemal Grandmother Maternal Grandfather Maternal Grandmother Name Uncle or Age Paternal or Address Living If Dead Give lAunt Maternal or Date of Death Dead 3 .....:.:,....:,......,':'.' fJ9~~646 I~ Name of Deceased Uncle Descendants or Aunt Subscribed and swom to before me this 7 My Commission Expires: J - /0-01 ~14 ~\\"""""""/~ i!"~"Q.~ R F£ "'II~ -~~........~...o~ ~ ,. I ... _'. ~ ... "ARY "'. ~ ::.. ." ~ - I. "J:. -. 1·- è: PIlBlC:: - . . - æ-: AT : = :. . .~ .::- \ ... LARGE ... ~ ~ ~~. ..~'# "+h~j;:~!~¡:'1ri, ,. ~III. ,,,,"~~\,,~ ~111'''tII'''''\~ ';.....;..;!."~".....'... ' :-. ,.1-,":.: ", ~ \1,::-';'" o Age ddress .~~~: >.i:,~'.:, ê; ....,,'-. ..."..~ ..·..,"z."\:~.:ê;;;;;.,' 000360 Living If Dead or Give Date Dead of Death ~ ::-~Jfr= 20 ¿J Þ ~~ e~p;J¿# County, c9/YJr1W ~, 4 IIIJ~J I . iIH~;':~, .'.,j ."..\~.,..t','.'.'.:-;". ,.~~~!:...',," ~~*S::i ,!.·j~j~i,'¡~iI8.·;·;;~~·,';Ii,i~iK:::¡,~~:!:":.',¿;;_~~_~.:..c"-":i:'¿:~:1..:':'::-;·~';_i.·.~"<:t",~.." 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