HomeMy WebLinkAbout934421
STATE OF WYOMING )
) ss.
COUNTY OF LINCOLN )
RECEIVED 10/29/2007 at 3:55 PM
RECEIVING # 934421
BOOK: 677 PAGE: 92
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
000092
AFFIDAVIT OF SURVIVORSHIP OF JOINT TENANT IN REAL PROPERTY
I, LAURA M. KAISER, Affiant, being of lawful age and first duly sworn, upon my oath
depose and state as follows:
1. I am an adult residing in Lincoln County, Wyoming.
2. This affidavit is made pursuant to W.S. § 2-9-102 (Lexis 2007).
3. By virtue of a Quit Claim Deed executed by Robert E. Beutler on March 9th, 2005,
and recorded in the records of the Lincoln County Clerk at the Lincoln County
Courthouse in Kemmerer, Wyoming, on March 9th, 2005, in Book 580, Page 468,
Receiving Number 906964, I am a joint tenant with Robert E. Beutler in the following
described real property located in Kemmerer, Lincoln County, Wyoming, to wit:
Lot 5 and the Northerly one-half of Lot 6 of Block 7 of the F airview
Addition to the Town of Kemmerer, Lincoln County, Wyoming as
described on the official plat thereof.
4. Robert E. Beutler died on December 2nd, 2006, and a certified copy of the original
death certificate on file in the office of Vital Records Services in Cheyenne, Wyoming, is
attached hereto as Exhibit "A".
5. By reason of the death of Robert E. Beutler his interest and title as a joint tenant
under said Quit Claim Deed is terminated and title to said property has vested absolutely
in Laura M. Kaiser continuously since the death of Robert E. Beutler.
FURTHER AFFIANT SA YETH NOT.
DATED this :J..q~aYOf &fo~r
,2007.
~/ÁÅa 01.. CÞ<~
~M. Kaiser
The foregoing instrument was subscrLbed and sworn tOJn~ by LAURA M. KAISER,
personally known to me, this ;:)q ~day of ~"ft:J'æ./ , 2007.
Witness my hand and official seal.
DENISE SARGENT - NOTARY PUBLIC
COUNTY OF STATE OF
LINCOLN WYOMING
My Commission Expires May 10, 2011
~~I ~h*
No ary Public .
I{J~ Z() II
My Commission expires: ~
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Decedent:
Name:
Gender:
Date of Birth:
DJêATH CERTIFICATE
\:~ta~:~ileNuL~er: 2d~6~OÖ37;8
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.}.SociaISecurity Nurr¡ber: .. ....
....... J}ge at l~eTitneOf peath~ 76 years
Robert Earl Beutler
Male .... ",.,.'
May åp, 1939/
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Cause of Deatl'l: <}, .,... /..''''-./.'''..'''...}',.....:..,.\.>,. . .,;. 0:' ..... .:...,.......
The immediatecauĊĦeis listedÒn thefi~#Jineiollowed by anYuáderiying c,auses.
(a) Metastatic Salivary I DuctCancer.· i . '" .......... .... '.'. .' .. . " .'
Qther $Îghifica/1t qÞr:tditiqris:··NqtRep6f~edJ,.··"c
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Date and Place of Death:
Date Ôf Deåth:i Ðeëembe(Ö2,2ÖQ6
Cityof Death: Kemmerer....··;
......Additional Deccder!t Information: ,',:
?i~Cè t¡f óittt,:·;: P.l)ê~t¢ílO, ia~h()+r
Residence:' . Kemnierer,Wyonììng
Marital Status: Widowed .... ....... .....,..:
Nar,neofFather:(i;toyd EarIBeutléÞ"C>
Mald.en Name of MÞther: Ma~..Bëaçh~m:'
Informant: Laura Kaiser ... ".
Ç}ÒUptYOf Oé~th: LigëOln'"
·..Disposition:<f)
Method of Dispòsition:,
Place of Disposition: ..
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Manner of Death: Natural Death
Certifier:
Name: .
Address:
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becerhber 08/2066/