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RECEIVED 7/23/2008 at 3:14 PM
RECEIVING # 940763
BOOK: 700 PAGE: 613
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO W.S. § 2-1-201
STATE OF WYOMING
}
OOC673
ss.
County of Lincoln
}
I, Theresa W. Jermstad, being first duly sworn, do hereby state and allege as follows:
(1) I am an adult, competent to testify, and the surviving spouse of Decedent Glen L.
J ermstad;
(2) I make the following affirmations as the sole claiming distributee of the Estate of Glen
L. Jermstad, based upon my own best investigation, information and beliefs;
(3) The value of the entire probate estate of the Decedent Glen L. Jermstad, wherever
located, less liens and encumbrances, does not exceed one hundred fifty thousand dollars
($150,000.00);
(4) Decedent Glen L. Jermstad passed away on January 4, 2008. (See Attached Death
Certificate). The place of last residence of said Decedent was the County of Lincoln,
State of Wyoming;
(5) Thirty (30) days have elapsed since the death of the Decedent;
(6) No application for appointment of a personal representative is pending or has been
granted in any jurisdiction;
(7) Glen L. Jermstad died intestate, and was survived by his spouse, Theresa W. Jermstad.
Glen L. Jermstad left no child or descendants of any child. Pursuant to Wyoming Statute
§ 2-4-101(a)(ii), the estate of Glen L. Jermstad is to be distributed to Theresa W.
Jermstad, surviving spouse of Glen L. Jermstad and sole claiming distributee. There are
no other distributees of the Decedent having a right to succeed to the residue of the
estate of Glen L. Jermstad under probate proceedings;
(8) Pursuant to W.S. § 2-1-201(b), the transfer agent for any security shall change the
registered ownership on the books of a corporation from the Decedent Glen L. Jermstad
to Theresa W. J ermstad;
(9) Pursuant to W.S. § 2-1-201(c), the county clerk of the county in which any vehicle is
registered, when presented with a copy of this Affidavit of Distribution, shall transfer
title of the vehicle from the Decedent Glen L. Jermstad to Theresa W. Jermstad;
AFFIDA VIT OF DISTRIBUTION
Page - I of2
000674
(lO)Pursuant to W.S. § 2-1-201(d), any bank, savings and loan institution, credit union or
any other like depository, when presented with a copy of this Affidavit of Distribution,
shall pay any deposit titled in the name of the Decedent Glen 1. Jennstad, together with
interest and dividends thereon, to Theresa W. Jennstad.
FURTHER AFFIANT SA YETH NAUGHT.
Dated this I gJ-'¡ day of ~ t1
~y
~ íÙJ~-fM,
Theresa W. Jennstad
,2008.
STATE OF WYOMING }
ss.
County of Teton
}
The foregoing Affidavit of Distribution Pursuant to W.S. § 2-1-201 was subscribed and sworn to
before me by Theresa W. Jennstad, on this /g..J1. day of Jp\(y ,2008.
Witness my hand and official seal.
M. JASON MAJOR~, ~ NOTARY PUBUC
i~: . 'l~ STATE or
COUNTY OF ~:'I~¡, Þ, UNOulNG
TETON 'i' .~' ... '"
fIf COMM§SION EXPIRES - 15 2011
Notary ic for the State of yoming
My Commission Expires: .$// ç;- /' Zc:;? /J
AFFIDAVIT OF DISTRIBUTION
Page - 2 of2
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