HomeMy WebLinkAbout938657
STATE OF UTAH )
) SS.
COUNTY OF DAVI'S' )
000485
AFFIDAVIT TERMINATING LIFE ESTATE
I, Roxie Dabel Bird, being of lawful age and first duly sworn according to law, upon
my oath, depose and state:
1. That I am of adult age, a resident of.Jb:e.,-0 a~iA4 -z¡; ~ and the
Affiant herein. '
2. That by virtue of the conveyance which is recorded in the office of the
County Clerk for Lincoln County, Wyoming, located at Kemmerer,
Wyoming in Book 434PR on page 145 is recorded a Warranty Deed. The
Warranty Deed, dated the 7th day of August, 1999 conveys unto Joy
Dabel Petersen, Roxie Dabel Bird, Peggy Dabel Hanson and Lori Dabel
Stratton with full rights of survivorship the following described property,
to-wit:
See attached Exhibit "A"
3. That said Ronald Dabel died on the 11th day of November, 2006, and a
copy of the original certificate of death, certified to as true an correct by
public authority in which the original of said certificate is a matter of
record, is attached hereto as Exhibit "B".
¿ ,i
4. That by reason of death of said Ronald Dabel by reason of 2-9-102 W.S.
(1980), the decedents interest and title in said conveyance has terminated
any right title and interest to said Life Estate mentioned in said Warranty
Deed.
FURTHER AFFIANT SAYETH NOT.
Dated Apri I II 08
#~~
R . .' abel Bird
State of U to h
County of nC\vis
)
)ss.
)
The foregoing instrument was subscribed and sworn to me by Roxie Dabel
Bird this 1...1 Sf' day of April, 2008
Witness my hand and official seal.
~¿( ¿~-iAA-
r Notary Public
My Commission Expires: f e b. () ) '1 011
RECEIVED 5/1/2008 at 1 :14 PM
RECEIVING # 938657
BOOK: 693 PAGE: 485
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
NOTARYPUBLIO
MAKALAH ATKINSON
33 Sou\h MaIn
Kayavllle, U\oh 849ª1
My Oommlaalon 8-1\plfl!§
February 1,\, 1011
STATE OF UTAH
'--
Exhibit A
File 6010716065 Description
000486
The land refeJ.Ted to m this document is sltuated ill the State of Wyoming, County of Lincoln, and 1S
described as follows'
Lot 3 of Lake Road Subdivision No, 2 and Lot 3 Amended of Lake Road Subdivision, Lincoln
County, Wyoming as described on the official plat fUed April 4, 2008 as Instrument No. 938025
of the records of the Lincoln County Clerk.
CERTIFICATE OF DEATH
State File Number: 2006013965
Ronald Dabel
DECEDENT INFORMATION
Date of Death:
City of Death;
Social Security Number:
Date of Birth:
Sex:
Marital Status:
Usual Occupation:
Education:
Father's Name:
Place of Death Type:
. November 11 , 2006
Kaysville
'Novelllber 7, 1913
Male'
Married
Sheet Metal Machinist
High School or GED
August Dabel
Home
Time of Death: 14:41
County of Death: Davis
Age: 93 . ...
Place of Birth: Freedom, Wyoming
Armed Services: No .
Spouse's Name: Lavon Barclay
Industry/Business: Hill Air ForceBàse
Residence: Kaysville,Ut,ah > .
Mqther's Name: Sarah I Snyder.,
F~cílity or Address: 158 South 500 Eást .
INFORMANT INFORMATION
Name: Roxie D Bird Relationship:
Mailing Apdress: 158 SQ,uth, 500 East, Kaysville, Utah 84037
Daughter
;_:;::'~,'
DISPOSITION INFORMATION. ..'
Method of Disposition: Burial/RemoVal/1
Place of Disposition: Aft?~:pe"D~tTry':,1\~ôn, Wyoni(ng
FUNERAL HOME INFORMATION;>
Funeral Home: JndepenqentFuneral Service
Address:'2:74Q,~ÒuttïState Street, Salt Lake City, Utah 84115
Funeral Director:, Y Frallk Cpon . . .' .
I,'
CAUSE OF DEATH
Pneumonia. P",
Tobacco Use;' '. Non-usef
Medical Examiner Contaêted:'No
)'
DATE ISSUED: December 27,2006
/
This is an exact reproduction of the docu~ent registered In the State Office of VitaIStatls~c$.
Security features ofthis official document include: Intaglio Border, V & R images. In top !cyclolds,
ultra violet fibers and hologram image of a hawk over the word valid. This dbcument displays the
date, seal and signature of the State Registrar of Vital Statistics.
Updated Utah State Seal replaces hawk over valid for authenticity.
~tH
Barry E. Nangle
State Registrar
1111111111111111111111111111111111111111111111111111111
*06~Ol .l .937*