HomeMy WebLinkAbout876790 AFFIDAVIT OF COLLECTION AND DISTRIBUTION OF
DECEDENT' S PERSONAL PROPERTY
BOOK tt ¢,.t PR PAGE
The unders±gned, be±ng f±rst duZ¥ sworn, on oath deposes and
states that the undersigned are making this affidavit pursuant t°
Section 2-1-201, W.S.A. (2001), and that they makes the following
statements as the. sole distributees of the decedent's estate as
hereinafter set forth:
1. That Rachel Kirkwood died on or about August 17, 2001, in
Lincoln County, Wyoming, and was a resident of Lincoln
County, State of Wyoming, at the time of her death; that
said decedent died intestate; that the undersigned are
the sole and only parties entitled to the property of the
decedent pursuant to Wyoming statutes on intestate
succession.
2. That the value of the entire estate subject to
administration wherever located, less liens and
encumbrances, does not exceed $70,000.00.
3. That more than thirty (30) days have elapsed since the
date of death of the decedent.
4. That no application or petition for the appointment of a
personal representative of said decedent is pending or
has been granted in any jurisdiction.
5. That 'the ~ecedent was, at the time of her death, the
owner and insured under a policy of life insurance issued
by The Western Slavonic Association (Policy No. DD-1293).
The named primary beneficiary of said life insurance
proceeds was the decedent's husband, George Kirkwood, Sr.
George Kirkwood, Sr., a/k/a John George Kirkwood died on
November 12, 1988, thereby pre-deceasing the insured.
There was no contingent beneficiary named for said life
insurance proceeds. It is believed that according to the
terms of said life insurance policy, the amount due as a
result of the insured's death is, therefore, to be paid
to the executor or administrator of the decedent's
estate. The decedent was survived by a son, William E.
Kirkwood, who subsequently died intestate on September 4,
2001. This affidavit is, therefore, also signed by all
of the surviving children of William E. Kirkwood,
deceased, being the only persons entitled to the property
of William E. Kirkwood
6. Since no probate proceedings are to be held as a result
of the decedent's 'death, the undersigned request that all
the amounts due under said policy of life insurance
issued by The Western Slavonic Association (Policy~No.
DD-1293 be distributed to Carol Ness, 609 Antelope
Street, Kemmerer, WY 83101.
2
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DATED this /~H' day of ~L~r?, , 20p
George ~>rkwood
Arthur Kirkwood
Rachel Fagnant~.~
Carol Ness
Daniel Kirkwood
i'lliam Earl KirkWood, Jr.
Sheila Hest~r
Sandra K. Kirkwood
Jta~i Kirkwo~dJ )
Renae Olsen
~annme Edwards
THE STATE OF ~F.~V'%'L-¢~'iL-~ )
) SS
COUNTY oF
The above and foregoing instrument was acknowledged before me
this Jip day of OC '~-0 ~)eF , 2001, by George Kirkwood.
WITNESS my hand and official
~ary Public
The above and foregoing instrument was acknowledged before me
WITNES$~"hand a~d official
Hy ~ommission ~xpiu~s:
ss
COUNTY OF ~ ~ I'] ~ ~/Z) .
The above and foregozng instrument was acknowledged before me
this ~Q~'7 day of -~"["[)-I~')~D~[- , 2001, by Rachel Fagnant.
~ f~~~~ o f f i c i a 1 s e ~ ~'~
Notary Public J
4
?he above and forego]_ng instrument was acknowledged before me
..................... ~ota~y Public ~ ) -
My Commission Expires:
) ss
COUNTY 0 ,[t&~,3~/7~_? )
The above and fp~egoing instrument was acknowledged before me
this ~ day of ~.'~~..&/ , 2001, by Daniel Kirkwood.
WITNESS my hand and official sea~,
THE STATE OF ~c~; )
) ss
COUNTY OF ~- ! {~.3~.~ )
The above and foregoing instrument was acknowledged before me
this' ~O4~--< day of .~e.~l~. , 2001, by Willi~ Earl Kirkwood,
WITNESS my hand and official seal.
Notary) Public
My Commiss ion Expi re s: ~~ ............... ~,~ ~
'~ JDUE~T~YPUBL~C ~
I'~ l,ty Commlss~ Expires Sept 16 2003 ~
THE STATE~ ~L~~q SS
COUNTY OF~ p~;/~.~.g., ~/~.~
The above and foregoing instrument was acknowledged before me
this ~ day of ~Z~.J~_) , 2001, by Sh~il~ ~ter.
'WITNESS my hand and official sea~ ~
No~[ry P~lic
THE STATE OF ~/z~~ )
) ss
The above and foreqoi~g instrument was acknowledged before me
this ~'~ day of ~g~~- , 2001, by Sandra K. Kirkwood.
WITNESS my hand and official seal.
Notary Public
My Cgmm~.ssion Expires: ,
PATRICIA A, DAVIS
THE STATE OF 'A/,/ut~,'~ )
) ss
The above and fo~e~oin~ instrument was .acknowledged before me
this ~O~ day of ~emb~.~ , 2001, by Joani Kirkwood.
WITNESS my hand and official seal.
Notary ~bl ic
My Commission Expires: ~JUL] ~'
6
THE STATE OF ~L~7,~z~ )
t/~,~ ~' ' ~ ) ss
CO~TY OF . ~ )
The~bove and fore~oin~ instrument was acknowledged before me
this ~7~3' day of ~3~ , 2001, by Renae Olsen.
WITNESS my hand and official seal
~y CommS~sSon ExpSres:
~f,~,~ C0mri~ssi0n ~xpires ~ay 24, 200~
The above and fD~ego$ng Lnst~ument was acknowZedged beffo~e me
this '~(Sq~ day of ~~-.t,,-.~.~.,~ , 2001, by Jeannie Edwards.
WITNESS my hand and official seal.
Notar~ubl ic
My Commission Expires: