HomeMy WebLinkAbout944153
WHEN RECORDED MAIL TO:
Gregory A. Steed
Richards Brandt Miller Nelson
299 S Main Street, 15th Floor
Salt Lake City, UT 84111
RECEIVED 12/15/2008 at 11: 12 AM
RECEIVING # 944153
BOOK: 711 PAGE: 86
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
00&08C
STATE OF UTAH
AFFIDA VIT OF SURVIVORSHIP
DEATH OF JOINT TENANT
)
:ss,
COUNTY OF SALT LAKE )
Duane L. Wignall, being first duly sworn, deposes and says as follows:
1. That Affiant is a citizen of the United States of America, over the age of twenty-one (21) years,
and a resident of Hurricane, Utah.
2. That Affiant is shown as a joint tenant on a parcel of property, described below, situated in
Lincoln County, Wyoming.
3, That Affiant is a grantee and joint tenant on that certain Warranty Deed dated September 23,
2003, and recorded as Entry No. 899586 of Book 556, Page 612 on 5/25/20004, vesting title in the names of
Duane L. Wignall and Virginia J. Wignall, as joint tenants
4, That Virginia J. Wignall, the other grantee on the afore described Warranty Deed, died onA ugust
31, 2008, (See attached Certificate of Death.)
This Affidavit is made for the purpose of terminating of record the joint tenancy interest of Virginia J.
Wignall in and to the real property conveyed by the afore described Warranty Deed and described as follows:
Lot 435 Star Valley Ranch RV Park Plat One (01) as platted and recorded in the Official
Records of Lincoln County, Wyoming.
RESERVING THEREFROM, all rights, title, and interest in and to any and all minerals and
rights appertaining thereto.
Subject to all Declarations of Covenants, Conditions, and Restrictions and Amendments thereto,
of record.
. ~
DA TED this :t~ day of November, 2008.
D~~ L. -AAJr4
"'* SUBSCRIBED AND SWORN to and acknowledged before me by Duane L. Wignall, the Affiant, this
2J,; day of November, 2008. ~
~----~šŸËËo-ï r:(~IC
'e--=I&_I
i . CoIftr¡IIII~ n ISIIIIiIO I
''-------~-----
G:\EDSI\DOCS\l78801000 I \MJ60 II. WPD
/
CERTIFICATE OF DEATH
State File Number: 2008009762
Virginia Jolene Wignàll
)
(;0&087
DECEDENT INFORMATION (
Date of Death: August 31,2008
City of Death: Sandy
Age: 71
Place of Birth: Fillmore, Utah
Armed Services: No
Spouse's Name: DuaneL Wignall
Industry/Business: Own Home
Residence: Hurricane, Utah
Mother's Name: Betty Nelson
Facility or Address: 9253 Durban'Road
Time of Death:
County of Death:
Date of Birth:
Sex:
Marital Status:
Usual Occupation:
Education:
Father's Name:
Facility Type:
07:55
Salt Lake
April 2, 1937
Female
Married
Homemaker
Associate Degree
Guy Jules Brunson
Daughtér'S home
\
INFORMANT INFORMATION
Name: Duane L Wignall Relationship:
Mailing Address: 2649 West, 240 North, Hurricane, Utahß47_37
DISPOSITION INFORMATION ". .... ....,.......
Method of Disposition: Buria) , . . ..' bate of Disposition:. Septel11bef3, 2008
Place of Disposition: VY,a.~atch}Law~Jv1emorial Park, Salt Lake City, Utah
'(:Husband
\
FUNERAL HOME INFORMATIÔN"
Funeral Home: .<Wasatch La.wn Mortuary
Address:"340LSoùth Highlar:1d,D~ive. Salt Lak.eCity, Utah 841 06
Funeral Director:,:,: Ronald E.,Nielson,,"· '.' '" .,' ., ., '..
'. .!~/
'-
MEDICAL CERTIFICATION",;.." '. .... ......,.... ..
Certifying Physician: Gary F Holland, 893 24th Street, Ogden, Utah8A401
CAUSE OF DEATH
Dehydration [Onset: 7 ,DaysF
Delirium [Onset: 7 DaY$l: "-,_
Metastatic cervical/uterinê cancer [Önset: 6
Tobacco Use: . _ ~ort.user :;i'.,
Medical Examiner Contacted: No ,AUtopsy Performed: No Manner of ~eath: Natural
----..
\
September 4, 2008
\
\
----..
This is an exact reproduction of the document registered in tl:lt! State Office of Vital Statistics.
Security features oHhis official document include: Intaglio Border, V & R images in top cycloids,
) ultra violet fibers and hologram image of the Utah State Seal, over the words "State of Utah". This
document displays the date, seal and signature of the State Registrar and the County/District Health Officer.
*061607181*
~~~
Di rector/Health Officer
Coun~ylDistrlct Health Department
~êH:-
Barry E. Nangle, State Registrar
Office of Vital Statistics
I ~~IIIIIIIIIIIIIIIIIII "IIIIIIIIII"II~IIIIII ~