HomeMy WebLinkAbout928184
IY
000644
AFFIDAVIT OF SURVIVORSHIP
STATE OF WYOMING )
) SS
COUNTY OF LINCOLN )
Denna Lee Fluckiger, being first duly sworn, upon oath, deposes and says:
1. John 1. Fluckiger and Mary Ada Fluckiger conveyed, by Warranty Deed dated April
1, 1958, the same being recorded with the Lincoln County Clerk in Book 26PR Page 535 No. 222813
on April 8, 1958 (a copy of which is attached hereto and incorporated herein), certain real property
described therein to Jack T. Fluckiger and Denna Lee Fluckiger, husband and wife, reserving unto
John J. Fluckiger and Mary Ada Fluckiger the right to occupy during the period oftheir natural lives,
both or either ofthem, the home and lot then occupied by John J. Fluckiger and Mary Ada Fluckiger.
2. John 1. Fluckiger, also known as John Joseph Fluckiger, died at Afton, Wyoming on
June 2, 1961. Attached is a copy of his official Death Certificate certified to by the State of
Wyoming Department of Health, the public authority with which the original Death Certificate is
of record according to law.
3. Mary Ada Fluckiger, also known as Mary Ada Turner Fluckiger, died at S1. Anthony,
Idaho on April 30, 1971. Attached is a copy of her official Death Certificate certified to by the State
of Idaho Department of Health, the public authority with which the original Death Certificate is of
record according to law.
4. By reason of the deaths of John 1. Fluckiger and Mary Ada Fluckiger, the life estate
reserved unto John J. Fluckiger and Mary Ada Fluckiger tenninated and Jack T. Fluckiger and Denna
Lee Fluckiger became the sole owners of the above-described real property on April 30, 1971.
RECEIVED 4/6/2007 at 2:23 PM
RECEIVING # 928184
BOOK: 653 PAGE: 644
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
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Denna Lee Fluckiger ~
The foregoing instrument was acknowledged before me by Denna Lee Fluckiger, this ~
day of April, 2007. Witness my hand and official seal. My commission expires: 9 -/__1; -()7
SEAL
APcvUcvk ~
Notary Public .
GLORIA K. BYERS· NOTARY PUBLlO
County of ~ State of
llncoln . Wyoming
My Commission Expires Sept. 15, 2007
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This is a true and exact reproduction of the document on file in
the ðffice of Vital Records Services, Cheyenne, Wyoming.
Ah1 -,-·3
2007
Date Issued:
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Gladys K. Breeden
Deputy State Registrar
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0928184
STATE OF IDAHO
IDAHO DEPARTMENT OF HEALTH AND WELFARE
BUREAU OF HEALTH POLICY AND VITAL STATISTICS
000646
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MARY ADA TURNER ~LUCKIGER
74 YEARS
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CERTIFICATION OF FACTS OF 'DEAtH
Date Flied
MAY 07, 1971
State File No.1971i - 0 0 17~3
AGE
SEX
SOCIAL SECURITY NUMBER
DATE OF BIRTH
30, 1971
FEMALE
SEPTEMBER 02, 1896
WAS DECEDENT EVER IN
U.S, ARMED FORCES?
MARITAL STATUS
PlACE OF DEATH
WYOMIN.G
UNKNOWN
WIDOWED
ST. ANTHONY, IDAHO
RESIDENCE. CllY, TOWN OR LOCATION
WYOMING
BEDFORD
BIRTHPLACE
STEPHEN TURNER
UNKNOWN
BIRTHPlACE
MARY ANN MICHAELSON
UNKNOWN
BEDFORD CEMETERY, BEDFORD, WY
HANSEN MEMORIAL CHAPEL
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This Is a true and correct reproduction of the document officially registered and placed
on file with the IDAHO BUREAU OF HEALTH POLICY AND VITAL STATISTICS,
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DATE ISSUED: MARCH 30. 2007
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JANE S. SMITH
STATE REGISTRAR
This copy not valid unless prepared 0,\ engraved border
displaying stata S~,¡¡J and slgnatur~" of the ~eglstrer,