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COC'435
I, Sharon A. Mootz, being of lawful age and duly sworn according to
law, upon my oath, depose and state:
Affidavit of to the Public
That under the date of March 28, 1990, for valuable consideration,
Wyoming National Bank Kemmerer tka Norwest Bank Kemmerer, by deed
of that date, which deed was duly filed of record in the Office of the Lincoln
County Clerk, on March 29, 1990, in Book 284PR, Page 291, conveyed to
Barry E. Mootz and Sharon A. Mootz, husband and wife, the following
described land, to-wit:
Lot 1 of Block 54 of the Second Addition to the Town of Kemmerer, County
of Lincoln, State of Wyoming
That by reason of said conveyance aforesaid, the said Barry E. Mootz
and Sharon A. Mootz, husband and wife, became the owners of said real
property, and title thereto vested in them continuously from the date of said
conveyance to the date of death of Barry E. Mootz, on the 8th day of
October, 2006. That by reason of and upon the death of Barry E. Mootz,
title to the above described real property vested in Sharon A. Mootz.
Affiant avers and certifies that Barry E. Mootz, also known as Barry
Edward Mootz, is the identical party named with Sharon A. Mootz in the
aforementioned deed, whose death terminated his interest, title and estate in
said real property; and Affiant attaches hereto and makes a part of this
affidavit, a copy of the Official Certificate of Death of said decedent, duly
certified by the public authority in which said death certificate is a matter of
record.
Dated this d\""'- day of
RECEIVED 7/21/2008 at 12:46 PM
RECEIVING # 940692
BOOK: 700 PAGE: 435
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
State of ~c....u ~ )
~, 2008.
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County of L\Q..)r"'l ...) )
Subscribed and sworn to before me, a notary public in and for said
County and State, by Sharon A. Mootz, this ði ~ day of cl' I J , 1---'
2008.
WITNESS my hand and official seal.
:fL/~A .
. otary Public
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DEATH CERTIFICATE
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\ -StåteFile Number: 2006-003042
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Decedent: .
Name:
Gender: .. .
Datebf Birth:
Barry Edward Mootz-
:. M. ale :'.'e ."... ..'
i AugUst 19,1948
:. SocialSeçurity tNumber:
Age at the Time of Death: 58 Y~ars
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Date a'nd Place qfDeath: . ..... ......
Dåt8ofDéê3thj .'. Oètobet08, 2001$
City of Death:> JKémmeter ... ..
.... Additional Decedent Jnformation:?, ...(
Placê of Birth:..Rosòóe,Nèwyqrk \) .
... Residènce:"\" ..'... Kemmeref,.Wyomir'ig .. .. .. .. ... ......
Marital Status: Married.·, ..... ..... ·'{.~,Name of Surviving Spouse; Sharon A. Bury
Nä.mè ofFather:nnknowrìUn~iïöwriUnkhbWn·\("i .( .. ....,... ..( ........ .>
MáicfenNarneof Mother:. Wïnifrèçl..MqbtZ·, ..... ,,/ )()/ p
Infor~nt: Sharon A Mootz, ...... . Rélationship: Wife
Cúunty ofbeafh: Linéoln··
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.Disposition;()' ..
... Method of Disposition:
Place of Disposition:-
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The immediatecàüse is list~d,Òhthef)ist'linêJolJowed by anyuridèrlying causes.
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Ott'ler Sign!fic~nt9bnditio~s:N()tR~¿qrd~dU};;\ .....
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Cêrtifier:
Name:
Address:
Manner of Death:
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plQ3 ·,Beeph,KemlJ1erj7f,yY¥pming
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. Date Filed:
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This Is a true certification of the document on fila in the offlcè··of Vital
R!lcQrds Servjces, Gheyenn!l, Wyoming, .
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DATEíSSUED: \NoverÝ!berb.t,20Q6
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}ñis~apyis not..yalid unlessprepared o~..pap~r wi,th·.n..~ngr'\red"þor~.r: .,.."
Bre':,tO, She,ard,M.O,,·M,P.t-t:
Oirector and State· Health·Offlcer
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