HomeMy WebLinkAbout944516
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STATE OF tJ7'~~
. SS.
COUNTY OF~)
RECEIVED 1/6/2009 at 3:38 PM
RECEIVING # 944516
BOOK: 712 PAGE: 463
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
6010817401
AFFIDAVIT TERMINATING ESTATE
I, Mary L. Gardner, being oflawful age and first duly sworn according to law, upon my oath, depose and
state:
1. That I am of adult age, a resident of Lincoln COtmty, Wyoming, and the
Affiant herein.
2. That by virtue of the conveyance which is recorded in the office of the County
Clerk for Lincoln Cmmty, Wyoming, located at Kemmerer, Wyoming in
Book 482PR on page 170 is recorded a Wmanty Deed. The
WarrantyDeed, dated the.æ: day of January, 2002 conveys unto
GLENN L. CORSI, Trustee, or successors in trust, tmder the GLENN L. CORSI LIVING
TRUST, dated January 11, 2002 with full rights of survivorship the following described
property, to wit:
See attached Exhibit "A"
3. That said Glenn Lee Corsi aka Glenn L. Corsi on the 220d day of October, 2008, died and a
copy of the original certificate of death, certified to as tnle an correct by public authority in
which the original of said certificate is a matter of record, is attached hereto as..
Exhibit "B".
4. That by reason of death said Glenn L. Corsi aka Glenn Lee Corsi and by reason of 2-9-102
W.S. (1980), the decedents interest and title in said conveyance has terminated and title to the
real property conveyed thereby has vested absolutely in Glenn L. Corsi, Trustee, or his
successors in trust, tmder the GLENN L. CORSI LIVING TRUST, dated January 11, 2002
continuously since the death of said decedent.
FURTHER AFFIANT SA YETH NOT.
Dated / - 5 - 09
State of Ú.JtfO'YYWYJ)~
)'g(
County of~
·.:~;'~1 t?J1< .~7¡;;~/tl ¿~
Mary L. arMer V
The foregoing instrument was subscribed and sworn to me by Mary L. Gardner
this5!l! . day of ~
January, 2009
Witness my hand and official seal.
~~/~.~
My Commission Expires: 9 - /5 - / /
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I" GLOF'::I/\ K. BYEfi;;~-:;;{;~, NOTAFIY PUBLiê~i
.. COLlnt}lof (tfr(~;i.\\;,;,VÇ\1\ State of (:,
Lincoln i,'ì· :,j·':i)!~p Wyoming ç,
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EXHIBIT A
Commencing at the Northeast corner of Lot 1, Block 2, of Townsite of Grover Lincoln County,
Wyoming, and running thence West 181.37 feet;
thence South 255.75 feet,
thence East 181.37 feet,
thence North 25.75 feet to the point of Beginning.
STATE OF IDAHO
DEPARTMENT OF HEALTH AND WELFARE
BUREAU OF VITAL RECORDS AND HEALTH STATISTICS
Date Filed
CERTIFICATE OF DEATH
NOVEMBE~ 17, 2008
State File No.
2008-09187
DECEDENT - LEG<\L N<\ME
GLENN LEE CORSI
SEX
SOCIAL SECURliY NUMBER
/ AGE
DATE OF BIRTH
MALE
86 YEARS
OCTOBER 16, 1922
BIRTHPLACE
PLACE OF RESIDENCE
AFTON, WYOMING
GROVER, WYOMING
~RITAL STATlJS AT TIME OF DEATH
\ lIME OF SURVIVIi'ß SPOlJSE (II Vlile. maióen neme)
WAS DECEDENT EVER IN
U.S. ARMED FORCES?
NO
WIDOWED
rATHEn· \ lIME
BIRTHPLACE
ARCANGELO CORSI
WYOMING
MOTHER· WAlDEN \ lIME
j~
BIRTHPLACE
EDITH LEE
WYOMING
METHOD OF DISPOSITION
CREMATION
FU~EPAL SERVICE LICENSEE
BàB M. CORNELISON
\ lIME AND ADDRESS OF FUNEPAL FACILliY
SCHWAB MORTUARY, AFTON, WYOMING
DA T OF DEA TH TIME OF DEATH
CliY.TOWN OR LOCATION OF DEATH
OCT. 22, 2008
12:00 NOON
POCATELLO, IDAHO
CAUSE OF DEATH (underlying cau.a la'l)
a
CARDIAC FAILURE
Approximsl8 Interval Between
Onel and eealh
1 WEEK
DUE TO (or a. a consequence 01): /
bpOST HIP FRACTURE & SURGERY
./
1 WEEK
-----------
DUE TO (or a8 a con,equence of);
c. F AL L
I
I
1 WEEK
DUE TO (or AI II consequence 01):
d.
OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH but nol resulting In 1I1e underlying cau.. given above
RENAL, iNSUFFICIENCY, CHF, MYOCARDIO INFARCTION, DEMENTIA
WAS AN AUTOpSY
PERFORMED'
NO
WANNER OF OEATH
\ lIME OF CERTIFIER
TITLE
ACCIDENT
KIM QUICK
CORONER SUBSEQUENT CERTIFICATION IF NECESSARY
CORONER
OCT. 15, 2008
7:00
NURSING HOME
LOCATION WHERE INJURY OCCURRE¡¡
425 SO SPRING\CREEK DR, SODA SPRINGS, IDAHO
DESCRiPTION OF IfJW Irl!URY OCCURRED
FELL
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o ~ DATEISSUED:. 0 ì / /"~ - ~
'/i:1, ! This copy Is not Víllld unless prepared on en€l~aved border JANE S. SMITH \
i displaying state seal and signature of the Registrar. STATE REGISTRAR \
f ________~_.____.__._____________.~_:::,..__.._.._________.__..-,.___._._......;;;...______.______.__________'~t
This is a true and correct reproduction of the document officially registered and placed
on me with the IDAHO BUREAU OF VITAL RECORDS AND HEALTH STATISTICS.
NOVEMBER 19, 2008