HomeMy WebLinkAbout934508
6010715790
RECEIVING # 934508
BOOK: 677 PAGE: 404
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
AFRDAVlT
000404
I, Lannice P. Montague, being first duly swom UP9n my.,path depq§e and statD as follows:
M' Ii f't?4./!..'.U4£ffl,.. ú-1Uf Ii 114'> tyu:t.- c!J
1. That I am the Successor Trustee ofthe rl7...fw~J llll(~ Trust dated ~
f",~,¿ f'Jr l(jÇ,Cj
2. That on October 30, 1969 in Book 88PR on page 363 of records of Lincoln County Clerk
was recorded a Quitclaim Deed from Harold R. Papworlh and Elmina C. Papworlh to
HR. Pap worth and Elmina C. Papworth as Trustees conveying the following described
land:
SEE A TTACHED EXHIBIT A.
3. The Quitclaim Deed conveying the properly to the trust was not properly defined as
required by W.S. 34-2-122 (1977) in thatthe name of the trust and the date of the Trust
was omitted. The name of th~ Trust is If Po fct'fW<1YtJ,., d. t\,,( : and, the date of
the Trust is ';J;A'I'~ l~lq 1..1. #~~~ ¡? PlÀf(¡(j(j,;'. th.. Living Trust
t.
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4. That said H. R. Papworlh AKA Harold R. Papworlh died on the --1.!1- day of h~ b
J 7 ~ and a copy of the original cerlificate of death, cerlified to as true an correct by
public authority in which the original of said cerlificate is a matter of record, is attached
hereto as Exhibit "8".
5. That said Elmina C. Papworlh died on the --!i- day of I1pr>/ l'rrtnd a copy of
the original cerlificate of death, cerlified to as true an correct t1y public authority in which
the original of said cerlificate is a matter of record, is attached hereto as Exhibit "C".
7. That by reason of deaths of said H.R. Papworlh AKA Harold R. Pap worth and of Elmina
C. Papworlh and by reason of §34-2-122 W.S. (1980), the decedents interest and title
in said conveyance has terminated and title to the real property conveyed thereby ha~ J .
jÌ¡~ vested absolutely in Lannic;€P. Montague, Successor Trustee of thet! P..~1iJ/I..'1f7J. ~'£þ...,J"--1!.
ry.'41r.!!!Æ trust dated 6f¡¿J ) ~ 'f continuously since the death of the saId dece ent.
*Living -b h(Ic>/'1ó
Dated this 2 3 day of October, 2007.
~
State of
County of
C.A
'S A JJ 0/ IE(,. tJ
I, Lannice P. Montague, do solemnly swear that I have read the foregoing Affidavit subscribed
by me; that I know the contents thereof and verily believe the statements therein contained are t e.
The foregoing instrument was acknowledged before me by Lannice P. Montague this ~
_ day of October, 2007.
Witness my hand and official seal.
1l.z. ~.~
Notary Public
My Commission Expires:
~-Il.. - I-b
Exhibit A
File 6010715790 Description
000405
The land referred to in this. document is situated in the State of Wyoming, County of Lincoln, and is
described as follows:
A portion of Lot 3 of Section 1, Township 31 North, Range 119 West, of the 6th P.M.,
Lincoln County, Wyoming, more particularly described as follows:
BEGINNING at a Cotton Gin Spike set at a point in the North line of Section 1, said
point being 694.07 feet North 89°44'50" West along said North line, from the Spike
found marking the Northeast corner of said Lot 3;
thence South 0°53'36" West 1,309.50 feet to an Iron Pipe Set;
thence North 89°38'53" West 314.18 feet to an Iron Pipe Set;
thence North 0°54'00" East 1,308.96 feet to a Cotton Gin Spike set at a point in said
North line;
thence South 89°44'50" East, along said North line, 314.03 feet, to the Point of
Beginning.
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STATE FILE NUMBER
IA. NAME OF DECEDENT-FIAST
(GIVEN)
HAROLD
liB. MIDDLE
1 RAY
,
8. HrsPANlc-SPKCIPV
LOCAL RI!GISt""TtON DISTRICT AND CaRTlflICAT. NUMBI!"
2A. DATE OP DEATH-MO. D..Y. VA,.2B. HO,,", 3. SEM
February 191 1993 10130 M
Cauc. .
October 12,
I,. UND." 2" HOU"S
Houns MINUTES
I
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19 TO 19
J IliA. U.U~L OCCU~ATION
A~ .
.... Business Mana er
p.. . I8A. RUIDIINC. STRUT AND NUM".II OR LOCATION
~ 36 West 4th Ave.
i~' :~§;C~'H
~ 190. STREBT ADDRESS IIT".ET "NO NUMII.R 0" LOCAnON
6682. Hu'~.son Pl.
B. STATE OF 9. CITIZEN OF WHAT
BIRTH COUNTRY
WY USA
Osborne Tavener
7. AGE IN II' UNO." I vaAII
"1/!fRS ' MONTHII DAYII
tJ/· I I
I
lOB. STAT. OF 11A. FULL MAIDEN NAME OF MOTHER
I I BIRTH '
Papworth: UT Grace Christy Couey
11 B. STAT. O~
I BI"T"
: UT
4. RACE
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18. SOCIAL SIICUIIITY NO.
14. MA"'T"L STATUII
lB. N~ME OF SURVIVING·SPOUSE ~~ WIP.. EN18" MAID.N N"MSI
520-34-9002
Widowed
,-- ,;
I II1B. USUAL KIND OP BUSIN..S
011 INDUST"Y
: School District
, 1 IIC. USUAL EMPLOYE"
: Lincoln County
1.IBD. VEA"S IN
I - ~CCUI'AnON
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ISB. CITY
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17. EDUCATION-VEA"S COMPLnED
16
Afton
ISC. ZIP COD.
I
83110
19B. IF HOSPITAL. SPECII'Y IIIC. COUNTY
: ONE' IP. ER/OP. DOA :
San Die 0
~O. NAM" RELA TIONIIHI~. MAlLIN. ADORE"
AND ZIP COD. OF INFO"MANT
'Lannice Montague, daug.
,6682 Húdson Pl.
San Die 0, CA 92119
,IBE. NUMSER OF v....". ,IBF. STATE 0" FO".,GN C.OUNT"Y
1 IN THIs COUNTY ,
82 WY
22. w.o. DBA,... R.I'O"T8D TO CO"ON.'"
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IF va.. LIST TYP..O~ OP.RATION AND DATI!.
, ~"""-Ð
I C.RTI" THAT TO ,.... BRST QF M1 KNOWLEDG. DEATH 278. .UJ~URI AND DE..REI OR TITL& OF CE"TlFIE" 27C. CIRn"'E"·. LIC.NII. NUM.....
OCCUR"ED AT TH. HOUR. OAT. AND PLACE STATED F"OM TH.1 -' ,-.., ~I G ~ -'2 6·
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"<:J' 27A. DECEDENT ATTINDID IINC.' DECIOINT LAST SEEN ALlV. I
MONTH. 0,01. VEAR : MONTH. DAY V.AR , 27E. TYPE AlTENDING PHYSICIAN'S NAME AND ADDRESS
~ /2.1 (90 I 11116/ r:¡ z. I David L. Lorenz, M.D., 1240 Broadway, E1 Cajon, CA
I I DE. CITY
I San Diego,
CENTHR ONL V ONE CAUSE! PER LINE FOR A. B. AND C,
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25. OTH'" SION1"'CA~O",!,TIONI CONT",.unNG TO.D.AT" BUT NOT RIlLATED TO CAU" GIVEN IN 21
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I CE"TlFY THAT IN M1 O~INION DEATH OCCUR"ED AT
TH. HOUR. DATI AND PLACE STATIO F"OM THI CAUSES
STA18D.
2SA. SI.NATu"a AND TITLe Of' CO"ONER OR DEPUTY CO"ONER
I 28B. OAT. SIGNED
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I 30B. INJUR1 AT WO"K , 3OC. DATE OF INJUR1 31. Ho,,",
I D D ' MONTH. 0,01. VEA
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33. D..CR... HOw INJURY OCC,,""IID "V.N'. WHICH "..UL TaD IN INJURY)
29. MANNE" OF DBAT..-1 IIdtJ !lilt: nal".." accident.
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3B. REGISTRATION DATE
FEB 2 0 1
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A 311A. NAME OF PUHB"AL DI"eCTOII fO" ~ER.ON ACTING ... .UCH) I 38B. LICENSE NO.
Featheringi11 Mortuary I 1083
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Exhibit "e"
STATE OF WYOMING
000')01-
TYPE
OR PRINT
IN
PEAMANENT
INK
FOA
INSTAucnONS
SEE
HANOBOOK
LOCAL FILE NUMBER
DECEDENT -NAME FIRST
DIVISION OF HEALTH AND _DICAL SERVICES
CERTIFICATE OF DEATH
MIOOlE
LAST
STATE FilE NUMBER
DATEOFDEATHtMo..Day, Yr.}
40.
1904
COUNTY OF DEATH
IF DEATH
OCCURREO IN
INSTITUTION.
see HANDBOOK
REGAADING
COMPlETION OF
RESIOEN~
STATE OF BIATH(lfnoÆin U.S.A..
Uta h..m.coUftlryl U.S.A.
.. 9.
SOCIAL SECURITY NUMBER
7.. Aft 0 n ,
SURVIVING SPOUSE (/fw;ft. .,1Ir meaide" norrw)
7d.Li n col n
WAS OECEDENT EVER IN u.S.
ARMED FORCES?
(SPft'f{\J')~ or NoJ
12.
KINO OF BUSINESS OR INDUSTRY
11~arol d
Papworth
520-34-9003
13.
RESIOENCE-STATE COUNTY
Education
140.
CITY. TOWN OR LOCATION
15b~in co 1 n
MIDDLE
15.. Af ton
LAST
36 w. 4th
FIRST
FIRST
MIDDLE
Frederick Campbell
Le t tl e Dewey
INFORMANT -NAME (Type or Prin.t}
MAILING ADDRESS
CITY OR TOWN
STATE
ZIP
18b. box 14
CEMETERY OR CREMA TORY-NAME
Afton, WY
LOCATION
83110
CITY OR TOWN
STATE
PM
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~
80
1;!!i
OU
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22..
PRONOUNCED OEADrHourl
HOUR OF DEATH
22b.
PRONOUNCED DEAO (Mo.. Da.v. Yr.
22d. ON
220. AT
I InllHVal between onset and de:
I
n onsel and del
(e)
PART IZT SIGNIFICANT CONDITIONS-Condillons conlributing 10 dealh
II
C '.
ACC.. SUICIDE, HaM.. UNDET.,
OR PENDING INVEST. (Sp«ify
NO
INJURY AT WORK' Specify Ytt.
, orNoJ
28b. 28..
PLACE OF INJURY-At home, rarm, atreel, 'aclory, office building,
.tc.(S~cifyJ
STATE
M 28d.
LOCATION
STREET OR R.F.O. No.
CITY OR TOWN
281.
28g.
',--,..
.-.\. ',~
THIS IS TO CERTIFY that this reproduction is a true copy of
a record on file in Wyoming Vital Records Services, Cheyenne,
Wyoming.
If this copy does not bear a raised seal and the signature of
the Deputy State Registrar is not in RED, this is not an official
certified copy.
Da te Issued
;; .'
~f~&--.s) ~~-Z__
Deputy State Registrar
April 16, 1987
..:..