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HomeMy WebLinkAbout951461APN: 34180622357500 ti. 0)494 AFFIDAVIT TERMINATING JOINT TENANCY The undersigned, being first duly sworn, deposes and says that JOYCE MARBERRY is the Affiant, is over the age of twenty -one (21) years and competent to be a witness as to the matter hereinafter stated. That the Affiant is one of the Grantees named in that certain Joint Tenancy Grant Deed recorded the 12 day of December, 2002, in Book 508 as Document No. 50, Official Records in the Office of the County Recorder of Lincoln County, State of Wyoming That JAMES MARBERRY was one of the Grantees named in said Deed and was the identical person named as JAMES LARRY MARBERRY, the Decedent, in that certain Death Certificate, a certified copy of which is attached hereto and made a part hereof. The property referred to in said Joint Tenancy Grant Deed is that property in the County of Lincoln, State of Wyoming, described as: Lot 575 of Star Valley Ranch RV Park Plat Two (02) 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 minterals and rights appertaining thereto. SUBJECT to all Declarations of Covenants, Conditions, and Restrictions and Amendments thereto, of record. IN WITNESS WHEREOF, the Grantor has caused this Instrument to be executed by a duly authorized officer of the corporation the day and year first above written. More commonly known as: Lot 575 Star Valley Ranch Plat 2, Lincoln County, Wyoming Therefore, JOYCE MARBERRY, being the surviving Grantee of that afore- mentioned Joint Tenancy Grant Deed, is the sole owner of such property. STATE OF NEVADA COUNTY OF CLARK ss. JOYCE MARBERRY, being first duly sworn, deposes and says: Affidavit Terminating Joint Tenancy Page 1 of 2 RECEIVED 1/8/2010 at 9:55 AM RECEIVING 951461 BOOK: 739 PAGE: 494 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY That she is one of the Grantees in the above referenced Joint Tenancy Grant Deed; that she has read the foregoing Affidavit Terminating Joint Tenancy and knows the contents thereof; that the same is true of her own knowledge, except for those matters therein contained stated upon information and belief, and as to those matters, she believes them to be true. SUBSCRIBED AND SWORN to before me this 31 day of July, 2009. �MAI BERRY NOTARY PUBLIC When Recorded, Please Return and Mail Tax Statements to: JOYCE MARBERRY c/o Bryan Lowe and Associates 4011 Meadows Lane Las Vegas, NV 89107 ni (Li Affidavit Terminating Joint Tenancy Page 2 of 2 04.495 Notary Public State of Nevada County of Clark KRISHNA GRANT My Appointment Expires No: 02- 75091 -1 April 30, 2010 INJURY AT WORK (Specify Yes or No) 28e. A HOSPITAL OR OTHER INSTITUTION—Name (If not either, give street and number) EN OF WHAT CON TRY S• Pl• Clark CI OR tr=rrI 150. Henderso DWTE SIGNECk Da TA TE) Decade s EducatiSR S grade completed. .io. G A \lll r A, M L R, OR CORONES. ype Henderson Nevada 89014 PLACE OF INJURY—At home, faun street, factory, office bulIding, buNding, etc. If Hosp. or Inst. Iodinate DOA, OP/Emer, Rm. Inpatient (Specify) PART OTHER SIGNIFICANT CONDITIONS—Conditions contributing to death buc not resulting in the underlying cause given in Part 1. Yr.) II C II admit 10114E15Z' MillAirCtm', '1;17 1W M T INJURYS WEE OF GIRT ov 4, SURVIVING SPOUSE (If wi e, give maiden naMe) INSIDE CI= MITS (Specify Yes or No) 15 e. es STREET OR R.F.D. No. CITY OR TOWN MA T-----,- ern Ave. 1\ -s vas i N.7 1k\ it NAME AND ADD SS OF FACILITY Palo Mortuary Eastern MME STATINGIFIE UNDERLYING CAUSE T \4\I CAUSE OF DEATH STATE EC ATE OFWINUM—Mr HU DIVIS101 HE --MN OF VITAL 0 7 2 4 2 7 CERTIFICATE OF DEATH '1 FiltM I FA a A 1\\ 1. JS CITY, TOWN OR LOCATION OF DEATH r STATEF SOUTHERN_NEWA.QHEALTH USTRICT 62 h so 1 SEALDF THEW UTHEMNEVADA_ HEARY4 a W ff 7 6 .1-=7. m w La N FILE WI u tfi TE FILE NM(EF ft= 'HEREISTRTAR ;AL OPT STATISM, 26 9F N Thi op s issued by_the S_puther_LlievadalealaDistriet from_State certifise I doeunuenas authorize State 175 10' \11.1 tiqt 11\11'1 1 '11141 '0101, Al4 100, v NOT HiD D 1)T O \0,,\,„0,\ 011 40. AISED Registrar ital Miistics 1111 I pB y t I Vegas, 'kJ ada,89127 ID# 88-W1573_ 90 .11alk Las