HomeMy WebLinkAbout944034
I
62213
\jHickl~an (
'. .~~:~I1,~,~,~C9 J
.._~.!'--
00&667
AFFIDA VIT
.==~-===~~':'
I, PRISCILLA ANDERSON, being first duly sworn on oath, depose and say:
That I am a citizen of Ihe United States of America over the age of 21 year~;, and a
resident of UTAH.
That I was well and personally acquainted with WARREN L. ANDERSON in thé1t
certain Warranty Deed dated 1/611992 and recorded 1/811992 in Book 306, at Page 2\, as Fi ling
No. 743063, in the office ofthe Recorder of LINCOLN County. Utah.
Thm I know of my own knowledge that WARREN L. ANDERSON in the said deed and
WARREN LE GRANDE ANDERSON menlioned in Ihe attached Certified Copy of Ccrlificale
of Dealh was one and the same person.
This affidavit is intended to terminate the HUSBAND AND WIFE BY THE
ENTIRETIES of said WARREN L. ANDERSON
in the following described property:
F;-.;hihi! ",\"
Tax Roll No. 37182830002100
').)
\ J
Dated this ~_._._ day of-NQ V~08 /\.0.
(?,r; /J/J /l f)
_..~
I'I\lSerLLA ANDE[{SON
I"
_ ,,:-=:=:,,~--=,-:'::=:':.~':-;''';;:':'~:'':'= :~,:.;...t..:..;:::.::..;.~
'.lr
~~-. '--_..__._._..._._,--.._._------_..,.....-."_.._~..._--_..."'-'--.---.- -'~-_.._-_._--_...._._.....
.... ..-.......-..--'.. ... ....-...........-... ...--...
COURTESY RECORDING
This document Is being recorded
solely as a courtesy al1(ft' '. ..' ,
accommodation to the. partlel );),.'; ..!,.' ,'.
I.. . ."d Tit'" C U"rDhlf t .-c.....¡. .... "0'
there_.... 1_· o.,,~.... ......".(\,'.-/".:,':,;,,\....,;..
'. = lal·· ." .:··d·;"~·~"ì;.\¡:·~"···
.vnMII ·VI..K.... ms anr.~· !,!~·.\r.~'m~.'h,,:. " ,.' .
......... tv llab·llty....· ., I'· . ~\.¡:.
res",· or IH..IW· .,...\"~';':"'::':~¡:,:'" .
the accuracy content thereof. ' .
RECEIVED 12/8/2008 at 10:29 AM
RECEIVING # 944034
BOOK: 710 PAGE: 667
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
62213
------
INDIVIDUAL ACKNOWLEDGMENT
STATE OF UTAH )
SS
County of$.H-~,¿. )
On the ,'t 1ß. day of /\Jo\Je~ A.D. 2008 personally appeared before me
C:Oû668
PRISCILLA ANDERSON
the signer(s) of the wilhin inslrumcnt, who duly acknowledged to me that hel. he/they executed
the same.
~~.
Commission expires: q -11-/0
Residing in: ~ t..c.. \ vtT
-_=-===-::'-::::'";=...~";..;..-=..-=.~~-~-::=:':"'_~~:-.z.,:-:=':"_~
<If
.__._--------_._-_.._--_.-._---_.--~--._._.._~-_._-~~--._-------_.._~_._-_..._--_...._--_._. . --- - .---..-.- ....-.- ....
. .
, .
EXHIDIT"A"
00&669
A portioll of the Soulhwest quarter of the Southwest quarler of Scctioll 28, Township 37 North,
Range 118 West, 61h P.M., located in the lown of Alpine, Lincoln County, Wyoming, being more
particularly described as follows: BegÌlming at a point in the South line of said Southwesl quarter
of the Southwest quarter, said point being East 644.22 feet from a mOnument found marking fhe
Southwesl comer of said Section 28; thence running North 287.63 feet, more or less, to a poilll in
the Soulhcrly line of Three Rivers Eslates, Subdivision B; thence Soulh 75°16'33" East, along
last said Southerly line, 174.27 feet; thence running South 0°59'41" Wesl243,37 fecI, more or
less, to 1\ point in first said South line, thence I1Uming West, a]ong last said Soulh Une 164.32 fecI
10 Ihl:J Poinl of Beginning.
For infonnalion purposes only, Iltc
property address is purported to be:
514 Nelson Lane
Alpine, Wyoming 83128
--:----~--:-------.~_~~.---_.__._._....___:_----~M.-___:__.---..-..---.--'"-.-.-_._....~_._~.~_~H.____~...
This is a true and exact reproduction of the document on file in
the office of Vital Records Services, Cheyenne, Wyoming.
,
Date Issued:
JAN
5 2007 \
Gladys K.lsreeden
Deputy State Registrar
~ ,
This copy is not valid unless it bear~ a raised seal and is produced on
multicolored security paper. 000670
039375
"
~ ,-11
'-"'-""'-""''':'''':''''';'".-
; -~'.'7:"::':':'7":' _ ...:, '"'-"::::::':i;:":;!:r';::--:::.~'::::'"::~;~~:C·':·-':r,'~.:-,.-.,.-
....-.,'....-....- -,,-.
'\
STATE OFWVOMING
DEPAR1\IIENT OF HEALTH
CERTIFICATE OF DE :J"H
/ STATE RU! NUlllER
3. DllTE OP I'TH rAla. DIy, 'It.,
NOVEMBER 9, 2003
. DATE OF 8IR1'H fA&. o.r. ttJ
SEPTEMBER 4, 1925
TVPE
OR_
IN
-...
......
He
FOR
INS'fIIUCJIOHS
SEE
IWaOOK
lOCAl. fU HU_R
1 D£œ:DEHT. '''SY
I. SEX
-... LAS'
¡'¡ARREN
4. :;ocw. SŒCURln' NUM8I:R
LE
MALE
-
7~ PU\Ç& 01' DBA," I~ ..... "'"
t!IIIIImI. JC......, Oen,o.._ OOOA QIIW ' 0__ 0..._ 0......,_""
1b. Y rw.ce (W nor ....... øre ... ftI "",.,} 7c:. em, TOWN, QR LOCATION OF DEATH
1d. QOUNTY OF DEATH
STAR VALLEY MEDICAL CENTER
e. S'MTE OF 8IATH,. new In U.s.A., __ ~,
AFTON
g. ~~~' 10 8URVMHG SPOUSE.," _Ie. ¡1M _.,.,......,
MARRIED PRISCILLA LEONE PACE
LINCOLN
\
UTAH
11. MS DECEœNT EVEA IN U.S. AnMiiD FORCES?
l.".", ... or no,
'211. IUND 0" lUSHER OR INDU&TRY
YES
I. UI!MML. OCCUMnoN ,œw. k,,", 01 worlI .. CJt.rttg moar
t1I warfchg' ... ... , iWtHl
GEOLOGIST
'31> CITY. _ OR LCCATIOH
1'" N8ID!NCI. lTATE
1'b. COUNTV
WYOMING
'3I.INSIDB CJTY Uofml1
,~ ,.. 01 no,
YES
LINCOLN ALPINE
14. W\S OECEOENT GFHI__
18ptcIfr ~ 01' "" . . ........-,
"""",,--_...,
514 NELSON LANE
'5.=-::::~,ndIo" ,.._a__
1_'" 1_...,....__1
WHITE ." -ü'- to-" """'"6"''''"·'
17. FATHER'S NAME Fnt
NolO v.. 0 I_I
- ...
--
II. MOTHER'S NNoIE
f....
ORLANDO
N
PRISCTLLA ANDERSON (
STRBET OR R.F.D._
ANDERSON
AGNES
NORTHMAN
"'-
1.... RlLATIOHSHP T DlCUIINT
SPOUSE
CITY OR_
S7AŒ
Zll'000B
ALPINE WYOMING
IDo. Cþ.tITIRY OR CAltMTOlW-NAME
NOVEMBER 26 2003 M
"'II. 0 I.....OIor...J .... D I I
11/27/2003 2:00 A M
TOD PONCIANO-DEPUTY CORONER, P.O. BOX 57,GROVER,WY
E AFT ON WYOMING 83110
.&11. 1M11IMc&MD IIY RI_ I.....
/"Jl-t.~ø7
r
I
! I
¡.
to ...................... or ...... ... ........... Do "".... .. IIIOdIIII dP'9. 1UCh. CMØIa
... ......." ........... .... .......IJII onIr _ ... ........
__1-
-"'-
__In_,"
~
HYPOXIA'
0lIl10 loti AI " CONSEQUeHC& 0F1:
,=-
10I0oI__
,
: 2'4 HOURS
1
,
! 1 DAY
1
I
: 4 DAYS
I
,
'4 DAYS
II, ... _D 10 COIOON&R
1-' .. """
..
ASPIRATIL
DUE 10 lOR ... A QUENCE Of,.
-...-
'''''.___11
......., .........
-1-.......
....--
_.._,Uft
-..
..
SUBDURAL HEMATOMA
DUl10 COR AI Ai CONIIQWHCI OF):
/
ALPINE
II. F
.,~._-_..........._--_..~
YES
XIiI. 1M,. OF' INr.UW
1- .... _I
PPROXIMATELY
OV 05 2003 UNK M
_PUalCII'''''''''''·.._......_-,.
__-1-" /
E
_ TN! Of
-
II. MNM" OIl' DlIIIH
- 0:...
:JOe. INJURY AT WOAK'
,..... ,.. ar nol
STUMBLED AND FELL WHILE
REBUILDING CAR-UNWITNESSED.
:JOf.I.C:IC^TlON I.................. If' AunII......·......,. QIy'.........
NO
DCOUId ... Þo
011_
VR 2·89
11/99 15M
514 NELSON LANE
-
}
WYOMING