HomeMy WebLinkAbout876701 State of Nevada ) '-'"" ...... ~; [",~! CLER}:(
County of CL.~£~.~' TS 't0 I 0[ rx"r i?
AFFIDAVIT OF SURVIVORSHIP ,,b. ~ .... i".~?:' ~.. ' ,"~':.' , ........
~ ....% ',~ r ~ ~ .... '~ ~ ~ '. ,,' ~ ~ ~;~. t' "~
I~ ~orokh7 Berr'oT~r, bein~ of lawful a~o and duly
sworn according ko iaw~ upon my oath, depose and
That under the da~o of November 20, 1978r for valuable
cons&derak&on~ ~aren Reiger~ an unmarried woman~ b7 deed
of tha~ da~er whSch deed was duly f~lad of record
Office of khe ~5ncoln County Clerk, on ~anuar~ ~B,
~n Book ~ B2 of Pho~os~a~Sc Rocord8 on Pa~o 1 83r conveyed
to Dorothy Berroyer~ an unmarried woman and Edith L.
an unmarr&ed woman~ as joint tonanks w~th r~hts of
surv~vorship~ the foilowin~ described properkyr to-wSk:
Lots Forty-Seven (47) and Forty-Eight (48)
of Prater Canyon Estates, Unit No. 1, Lincoln
County, Wyoming
That by reason of said conveyance aforesaid, the said
Dorothy Berroyer and Edith L. Smith became the owners
of the above described land, and title thereto vested in
them continuously . from the date' of conveyance described
in said deed to the date of death, of Edith L. Smith, on
the 8th day of July, 2001. That by reason of and upon
the death of Edith L. Smith, also known as Edith Louise
Richardson-Smith, title to the above described real property
vested absolutely in Affiant, Dorothy Berroyer, as the
survivor.
Affiant avers and certifies that Edith Louise
Richardson-smith, is the identical party named with the
Affiant in the aforementioned deed whose death terminated
her interest, title and estate in said real property;
and Affiant attaches hereto and makes a part of this
affidavit, a copy of the Official Certificate of Death
of said decedent, duly certified by the public authority
in which said death certificate is a matter of record.
DATED this. J day of .~//~/4~,~/ , 2001.
-- ,
~D6r~thy Be~roye~
Subscribed and sworn to before me and .in my presence
by Dorothy Berroyer, this :'~ day of O(~f~e/ ,
2001 .
~~~WITNESS my hand~ and official seal.~~/~
~ Appointment No. O0~5~ ~ Notary Public
'~ [~y ~ppt. Expiros Oct. ~0. ~
My Commission Expires: ~-\0
STATE OF NEVADA -- DEPARTUE.T OF HUMAN RESOURCES
TYPE NUMRE H
IN Lasl FILE
.~.~.~.~ ~ Edith Louise RIC~RDSON-SMITH
.~c~,~ July 8. 2001 ~Clark
a~. N. Las Vegas ~. Lake Mead Ho~ ~ital
.~ (s~,~) ~. Inpatient ~. Female
~' White ~.
~ 0~mus~ ........... .,.~ : ~.Feb 25. 1920
~ 12 D~vorced
'~. Trailer Park
'~ Nevada '~, . Clark ,~. Las Vegas ,~.~3~0 Anderson Lm ~. No
~I~ Yes or
~" William Woodrow Wilson ~, Tres~a Blackburn
~ Dorothy Berroyer ~a~ 34~3. Anderson Lane, Las Vagas,~.Nevada..89'106
~ Burial ,~.Memory Gardens Cemetery ,~ Las Vegas Nevada
925 LaB Vegas Blvd. N.
,~,~, ~. Bunker~ Mortuary Las Vegas, Nevada 89101
.j ~ ~ d ~ - .me, ~ma aha ~a~e a~ dbe t~ th ...... 2.-, y.~mn ~alh ~urred
J ~ ~ J~ DATE SIGN~
~ o~ NAME O~[N~ ~ ~ ~ ~ ' ~J 22b. J ,,~
O K~ONOUNCEO DEAf) Mo,-
~ ~ NAME ~0 ADDreSS OF' ~m~~ ..... ~~ ~ -- - 22~ m~ ~ '
, ' ', /~ c~, ' ~ . .' ' ~O i
res Or ~o,I CORONER (~i~ Yes or N~} .
STATE "EGISTRAR NO. 2 0 5 6 3 4
O~'~?~;"70& 889
"CERTIFIED :7'0 BE A TRUE AND CORRECT COPY OF 2'HE DOCUMENT ON FILE WITtI THE REGISTRAR OF
VITAL STATIS2YCS, STATE OF NEV~A." This copy w~ issued by the Clark County Health District fi'om State
ce~ified documents as authorized by the State Board of Health pursuant to NRS 440.175.
RA[~D' S~k~F'''~' 0 ~ THECLARK Reg's[rar of Vita, S~at~s[ics
CO~TY; ~HEALT.H DIsTRicT
~ By:
.¢ ~ Dale ~ssued:
" ", AUG 08 2001
CLARK COUNTY HEALTH DISTRICT
625 Shadow Lane P.O. Box 3902
Las Vegas, Nevada 89127
702-383-~223
Tax ID~ 88-0151573