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RECEIVED 8/24/2007 at 10::
RECEIVING # 932428
BOOK: 669 PAGE: 826
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
PROOF OF DEATH AND HEIRSHIP
STATE
COUNTY
WYOMING
LINCOLN
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Ò00826
Affidavit of Death and Heirship concerning the estate of MARY ANN EVERTS ,decedent; Affecting title to the
following described lands in Lincoln County, State of Wyomina
TOWNSHIP 24 NORTH. RANGE 118 WEST. 6th P. M.
Section 25: SW~SW~
Section 26: W~SE~. SE~SE~
Containing 160.00, acres more or less.
ROBERT EVERTS, of P. O. Box 21, Fairview, Wyoming 83119, of lawful age, being first duly sworn, states:
That the statements hereinafter set forth, including answers to questions, constitute a true and correct and complete
statement of the family history of the person hereinafter named as "decedenf and of the estate of such decedent.
è.' Name of decedent:
MARY ANN EVERTS
I Date and Place of Death:
Died in December of 1969 as a residence of Salt Lake City. Utah
Was Decedent married or single at the time of death: Widow
Did Decedent leave a will?
Where: City:
. Has the estate ever been probated? No
; State
No
; County
Is administration pending on the estate of Decedent? No
; If so what court, county and state?
Has an Executor, Administrator, or Personal Representative been appointed for the estate of the Decedent? .M2..
If so, give his/her name and address:
What is the present condition of the administration? (answer this question whether or not decedent left a will.)
Decedent did not leave a Last Will and Testament and there is no Dendina administration of her estate.
If Decedent was married one or more times, give the following information (list names in order of marriages)
Name of Spouse
living or
Dead?
Deceased
Date of
Death
7/23/1960
Plate of Death
Divorce
Kemmerer. Wvomina
Charles Lorenzo Everts
If decedent had any children by any spouse, give the following information:
Robert Everts
P. O. Box 21
Fairview. Wvomina 83119
Present
Age
75
Son or Living or
Daughter Dead
Son Livina
Name of Child
Address:
If decedent had any children by adoption, give the following information:
Name of Child
Address
Present Son or Living or
Age Daughter Dead
None
For each child adopted state the County, State, and date of adoption:
The above named children who have died had only the following children (natural or adopted) and other heirs:
000827
Name of Deceased Child:
Names of Spouse
or child:
Address:
Age: Living or
Dead:
None
In case decedent left no surviving spouse and no children or children of deceased children, give the following
information:
Name
Address:
Living or
Dead
Date of
Death
Mother:
Father:
Brother:
Sister:
Niece:
Nephew:
That all of said heirs at law were and are of sound mind, and that none of them are incompetent, except:
Affiant states he was well acquainted with the financial condition of the decedent and knows that decedent died solvent
and that all debts against the estate were paid in full.
Was the land described in the caption hereof occupied by the decedent as a homestead at the time of death? No
STATE OF WYOMING
COUNTY OF LINCOLN
)
)
)
The undersigned being first duly sworn, deposes and says:
That Affiant is the SON of the decedent, and was acquainted with the decedent, MARY ANN EVERTS, during
decedent's lifetime, and that Affiant was well acquainted with the family of the decedent, and with all those who under
the laws of the State of Wyoming would be the heirs of the decedent, and that the above statements and answers are
based upon the personal knowledge of Affiant and are true and correct to the best of the undersigned's knowledge and
belief.
:Urth:<;~otl2ý A-
'" ROBERTEV~
/1/Æ day of ~O,r;' / , 2007.
~~d~
SUBSCRIBED AND SWORN to before me this
My commission expires: t¡ ILI.I ;l'll /0
SEAL:
ROXIE JENKINS NOTARY PUBLIC
COUNTY OF . STATE OF
LINCOLN WYOMING
MY COMMISSION EXPIRES APRIL 4. 2010
STATE OF WYOMING )
) ss
COUNTY OF LINCOLN )
BEFORE ME, the undersigned, a Notary Public, in and for said County and State, on this /7f!! , day of April, 2007,
personally appeared ROBERT EVERTS to me known to be the identical person described in and who executed the
within and foregoing instrument of writing and acknowledged to me that he executed the same as his free and voluntary
act and deed for the uses and purposes therein set forth.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal the day and year last hereinabove
written.
My commission expires:
¡¡J¡ !J-tJ! ()
ROXIE JENKINS NOTARY PUBLIC
COUNTY OF . STATE OF
LINCOLN WYOMING
MY COMMISSION EXPIRES APRIL 4. 2010
SEAL: