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000376
AFFIDAVIT OF SURVIVORSHIP
I, NEOMA R,SOELBfJRG, a,k.a. NEOMA R. HEAP, being duly sworn under oath,
states as follows: \'\A....-
1. RICHARD LEE DANA and I are the record owners, as joint tenants with rights of
survivorship, of property in Lincoln County, state of Wyoming, pursuant to a Warranty Deed
that was recorded in Book 214 PR at Page 6 on May 22, 1984, as Instrument No. 615965; said
property being more particularly described in the Deed attached hereto as Exhibit A.
2. Richard Lee Dana died on JHL¿, 21), , q fc. An original copy of the Certificate of
Death for Richard Lee Dana is attached hereto and incorporated herein by reference.
3. I am hereby requesting that title to the above property be, by the recording of this
affidavit, vested solely in my name: NEOMA R. SOELBURG.
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DATED this _th day of October, 2006.
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NEOMA R.SOELBeRG
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STATE OF UTAH )
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COUNTY OF U/.. )
ON THIS, the It, _ d,y,oJ October, 2006, before me the undersigned, a Notary
Public, in and for the State of ~~ personally appeared NEOMA R. SOELBURG, a.k.a.
NEOMA R. HEAP, who, under oath, signed the above Affidavit of Survivorship, and
acknowledged that the statements contained therein are true and correct to the best of her
knowledge, infonnation, and belief.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the
day and year in this certificate first above written.
RECEIVED 11/6/2006 at 11 :46 AM
RECEIVING # 924105
BOOK: 639 PAGE: 376
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
My Commission expires: ~
~~
NOTA PUBLIC
CHERYL BINGHAM
NOTARY PUBUC. STATE OF UWI
1344 WEST 41675 SOU11t
OGDEN ur ~MtIfIW
My Comm. 1..,...~
OCT. 11.2006 2:05PM
LINCOLN CO CLERK
NO. 836
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000377
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WARRANTY DEED
~ife, Grantors of Thayne, County of Lincoln, and S~ate of Wyoming, for
and in consideration of TEN DOLLARS ($lO.OO) and o~her valuable
consideration,. in hand paid, receipt of which is hereby acknowledged,
BERNARD SEALY LARSEN and ANNA MARCINE LARSEN, husband and
CONVEY AND WARRANT to NEOMA R. HEAP and RICHARD LEE DANA, as joint
tenants with full right of survivorship, whose address is Thayne,
Wyoming, the following described real estate situate in County of
Lincoln and State of Wyoming, hereby releasing and waiving all rights
under and by virtue of the homes~ead exemption laws of the State,
to-wit:
A portion of the Northwest Quarter of the Northwest Quarter of
the Northwest Quarter (NW~NW~NW~) of Section 15, Township 34
North, Range 119 West, of ~he 6th P.M. near Thayne, Wyoming, more
particularly described as follows:
Commencing at a point along the East side of the Lincoln County
Road No. 125 right-of-way Which point is 30 feet east of the
Northwest corner of Section 15, Township 34 North, Range 119 West
of the 6th P.M., Lincoln County, Wyoming, said corner being
marked by a brass cap set by Charles V. King RLS 698, thence east
along the North section line of said Section 15 a distance of 354
feet, thence South along an existing fenoe 358.00 feet, thence
West a distance of 294.00 feet to ~he Lincoln County Road No. 125
right-of-way, thence Northwesterly along said right of way to the
point of beginning. This parcel contains approximately 3 acres
of land more Or less.
WITNESS our hands this 1'1' day of '7r/.a y , 1983.
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RNARD SEALY r. SEN
STATE OF WYOMING )
) SS.
COUNTY' OF LINCOLN )
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N MARCINE a\ EN
. ,.....~'[..."" "" 'I'he foregoing instrument was aCknowledged before me by
. ", ~ ~ '.B:e'Íir).a'rç Sealy Larsen and Anna Marcine Larsen this Æ day of
/'", >. . '"J?((j.9 1993 ·
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; ; \.\0 Þ.'~ (' :..J E WITNESS my hand and
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NOTARY PUBLIC
My Commission Expires:
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