HomeMy WebLinkAbout949107t`t
STATE OF WYOMING
COUNTY OF LINCOLN
AFFIDAVIT OF SURVIVORSHIP
ss.
e501
Sonja L. Huhtala aka Sonja Lea Huhtala of PO Box 715, Thayne, WY 83127, upon her oath
deposes and says:
1. That JERRY E. HUHTALA aka Jerry Eugene Huhtala, the decedent mentioned in
the attached copy of Certificate of Death, is the same person as JERRY E. HUHTALA named as
one of the grantees in that certain Warranty Deed dated the 13th day of April, 1993, executed by
Lloyd E. Forcum and Lou V. Forcum, husband and wife, grantors, and recorded April 22, 1993, as
Instrument No. 763609 in Book 327 PR, page 502, of the Official Records of Lincoln County,
Wyoming, covering the following described real property located in Lincoln County, Wyoming, to-
wit:
Lot 26 of Cedar Creek Ranches, Lincoln County, Wyoming, as described on the
official plat thereof.
2. That the undersigned affiant is the same identical person as Sonja L. Huhtala aka
Sonja Lea Huhtala named as one of the grantees in the above-described Warranty Deed, that she
and JERRY E. HUHTALA were husband and wife at the time of the execution and recording of the
Warranty Deed described above, and that as the surviving cotenant and spouse of JERRY E.
HUHTALA, named in said conveyance, the undersigned, Sonja L. Huhtala, became on July 23,
2009, the date of the death of the aforementioned decedent, the owner of the lands or the owner of
any interest of JERRY E. HUHTALA, in the lands described in the foregoing, subject to any then
existing liens and encumbrances.
DATED the 24th day of August, 2009.
RECEIVED $/26/2009 at 9:35 AM
RECEIVING # 949107
BOOK: 730 PAGE: 501
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
r
Sonja L. Huhtala
1
11'50
Subscribed and sworn to by Sonja L. Huhtala aka Sonja Lea Huhtala before me this 24th
day of August, 2009.
Witness my hand and official seal.
GERALD Y PUBLIC 't'o 01
jewy
State of W,
yoming
NOTARY PUBLIC
2011
RAM
My commission expires: May 2, 2011.
2
. .
~r
Date Filed AUGUST 03, 2009
STATE OF IDAHO
DEPARTMENT OF HEALTH AND WELFARE `
BUREAU OF VITAL RECORDS AND HEALTH STATISTICS,';
* -A~
CERTIFICATE OF DEATH a `
State File No. 2009-06178
JERRY EUGENE HUHTALA -
~IX
BOCIALSECURITY NUMBER
AGE
047E OF BIRTH
MALE
82 YEARS
FEBRUARY 01, 19,27
BIRTHPLACE
PLACE OF RESIDENCE
ROCKLIN, CALIFORNIA
THAYNE, WYOMING
MARITAL STATUS AT TIME OF DEATH
NAME OF SUFNNING SPOUSE (If µ11e, maiden name)
WAS DECEDENT ERIN
MARRIED
SONJA L. FINK
U.S.ARMED FORCES?
YES
FATHER - NOME
BIRTHPLACE
ALFRED J. HUHTALAI
-
CALIFORNIA
MOTHER - MAIDEN NAME
%
BIRTHPLACE
HELEN M. BARNES
CALIFORNIA
METHOD OF DISPOSITION
FUNERAL SERVICE LICENSEE"-.
CREMATION
BRUCE W. BAXTER -
NAME AND ADDRESS OF FUNERAL FACILITY
FLAMM FUNERAL HOME, INC., REXBURG, IDAHO
DATE OF DEATH
TIME OF DEATH
CITY TOWN OR LOCATION OF DEATH
COUNTY OF DEATH
JULY 23, 2009
8;04 P.M.
REXBURG, IDAHO
MADISON
CAUSE OF DEATH (underlying cause last) Appbmxinrat Interval Between
d D
O
t
W
e
e
en
n
an
a,
DIFFUSE LARGE B-CELL PNEUMONIA 2'MONT'H'S
DUE TO (or as a consequence of);
b-WALDENSTROM MACROGLOBULINEMIA 5.5 YEARS
DUE TO (or as a. consequence of):
c
DUE TO (or as e: consequence, of):
J
OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH but not resulting in the underlying rouse given above
WAS AN AUTOPSY
PERFORMED?
HEPATIC AND RENAL FAILURE
NO
MANNER OF DEATH
NAME OF .CERTIFIER
TITLE
NATURAL
DANE J. DICKSON, M.D.
PHYSICIAN
CORONER SUBSEQUENT CERTIFICATION IF NECESSARY
cXT ERNALGAUSES ONLY
FE OF INJURY
TIME OF IN1URt' r'LACE.OF
~WOUINJ A I
LOCATION WHERE INJURY OCCURRED
DESCRIPTION OF HOW INJURY OCCURRED :
a
``\q ,~tt4iF This with the IDAHO BUREAU OF VITAL RECORDS ANDI HEALTH registered placed
STATISTICS
on
Y ~,.~0 PERP T O IIII
r A III. i
AUGUST 04, 2009
0 DATE ISSUED:
displaying Istate t Sevad at and signature prepared he Red border JANE S., SMITLH
ga ure of Registrar. STATE I
. REGISTRAR 100,
I
(1~
U!In.