HomeMy WebLinkAbout936843
STATE OF WYOMING )
)ss.
COUNTY OF LINCOLN )
AFFIDA VIT OF SURVIVORSHIP
RECEIVED 2/11/2008 at 12:38 PM
RECEIVING # 936843
BOOK: 686 PAGE: 269
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
RA YMA ANGLESEY, being first duly sworn on oath deposes and say:
1. That RA YMA ANGLESEY is of adult age and is the surviving wife of Keith H.
Anglesey, who died December 9,2007, in Idaho Falls, Idaho, as hereinafter more fully appears.
2. That by a Quitclaim Deed dated April 5, 1996, and recorded April 8, 1996, in the
office of the Lincoln County Clerk in and for the County of Lincoln, State of Wyoming, in Book
382 PR, Page 22, Eric J. Shumway and Heidi Shumway, husband and wife, conveyed to Keith
H. Anglesey and Rayma Anglesey, husband and wife, as tenants by the entireties, ofP.a. Box 36,
Smoot, Wyoming 83116, Lincoln County, State of Wyoming, the following described real estate
situated in Lincoln County, State of Wyoming, to-wit:
That property as described on Exhibit "A", a copy of which is attached hereto
marked as Exhibit "A" and by this reference made a part hereof.
:')ó
SUBJECT TO reservations and restrictions contained in the United States Patent
and to easements and rights-of-way of record or in use.
TOGETHER WITH all improvements and appurtenances thereon.
5. That Keith H. Anglesey died on the 9th day of December, 2007, in Bonneville
County, State ofIdaho, and thereupon, the certificate of his death was duly filed with the State of
Idaho and made a matter of record in said office, and a certified copy of said certificate is attached
hereto and made a part of this affidavit.
6. That upon the death of Keith H. Anglesey, as aforesaid, the joint tenancy created by
the aforesaid deeds were tenninated, and Rayma Anglesey, surviving wife, became vested with all
of his right, title and estate in the above property.
DATED this 7th day of February, 2008.
~»<-<~~
Ra "Angles C/
2008.
SUBSCRIBED AND SWORN to before me by Rayma Anglesey this 7th day of February,
County of
Lincoln
State of
Wyoming
BECKY BARBER - NOTARY PUBLIC
~
My Commission Expires August 3'!, 02(10)
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WARRANTY DEED
ERIC J. SI-IUMHAY and HEIDI SHUMWAY, husband and wife
grantor S of
CONVEY and WAHRANT to
'I Count,y of
Lincoln
. State of Wyoming, hereby
KEI11{ H. ANGLESEY and RAYMA ANGLESEY, husband and wife,
as tenants by the entireties
000270
grantee S of Box 34i Smoot, WY 83126
for the sum of Ten do lars and other good and valuable consideration--------------------
the following described tract of land In Lincoln County, Slate of Wyoming,
hereby releasing and waiving all rights under and by virtue of the homestead exemption laws uf the State, to-wit:
That part of Lot 3, Section 6, T30N, RU8H, Lincoln County, \ryoming, being part
of that tract of record in the Office of the Clerk of Lincoln County in Book 357
of Photostatic Records on page 523, described as follows:
Beginning at the northeast corner of said Lot 3; thence SOo027.5'E, 1341.22 feet,
along the east line of said Lot 3, to the southeast corner thereof; thence S89°
29.21~'¡, 3l9~81 feet, along the south line of said Lot 3, to a point; thence NOoo
27.5'W, 1339.36 feet, parallel with said east line, to a spike on the north line of
said Lot 3; thence N89°09.1'E, 319.81 feet, along said north line to the Corner
of Begimling; ENCOMPASSING an area of 9.94 acres, more or less; the Base Bearing
for this survey is the east line of Section 6, T30N, RU8H, being NOo015.0'H; each
"corner" fOood as described in that Corner Record filed in said Office; each "point"
marked by a 5/8" x 24" steel reinforcing rod with a 2" aluminum cap inscribed
"SURV1'Y SCrŒRBEL LTD BIG PINEY HY PLS 5368", with appropriate details; each "spike"
marked by 3/8" x 12" steel spike; all in accordance with the plat prepared to be
filed in the Office of the Clerk of Lincoln County titled "PLAT TO ACCONPANY PARCEL
DIVISION APPLICATION FOR LAWRENCE H. WELCII \'¡ITI1IN LOT 3 AND LOT 4 SECTION 6 T30N
RU8W LINCOLN COUNTY, HYOMING", dated 1 April 1995. '
Subject to reservations and restrictions contained in the United States Patent
and to easements and rights-of-way of record or in use.
Together with all improvements and
WITNESS, Ihehand of said grantor
, th is
5th
appurtenances thereon.
R~d ,~.~.f.."a.Ù~\,¡...."at...\.:..~..~..p.~...........M
In Book.~.mPa.ge.........Z.z...Kemmerer, WY.
No.............,8.1!.2852............Marsha Moe, Clerk'
da y of April t\ , D. 1996
~ :) ~u-v'.~
Erj~ J. Shumwé}j/,
.11 Æd,' ~1"m'LY/ð-
liei i Shumway
Signed in the presence of
STATE OF
WYOMING
¡
l' ss.
Entry No.
RECORDING 0;\1'/\
fee $
County of
Ou the
A.D. 19 96
Lincoln
5th day of April
personally appeared before me
RECORDED 0
PLATTED 0
COMPARED 0
INDEXED 0 0
AU5TRr\CTElJ 0
DEUVEIŒD 0
Eric J. Shumway aDd lIeidi ShWr.Wãy
the signerS of the within instrument, who duly
aelmowledged to me Ihat t heY executed the same.
PENNY JONES - NOTARY PUBUC
County of ~ Slato of
Uncoln .~ Wyoming
My Commission Expires Sept 13. I ~99 I
---.::.':....:.::-.. ..."......
The knd lìtle (òmpany
/
/
'STATE OF IDAHO
IDAHO DEPARTMENT OF HEALTH AND WELFARE
ª-llREAYuQfHEAL;[H POLICY, AND VITAL STATISTICS
~(?~~.:i:'_ "-.": ',1. ·.f2r,.C - -'~~t9:'Of Idàho'
CERTIFICATE OF DEATH
STATE FILE NO. '
2007-, 10208
< 820-7-
\...
#1,15 amended 01-11-08 ns
DATE FILED BY STATE RE0I8TRARr
DEC 2 ·ft 2001
TYPIOII
.........
P.........,
.lACk ...
DO NOT usa
nLT TIP PIN
PO.
1N8TAUCT1ON8
...
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OM.::"~':~~~~':~~~,:"~~~":=~'::=NII 'Leal Reg.~.
* I. DECEDENT'S LEGAL NAME (Indude AKA'. " any) (FI..~ Middle, Lø.~ SuIIIx) 2. SEX 3. SOCIAL SECURITY NUMBER
,6 H I
: Keith *' ' Anglesey
C oIL AGE·wl Bll1hday 4b. UNDER 1 YEAR <e. UNDER 1 DAY S. DATE DF lATH (Mo/DoyN~
'õ ..... .
~ 61 (Y....)
~ 7.. EBIDENCE· ST"
~ Wyoming
¡¡¡7. REE NUBR
§: 493 Smoot Afton County Road 11148
æ "¡MARITAL STATUS AT TIME OF DEA!H
~ Ì:J Mon1ed 0 MorrIod, buI..p...,.d 0 WIdowed 0 Divorced 0 Nove, monied OUnknown
~ IO'~~MED .. 11.. 'SNA (IIII,M., uf
~ FORCE.? 2a. M
_ OY..
! Ql:No
ð 130.1 FOR
~
(j
¡::
a:
o
:i!
October I, 1946
--
""
Graèe Annie
S AME (1ÿpe '" plinl)
, . .
Rayma Anglesey
* 14. METHOD OF rnSPOsmON
o Buflal - 0 Cf8JM11on
Q_DonaUon 0 Entombment
cKRømov.' from Idaho
oòt Iy
7Qron
83126
NERAL F: CIUTY
\ .
22. CO NTY F
Bonneville
25. DATE PRONOUNCED DEAD (MoIDaylYr) (SpøN monlh)
)
2L TIME PAONOUNCED DEAD
1013 (24h,)
'--
Approxtmate Inlerval:
Onset to Death
z5 kr I
¿-f ~ I
Z-SJ,..'I j
3 /'t11/r11J, I
../
rB~O
IF DEATH WAS
DUE TO 0l'H1!R
THAN NATURAL
CAUSES,
TH8 CQRONm
MIlII
COMPUr,ïB AND
BlGNTIfII
CERl'FICATa
o ~ 0 Probobly
S ~ 0 Unknown
'"
"6. 32. DATE OF INJUR (McYDayfYr)
E (SpoI moI1lh)
8
'..38. 0 ;no
a:
~ S1teelondN""'""'",L.ocoIlon··C. I _Number
i= 37. DESCRIBE HOW I~JURY OCCURRED, IF TRANSPORTATION INJURY, STATE THE TYPE(S) OF VEHICLE(S) INVOLVED (Automoblle,~, mototoyd" e, A ,bicycle, elc.)
.IX: SPECIFY WHICH ,EHICLE DECEDENT OCCUPIED, If appIlesble '
W /
O· ·.TRANSPORTATlON. 38&. WAS DECEDENl1 U DriYerlOperator U PBuenger ; 38b. WHAT SAFETY DEVICE(S) DID DECEDENT USElEMPLOY?
INJURY ONLY ! OPed.strlan OOlher IOSeatael1 o ChHd 881ety seat o Helme' DAlrbag. DNone DUnknown
. 3'a. CERTIFIER (Check only one, bend on oftlQal capacity for thll certIficate) 3ab. UCENSE NUMBER
aø. PHYSICIAN 0 PHYSICIAN ASSISTANT 0 ADVANCED PRACTICE PROFESSIONAL NUnSE'
- To the best of mÿ knowledge. dealh occurred at the time, date, and piece, and due 10 the MlIlllIl cause(IYmanner atated.
o CORONER
- On the basis olllxßfTWnal1on and/or I
and manner alated.
Slgn.lure and TUle of CertiDer"
* 31d. NAME, ADDRESS. MD ZI
¡ 28.. AS AN AUTOPSY I 2Bb. WERE AUTOPSY FINDINGS
. PERFORMED? I AVAILABLE TO COMPLETE
....../"': 1'HE!~USE!OFDEATH?
"OV.. """" ,I o V.. ONo
o Not pregnant, but pregnanl43 days 31. MAN.!JiR Of DEATH
to 1 year before death G14ahJral 0 HomIcIde
o Unknown ø pregnonl wIIhIn the pasl 0 _, 0 Pendi'og 1rMI.1igoIIon
YO.' 0 sUictdo 0 Could notOO_nrinod
34. PLACE OF INJURY (Deoedenra home, lann, street, conetrucUon alIe, as. INJURY :r WORK1....
nur&lng home, Ifttaurant, forest. ate.)
o Yes
o No
(24hr)
J Y:
SIal.
Cltyffown or County .
Zip coo.
416'63D
o lon, 8 occurred 81 the Ume, date', and place. and due 10 the cauøe(a)
380. DATE SIGNED
.J.1.cJ.Lb~
MM DO YYYY
\..
Dr.Dou la
Falls ID 83404 208-535-4 00
. 'I n,
iJ/-r.{"
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MM DD YYYY
41b. DAU SIGNED
~-1.b 'ZPO'i?
MM DO YYYY
I .
This is a. true and correct reproduction of the document officially registered and placed
on file with the IDAHO BUREAU OF HEALTH POLICY AND VITAL STATISTICS
\ .
-------..-----
'.
DATE ISSUED:
JAN 1 1 2008
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c-;)~~~~,
JANE S: SMITH
STATEREG~TJtAR .
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This copy not valid unless prepared on engraved border
displaying ,state seal and signature of the Registrar.
11106 \