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AFFIDA vir OF SURVIVORSHIP
000230
THIS AFFIDAVIT is made pursuant to W.S. § 2-1-201 by Daniel R.
Levenhagen and Kiefer Ludlow, who, being first duly sworn and upon their oath,
state as follows:
1. Daniel R. Levenhagen is the father of Marcie Gale Levenhagen
who died intestate on May 28, 2007, in Kemmerer, Lincoln County,
Wyoming.
2. Kiefer Ludlow is the son of Marcie Gale Levenhagen who died
intestate on May 28,2007, in Kemmerer, Lincoln County, Wyoming.
3. At the time of her death Marcie Gale Levenhagen was a resident of
Lincoln County, Wyoming.
4. We are the sole heirs and distributees of Marcie Gale Levenhagen,
and there are no other heirs or distributees having a right to
succeed to the property of Marcie Gale Levenhagen.
5. The value of the entire estate of Marcie Gale Levenhagen,
wherever located, less liens and encumbrances, does not exce,ed
one hundred fifty thousand dollars ($150,000.00).
6. Thirty (30) days have lapsed since the death of Marcie Gale
Levenhagen.
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7. No application for appointment-õra-persoñarrepresentativë--îS-
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pending or has been granted in any jurisdiction.
-
8. As claiming distributees, we are entitled to payment or delivery of
any tangible personal property of Marcie Gale Levenhagen,
RECEIVED 10/11/2007 at 9:43 AM
RECEIVING # 933932
BOOK: 675 PAGE: 230
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
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including motor vehicle titles, property in safety deposit boxes,
and/or deposits held by any bank, savings and loan institution,
credit union, asset management service, or like depository.
000231.
DJ ~~~Á~~
Daniel R. Levenhagen \
~ LJ¿¿
Kle LudlO~
STATE OF WYOMING )
) ss.
County of Lincoln )
The undersigned DANIEL R. LEVENHAGEN, being first duly sworn,
states that he has read the foregoing Application and hereby affirms the
same as the truth to the best of his knowledge and belief.
~u~ R J~e'1
D mel R. Levinhagen -
DANIEL R. LEVENHAGEN, personally known to me did appear
before me and, upon being duly sworn, personally did sign the foregoing
document and verification thereof this q--ft1 day of OC¡""" her
2007.
Witness my hand and official seal.
KRISTINE RICHARDSON - NOTARY PUBLIC
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MYCOMMISSIONEXPIRESJULY1T,200S- ---~----------- -- N-o ~ry Public'--
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My Commission Expires: ~ /7, d-oO 8"
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STATE OF WYOMING )
~ sl
County of Lincoln
000232
The undersigned KIEFER LUDLOW, being first duly sworn, states
that he has read the foregoing Application and hereby affirms the same as
the truth, to the best of his knowledge and belief.
~_/~
- Kiefer: udlow
KIEFER LUDLOW, personally known to me did appear before me
and, upon being duly _ sworn,~erSOnallY did sign the foregoing document
and verification thereof this ~ day of tJ cf-o b.ør- , 2007.
Witness my hand and official seal.
KRISTINE RICHARDSON· "JOTARY PUBLIC
COUNTY OF _ STATEOF
LINCOLN _ WYOMING
MY COMMISSION EXPIRES JULY 17, 2008
&~ß~tÆ~
Notary Public
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My Commission Expires:
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