HomeMy WebLinkAbout943606
6010817262
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THE STATE OF WYOMING
RECEIVED 11/13/2008 at 2:56 PM
RECEIVING # 943606
BOOK: 709 PAGE: 49
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
COû049
THE COUNTY OF LINCOLN
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AFFIDAVIT TERMINATING ESTATE BY
JOINT TENANCY
Loran V. Erickson, being of lawful age and first duly sworn according to law, upon my oath,
depose and state:
1. That PatrIcIa V. Erickson died on October 26, 2003 in Rexburg, Idaho.
2. That on October 13, 1960 for valuable consideration Lyle W. Walton and Nethle Walton
by their Warranty Deed of that date, which deed was duly filed for record in the Office of the Lincoln
County Clerk on November 17, 1960 in Book 46PR on page 283, conveyed unto Verd B. Erickson and
Patricia V. ErIckson, as joint tenants with full rights of survivorship, the following described real property,
to wit:
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Lots 1, 2 and 3 of Block 13 in the Auburn, Lincoln County, Wyoming Townsite.
3. That on November 18, 1960 for valuable consideration H. R. Christmas, Judge of the
DIstrict Courl in and for LIncoln County, Wyoming, Successor Trustee for the Auburn, Wyoming Townsite,
by his Deed of that date, which deed was duly filed for record In the Office of the Lincoln County Clerk
on December 22, 1960 in Book 47PR on page 41, conveyed unto Verd B. Erickson and Patricia V.
Erickson, as Husband and Wife, the following described real properly, to wit:
The West 1/2 of Lot 1, Lots 2 and 3 in Block 13 in the Town of Auburn, Lincoln County, Wyoming.
4. That on November 4, 1963 for valuable consideration Lyle Walton and Nethle Walton, by
their Quitclaim Deed of/hat date, which deed was duly filed for record in the Office of the Lincoln County
Clerk on November 13, 1963 in Book 63PR on page 289, conveyed unto Verd B. Erickson and Patricia
v. Erickson, the following described real property, to wit:
Lot 4 in Block 13 of Auburn Townsite, Lincoln County, Wyoming.
5. . That by reason of the said conveyance, Verd B. Erickson and Patricia V. Erickson became
the owners of the real property as joint tenants and title thereto vested in them continuously from saId
date of conveyance as described in said Deeds, until the date of death of PatricIa V. Erickson on October
26, 2003 at which time title to the above described real property vested absolutely In Verd B. Erickson
in accordance with the provisions of §2-9-102, W.S. (1980).
4. Affiant avers and cerlifies that deceased is the Identical party namad with Affiant In the
aforementioned daed whose death terminated her interest, titie and estate In the said real proparty; and
Affiant attaches hereto and makes a part of this Affidavit a copy of the official certificate of daath of
decedent, duly certified by the public authority in which said death certificate is a matter of record.
Dated this I ~ of November, 2008.
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State of Wyoming
County of Lincoln
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J 1'\ The foregoing instrument was subscribed and sworn to me by C/) i -4: k/1 om thIs
~ day of November, 2008.
Witness my hand and official seal.
My Commission Expires:
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Af~cuJ!.&~
NO~IIC
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'1)\ GL~:~:t~·:YERS NOTA;:t:~~LlC~
Lincoln Wyoming "
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NOVEMBER 10,
STATE OF IDAHO
IDAHO DEPARTMENT OF HEALTH AND WELFARÈ
BUREAU OF HEALTH POLICY ÀND VITAL STATISTICS
CERTIFICATE iOF DEATH
2003
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State File No.
2003-08369
DECEDENT - LEGAL NAME
PATRICIA FLORENCE V. ERICKSON
SOCIAL SECUAllY NUMBER
AGE
DATE OF BIRTH
FEMALE
67 YEARS
SEPTEMBER 12, 1936
PLACE OF RESIDENCE
LONG BEACH, CALIFORNIA
AUBURN, WYOMING
M<\RlTAL STATUS AT TIME OF DEATH
MARRIED
NAME OF SUFNJVING SPOUSE (11..t.. ma/don n."",)
VERD B. ERICKSON
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WAS DECEDENT EVER IN
u.S. ARpAED FORCES?
NO
/"
CHRISTINE EULA HOOKUM
TENNESSEE
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BIRfHPLACE
, I
~YOMING
CLARENCE KILBY VAN NOY
BIRTHPLACE
.. METHOD OF DISPOSITION
~REMOVAL FROM STATE
FLAMM
NA"IE AND ADDRESS OF FUNERAL FACILIlY
HOME, INC., REXBURG, IDAHO
CllY.TOWN OR LOCATION OF DEATH
COUNlY OF DEATH
REXBURG, IDAHO
MADISON
RENAL FAILURE WITH SEPSIS AFTER'$IGMOID COLECTOMY
~proxlmate Inlerval Between
Onsot and Death
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DUE TO (or as III conaequBnce of):
b'METASTATIC COLON CANCER - SIGMOID COLON
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DUE TO (or 8S a coßlloquence ot):
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DUEro (or ,18 a conHqu.nce of):
d.
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OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH bulnolraaulüng In th. un dOllying cou.. given above
NONE STATED
WAS AN AUTOPSY
PERFORMED? I
NO
NAME OF CERTlFiER
TITLE
NATURAL
DWAYNE M HANSEN, M.D.
CORONE[I ~UBSEQUENT CERTIFICATION IF NECESSARY
"
PHYSICIAN'
.' DESCRlf'TiDN DF HOW .INJURY OCCURRED
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DATE ISSUED:
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JANE S. SMITH
STATE REGISTRAR
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This Is a true and correct reprodu¿tion of the document officially_registered and placed
on file with the IDAHO BUREAU OF HEALTH POLICY AND VITAL STATISTICS.
JANUARY 23, 2008
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This copy not valid unless prepared on engraved border
displaying state seal and signature of Jhe Registrar.