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PROOF OF DEATH AND HEIRSIDP
STATE OF Wyoming
COUNTY OF Lincoln
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Clara M. Dayton
of lawful age, being duly sworn, states:
of
Cokeville, Wyoming
1. That the statements hereinafter set forth, including answers to questions, constitute a true and correct and complete statement of
the family history of the person hereinafter named as "decedent" and of the estate of such decedent.
2. Name of decedent Edvigie Maninfior. a/k/a Edna Maninfior
3. Date of death
1/4/1976
Where
Cokeville. Wyoming
4. Was decedent married or single at time of death
Single Did decedent leave a will
No
Has estate been probated No
County
Where? City
State
5. If decedent was married one or more times, give the following information (list names in order of marriage):
LIVING OR DEAD DIVIORCE PLACE OF DEATH OR DIVIORCE
NAME OF SPOUSE (IF DEAD-DATE) (DATE) (CITY, COUNTY AND STATE)
August Maninfior
12/19/1972
N/A
Cokeville. Wyoming
6. If decedent had any children by any spouse, give the following information:
NAME OF CHILD ADDRESS PRESENT
AGE
SON OR
DAUGHTER
LIVING OR DEAD
(IF DEAD-DATE)
Clara M. Dayton
Cokeville, WY
81
Daughter
Living
Alma R. Brandt
Rock Springs
77
Daughter
Living
7. If decedent had any children by adoption, give the following information:
NAME_OF CHILD ADDRESS PRESENT
AGE
SON OR
DAUGHTER
LIVING OR DEAD
(IF DEAD-DATE)
8. The above children who have died had only the following children (natural or adopted) and other heirs:
NAME OF NAMES OF SPOUSE ADDRESS AGE
DECEASED CHILD AND CHILDREN
LIVING OR DEAD
(IF DEAD-DATE)
N/A
9. In case decedent left no surviving spouse and no children or children of deceased children, give the following information:
NAME ADDRESS LIVING DATE OF DEATH
FATHER
MOTHER
BROTHERS
& SISTERS
10. Affiant states he was well acquainted with [mancial conditions of decedent and knows that decedent died solvent and that all
debts against the estate were paid.
11. State you relationship or acquaintance with decedent and how long and how well you knew the decedent and the decedent's
family Daughter. knew her mother her whole life
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Signed' ~d/ Ø( cp.z::
Clara M. Dayton --
RECEIVED 6/23/2008 at 1 :04 PM
RECEIVING # 940003
BOOK: 698 PAGE: 164
JEANNE WAGNER
LINCOLN COUNTY CLERK KEMMERER WY.
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The foregoing instrument was acknowledged before me this ;51 - day of , 2008.
By: Clara M. Davton
Further affiant saith not.
STATE OF WYOMING)
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COUNTY OF LINCOLN)
IN WITNESS WEREOF, I have set my hand and official seal the day and year last written above.
My Commission expires: ¡1) ¿TV . ~ ó<D II
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