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HomeMy WebLinkAbout952513RECEIVED 3/11/2010 at 3:37 PM 6011018822 RECEIVING 952513 THE STATE OF WYOMING BOOK: 743 PAGE: 723 SS. JEANNE WAGNER THE COUNTY OF LINCOLN LINCOLN COUNTY CLERK, KEMMERER, WY Alliance Title Escrow P O. Box 1367 Kemmerer. WY 83101 AFFIDAVIT TERMINATING ESTATE BY THE ENTIRETIES I, Richard Gene McCormick, being of lawful 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 County, Wyoming, and the Affiant herein. 2. That by virtue of the conveyance which is recorded in the office of the County Clerk for Lincoln County, Wyoming, located at Kemmerer, Wyoming in Book 622PR on page 503 is recorded a Warranty Deed. The Warranty Deed, dated the 31 day of May, 2006 conveys unto Richard Gene McCormick and Ethel McCormick, as Husband and Wife the following described property, to -wit: 3. That said Ethel McCormick died on the 29th day of December, 2009, and a copy of the original certificate of death, certified to as true an correct by public authority in which the original of said certificate is a matter of record, is attached hereto as Exhibit "A 4. That by reason of death of said Ethel McCormick 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 Richard Gene McCormick continuously since the death of the said decedent. FURTHER AFFIANT SAYETH NOT. Dated: .47/(,) State of Wyoming County of Lincoln Lot 105 of Star Valley Ranch Plat 5, Lincoln County, Wyoming as described on the official plat filed on June 7, 1971 as Instrument No. 431709 of the records of the Lincoln County Clerk. and Gene McCor The foregoing instrument was subscribed and sworn to me by Richard Gene McCormick this day of /Wo 17 2010 Witness my hand and official seal. SHARON NOTARY PUBLIC WALKER STATE OF COUNTY +z s MING LINCOLN MY CnMMItS:QN E It F JUNE 14, 2012 ommission Expires: Notary Pu lic CERTIFICATION OF VITAL RECORD STATE OF WYOMING Certifier: Name: Kitchner P Head, M D Address: PO' Box 280, Afton, Wyoming Date Filed: January 04, 2007 329781 This is a true certification of the document on file in the office of Vital Records Services, Cheyenne, Wyoming. 1 DATE ISSUED: January 22:2007 This copy is not valid.unleas prepared on paper with an engraved border. DEATH CERTIFICATE Decedent: State File Number: 2006 004027 Name: Ethel D McCormick Gender: Female Social Security Number: Date of Birth: June 15, 1938 Age at the Time of Death: 68 years Date and. Place of Death: Date of Death: December 29 2006 County of Death: Lincoln City of Death: Afton Additional Decedent. Information Place of Birth: Ogden, Utah Residence: Star Valley Ranch, Wyoming Marital. Status: Married. Name of Surviving Spouse: Richard McCormick Name of Father: John Coyne Maiden Name of Mother: Olga Lehman Informant: Richard G McCormick Relationship: Husband Disposition: of Disposition: Removal from 'State Place of Disposition: .E=agle Rock Crematory, Idaho Falls, ID Cause of Death: The immediate cause is listed on the first line followed by any underlying causes. Interval: a Respiratory Failure Not Recorded b Metastatic Cancer of the rung c Life Long; Smoking Other Significant Conditions: Not Recorded Manner of Death: Natural .Death.. Time.of Death: 09:40 Brent D. Sherard, M.D M.P.H. Director and State Health Officer 0®6°724