HomeMy WebLinkAbout925509
K~IVI:U IUILUILVVV en .....".... . ...
R . --.. 923584
BOOK: 637 : 712
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
AffffiAVrr OF SURVIVING CO-TRUSTEE
RECEIVEOu 12/2012006 at 3:04 PM
RECEIVING # 925509
BOOK: 644 PAGE: 243
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
SIDELLA C. METCALF, the undersigned, being first duly sworn upon oath deposes and
Ouu'/12
STATE OF WYOMING
)
) ss.
)
COUNTY OF LINCOLN
states:
1. I am the wife of Donald J. Metcalf and the surviving Co-Trustee of the Donald J.
Metcalf Revocable Trust.
2. Donald J. Metcalf died on August 5, 2002, a resident of Etna, Lincoln County,
Wyoming. A certified copy of his death certificate is attached to this Affidavit.
3. Donald J. Metcalf entered into a Trust Agreement, as Settlor and Co-Trustee, dated
November 1, 1996 which is named the Donald J. Metcalf Revocable Trust (hereinafter referred to
as "Trust Agreement"). I was the other Co-Trustee named in the Trust Agreement.
4. Donald J. Metcalf and Sidella Clinger Metcalf executed a Quitclaim Deed dated
November 1, 1996, which conveyed certain real property to Donald J. Metcalf and Sidella C.
Metcalf, Co-Trustees of the Donald 1. Metcalf Revocable Trust under agreement dated November
1, 1996. The Quitclaim Deed is recorded in the official records of Lincoln County, State of
Wyoming, in Book 390PR, page 378. Such Quitclaim Deed covered the following described real
property, situate in Lincoln County, Wyoming, to wit:
~,
Beginning at a point 337 feet West from the SE corner of the NWY-í
of Section 12, T35N, R119W, and running 313 feet West, thence 313
feet North, thence 313 feet East, thence 313 feet South to a point of
origin, containing 2.26 acres, more or less.
(4'
/)
¿,-
5.
Donald J. Metcalf and Sidella Metcalf executed a Quitclaim Deed dated November
1, 1996, which conveyed certain real property to Donald J. Metcalf and Sidella C. Metcalf, Co-
Trustees of the Donald J. Metcalf Revocable Trust under agreement dated November 1, 1996. The
I
Quitclaim Deed is recorded in the official records of Lincoln County, State of Wyoming, in Book
390PR, page 379. Such Quitclaim Deed covered the following described real property, situate in
Lincoln County, Wyoming, to wit:
Lot #4 of the Rees Subdivision, Lincoln County, Wyoming.
6. Donald J. Metcalf entered into an amendment to the Trust Agreement on December
10, 1997, which amended the Trust Agreement in its entirety. I continued as the other Co-Trustee
named in the Trust Agreement, as amended.
Affidavit of Surviving Co-Trustee, Sidella C. Metcalf
Page 1 of2
-...."'-~-..!iv....,,
03;':;J5~/l
000244
00071.3
7. Pursuant to paragraph 14.05 of the Trust Agreement, as amended, I became the sole
Trustee of the Donald J. Metcalf Revocable Trust upon the death of Donald J. Metcalf.
Dated this ,¿ 7 day of ~ ~ ~ ~ , 2005.
~á,~a ~
idella C. Metcalf
STATE OF MISSOURI )
) ss.
COUNTY OF JASPER )
The above and foregoing Affidavit of Surviving Co-Trustee was subscribed and sworn to
before me by Sidella C. Metcalf this f)1 -t.!J day of OQlI QJYìbe£"" , 2005.
Witness my hand and official seal.
EMIL'{ GARCIA
Notary Public - ¡·;·)tary Seal
State of Missouri, .;.isper County
Commission # ')5781528
My Commission Expires: Oct. 11, 2009
My Commission Expires:
~
Affidavit o/Surviving Co-Trustee, Sidella C. Metcalf
Page 20/2
..............................n...··..STÄTE·OF··ÜTAH··=-ÕEPARTMËNT -OF-¡::¡ÊÃl TH --- 00 Q
CERTIFICATE OF DEATH STATE FILE NUMBER 0245
MIDDLE LAST 3.. DATE DF DEATH (Mo.. Diy. Yr.) 3b. TIME DF DEATH (24 .
Dona I d J.
4. DATE OF BIRTH (Mo.. Doy. Yr.)
Dee 23, 1922
8.. PLACE HOSPITAL I...... _. ""Ho.",,,,,,,,,,}: ALL OTHER LOCATIONS:
~~ I ~ 1. Inp.llont I 0 5. Nursing Hom. 0 8. R..ld.nc. (ony)
one) 02. ERJOutpol1ont 03. DOA 0 7. Olher (.podfy)
8e. CITY. TOV\ot . DR LOCATION OF DEATH 8d. COUNTY OF DEATH
Male Au ust 05 2002 1220
8. BIRTHPLACE (City & SIote or FonIign Counl/)'} 7. SOCIAL SECURITY NUMBER
RexDurg, Idaho 528-20-4203
8b. NAME OF HOSPITAL. NURSING HDME OR OTHER FACILITY
(if outside a facility, give street addreu oIlocaticn)
University Hospital
9. SURVIVING SPOUSE (II wile. give mokien n.me)
Salt lake
10. WAS DECEDENT
EVER IN THE U.S.
ARMED FORCES?
!J1. v.. 0 2. No
138. RESIDENCE· STREET AND NUMBER
739 South 600 East
131. ZIP CODE 14. wAs DECEDENT OF HISPANIC ORIGIN?
(If ye~ Spodfy)
Salt lake Sidella Clinger
120. OECEOENrs USUAL OCCUPATION (Glve/rlnd of work done 12b. KIND DF BUSINESS OR INDUSTRY
during moll of worldng Ute. Do NOT ent8/" retired)
Retired Col.
U.S. Army
3. Puerto Rican
13b. CITY. TOVIIN OR COMMUNITY 13c. COUNTY 13d. STATE
Salt Lake City Salt Lake Utah
o l.y.. I!] 2.No 15·:~~i':~:':~;'d). 16'=~;I:i1~~~h:"
J.p.n.... .Ic. (Specify) S.cond./}' (0-12) Colleg. (13·16
or 17+)
16+
White
84102
o 1; Mexlcon
o
o 2..CubIIn
o
4. Other (Specify)
17. FATHER'S NAME (First. Middle. Lo") 18. MAIOEN NAME OF MOTHER (First, Middl., u.t)
John L. Metcalf Mary Jensen
19. NAME. RELATIONSHIP AND MAILING ADDRESS OF INFORMANT
Sidella Metcalf (Wife) 739 South 600 East Salt Lake City, Utah 84102
20. METHOD OF DISPOSITION
218, DATE OF DISPOSITION 21b. PLACE OF DISPOSITION (name afcemetery, 21c. LOCATION· City or Town. State
crem.tory, or other place)
0.1. Entombm.ntO 2. Donollon 0 3. Other
04,Burlat QPt CremellonO 8. R.mov.1 August
I.P.S. Crematory
SLC, Utah
23. LICENSEE NUMBER
48708
24. FUNERAL HOME (N.me and IJddress)
Independent Professional Services
1. v.. 2. No '4555 So. rRedwood Road
Salt Lake Ci§¡12~tah