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000258
AFFIDAVIT OF SURVIVORSHIP
I, Betty Jean Bundy, after being duly sworn according to law, do hereby state and
affirm that the following-described property:
Lot 592 of Star Valley Ranch RV Park Plat 2 as platted and recorded in
the Official Records of Lincoln County, Wyoming
was conveyed by Leisure Valley, Inc., a Nevada corporation, to James A. Bundy and Betty
Jean Bundy, husband and wife as joint tenants on the 20th day of October, 2006 by Warranty
Deed; that said Warranty Deed was filed in the Office of the County Clerk of Lincoln County,
Wyoming on the 2ih day of November, 2006 at Book 641, Page 247. A Corrective Warranty
Deed from Leisure Valley, Inc., a Nevada corporation, to James A. Bundy and Betty Jean
Bundy, husband and wife as joint tenants with full rights of survivorship was executed on the
-tJ'7
~ day of January, 2008 and filed in the Office of the County Clerk of Lincoln County,
th .
Wyoming on the JK day of January, 2008 at Book6cf<¡ , Page I C¡L/.
I further state and affirm that I, Betty Jean Bundy, am named in said Warranty Deed
and said Corrective Warranty Deed as one of the Grantees; that James A. Bundy, the other
Grantee, died in Cheyenne, Wyoming, on July 6, 2007; that a copy of the Death Certificate of
James A. Bundy, duly certified, is hereby attached to this Affidavit; that the joint tenancy
between myself and James A. Bundy was terminated by death and that I, Betty Jean Bundy,
anl the sole survivor of said tenancy and, therefore, the sole owner in fee simple of the
above-described property; that this Affidavit and the accompanying Death Certificate are
prepared in accordance with Section 2-9-102 and 103 of the Wyoming Statutes.
DATED this ~ day of January, 2008.
,~~~~
Betty Jean Bundy/ ' 7
STATE OF WYOMING )
)SS
COUNTY OF LARAMIE )
Subscribed and sworn to before me by Betty Jean Bundy this ~y of January,
2008.
NO ARY
My Commission EXPireS~ 7, 2.ð.l.:<
RECEIVED 2/11/2008 at 12:33 PM
RECEIVING # 936835
BOOK: 686 PAGE: 258
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
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"·"STATÈiO:F"mOMING
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Decedent:
Name:
Gen.d~r: /\
Dat~ óf Birth:
.H,DI;AIHCERTlfICÀ TE
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James Alan Bundy
··}"·"",Male,·, "'",,' ",',"
< JuriØ 30, 1~31
H JtatlFife~U~ber:20oAooko!9
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SociaJSecurityN\Jmber: ~ .".~ , .
Age~!~he}~i!f1eþfDe~th: 76xear~
Dat~ and Plaåe.ofDeath:.
Oate of D~ath:I, ,July Oq;' 2001
City of Death: :HCheyehne>"
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AddltionaIDecØdent.lnformatioœ.." . ,"
Plaqe of$irt~:'Go~eville,YVyoq,i~g",
Residence:' "",., 'Cheyenn~f\^lyoTtng,'"
Marital Status: . Married < ' "<),'
Nameóff; atþer'::'liomer,;BiJ n,(lìj} "~'Wi/·.'I./
Maidèh Name ofMöther: 'Eleanor/Gléason};,
Informant: Betty Jean Bundy "
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Dispositibn~; "'.....),.\
Method of'Disposition:
Place of Disposition:
Manner of Death:'NaturaVDeath"
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Certifier:
Name:
Address:
Date Filed: