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006688
AFFIDAVIT FOR
DISTRIBUTION OF PERSONAL PROPERTY
STATE OF WYOMING
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RECEIVED 9/12/2008 at 9:53 AM
RECEIVING # 942201
BOOK: 704 PAGE: 688
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
COUNTY OF LINCOLN
Denna Lee Fluckiger, upon oath, deposes and says as follows:
1. I am the wife of Jack T. Fluckiger ("the Decedent") and the Trustee of the Jack T.
Fluckiger and Denna Lee Fluckiger Family Trust under agreement dated April 15, 1997, and am the
applicant by virtue of my claim to be a distributee of the Decedent as set forth hereinafter.
2. The Decedent died on January 3, 2003, a resident of Bedford, Lincoln County,
Wyoming.
3. The entire estate of the Decedent within the jurisdiction of this court and the purview
of Wyoming law, wherever located, less liens and encumbrances, does not exceed $150,000.00.
4. More than thirty (30) days have elapsed since the date of death ofthe Decedent.
5. No application for appointment of a Personal Representative for the estate of the
Decedent is pending or has been granted in any jurisdiction within the meaning of Wyo. Stat. §2-1-
I
201 (a)(iii).
6. The undersigned is entitled to payment or delivery of the property of the Decedent
for the reason that she is the Trustee of the Jack T. Fluckiger and Denna Lee Fluckiger Family Trust
under agreement dated April 15, 1997, which Trust is the sole distributee named in the Last Will of
the Decedent. There are no other distributees of the Decedent having a right to succeed to any
property of the Decedent under probate proceedings.
7. All persons indebted to Jack T. Fluckiger or having possession of tangible personal
property or an instrument evidencing a debt, obligation, stock or chose in action belonging to Jack
T. Fluckiger shall make payment of or deliver the same to the above-described distributee.
Dated: September g, 2008.
Jack T. Fluckiger and Denna Lee Fluckiger
Family Trust under agreement dated
April 15, 1997
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Denna Lee FIUCkiger,~
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Subscribed and sworn to before me by Denna Lee Fluckiger, Trustee of the Jack T. Fluckiger
and Denna Lee Fluckiger Family Trust under agreement dated April 15, 1997, this 84-f-.dayof
September, 2008.
Witness my hand and official seal.
My commISSIOn expIres:
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.JENNIFER IIRVANt
Notary PublIC
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