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Home My WebLink About942393 Kt:.l,;t:.I\I~11 1.¡/;¿LI;¿UU8 at 2:49 PM RE~_.."..3 # 942393 BOOK: 705 PAGE: 341 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY AFFIDAVIT OF HEIRSHIP ûOû3¿1:1. klw XTO ENERGY INC. - OWNER #: 53601 For: MARY CATHERINE PAUL (Deceased) Re: 65009/ FONT FED UNIT 11-24, ET AL (Well/Property) Legal Desc: SEC 24 TWN 26N RNG 112W County/State: LINCOLN COUNTY, WYOMING Martin A. Levy (Name of Affiant) , residing at 11400 w. Olym~ic Blvd.. #330 (Address) Los Angeles (City) CA (State) . . being first duly sworn, on oath deposes and says that the answers and other statements hereinafter set out are true and correct. 1. How long and how well were you acquainted with the decedent? 15+ years 2. If related to decedent, state ih what way. N/A 3. When and where did decedent die? 1/22/08 Los Angeles. County, CA 4. Where was decedent's pel1Ï1anent residence at the time of his/her death? 750 Napoli Drive Pacific Palisades, CA 5. How many times was decedent married? Once 6. Name and address of surviving spouse (if any). None residing at 7.. If decedent WßS ever married, í~t in the following table each such marriage, indicating in each instance the date of marriage, the name of spouse, whether such marriage was tEmI1¡¡'àt~dby ae~th ór divorce, the datE¡ of termInation of the marriage, the address of each spouse now living, and (if dead) wh.ether or notsuch spouse left ~ will: . . ! .. Date of Name of $pouse Marriag~ . D~te of Address if Living If dead, did Marriage Terminated Termination such sPQuse by De~th.Q.r leave a Will Dixb,rce .. 7 31/43 Clinton D. Paul 5/1/86 No 1 8. (a) When was the property described at the beginning of the affidavit acquired by decedent? Unknown (b) Was it acquired by gift, devise, inheritance or purchase? (State which) (c) If bv purchase give the following information: . (1) Where did decedent reside (the State in which decedent had his/her permanent residence will suffice) when property was acquired? (;OG3~12 .;,L ____(2L.wg$J.h.eJ;j.eç-ª-d..~o.1 marri~çLw.b~n_ª.l,IºI1~_~~§!!1Y.~-ª~-ªÇ.~r~Q? - -. .. .--..--- ---Unknew-n--. If so, give the name of decedent's husband or wife. If such husband or wife is now deceased, did such party leave a Will? 9. Did Decedent leave a Will? Yes If so, (a) was the Will probated? No If the will was ¡¡¡dmitted to probate, name aU counties and states in which it has been probated and give the name and address of the executor or administrator. (b) Has there been any contest of the Will or appeal from the order admitting it to probate? No To your knowledge, is any such cqntest or appeal contemplated? No 10. If decedent did not leave a Will, was any administration had on decedent's estate? N (A If so, name the counties and states in which administration was had and give the name and address of the administrator. 11. To your knowledge are there any deþts or Federal estate or state inheritance taxes still owing by d(;!cedent's estate? No If so, will decedent's personal estate be sufficient, in your opinion, to pay such debts and taxes? What is the estimated net value of the entire estate? Less than $100,000 12. List in the following table the name of all children born to or adopted by decedent, whether living or dead, giving all other information called for in the table below. Anyadopted children should be desiglÌated as such if decedent had no children, so state. Nâme of Child Nàme öf Child's Other· Birth Address Living or If Deaq, Give Parent" Date Dead Date of Death *Deborah A. Lebowi Clinton D. P Deceased *C inton D. Paul Clinton D. Paul 0(20 44 Deceased *Social Security If . **Social Security If Pacific Palisades CA 90272 70 De Silva Island Drive Mill Valley, CA 94971 2 13. Give information called for in the following table concerning descendants of any deceased child of deceden000343 whether natural or ado ted. If no descendants, so state. Name of Deceased Child Descendants Birth Address Date Living or If Dead, Give Dead Date of Death 14. If decedent left surviving no child or descendant of a child, then list names of decedent's parents and brothers and sisters and give information called for in the following tables. If half brother or sisters, state whether maternal or parental. N / A Name Address Living or Dead Father Mother Brothèr Brother Sister Sistêr Descendants of deceased brothers and sister. If none, so state. Name of Deceased Descendants Address Brother or Sister If Dead, Give Date of Death Age Living If Dead, or Dead Give Date of Death None 15. If decedent left no children or their descendants, or father or mother, or brothers or sisters or their descendants, then ive the information called for in the followin tables: N / A Name Address Paternal Grandfather Paternal Grandmother Máternal Grandfather Máternal Grandmother Name I,)ncle or Age Paternal or Address Aunt Maternal Living If Dead Give Qr Date of Death Dead 3 Living or Dead If Dead; Give Date of Death Name of Deceased Uncle Descendants Age Address Living If Dead or Aunt or Give Date Dead of Death ~~ 0034014 Signa~~~a~ /!!J Subscribed and sworn to before me this ß day of S e pf.etA.G0 t2-r 20 O~· ø -/~~~,( 8. ptt( fl('p-s Notary Public in and for . ~ ~~t"L5> County. G ¡;~/"h t't My Commission Expires: r(tJ;. :2 'r J-Q~~ ,¡"í~"..~; ·-·""~."'),."~A~~~'.ot¡¡¡$¡,._, ..".In... '."". "'{~ MARIAM S. PHIlliPS , I:r::-:r. 'J&~; ,'. CommIssion # 1548221 ,I \:\:'f'i~:' No¡ary Public - California ; t ~ M OS Angeles County ~ ,_~~'C\.~omm. EXPires Feb2ó, 2~ - .--. - -- - - 4