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Home My WebLink About9544176011019077 STATE OF WYOMING SS COUNTY OF LINCOLN AFFIDAVIT ESTATE BY ENTIRETIES Lot Four (4), of Block Eighteen (18) in the Auburn Townsite, together with improvements and water rights, Lincoln County, Wyoming. hi 0 5'72 Eileen I. Burton, first duly sworn, upon oath, deposes and says: 1. Ralph A. Izatt and Verla W. Izatt, were married to each other at Idaho Falls, Idaho on February 23, 1949 and they lived together as husband and wife for many years and continuously until the death of Verla W. Izatt. 2. On September 29, 1951, Forrest L. Walton and Maxine J. Walton, husband and wife, conveyed by Warranty Deed to Ralph A. Izatt and Verla W. Izatt, husband and wife, by entireties, the real estate described as follows: The Warranty Deed was recorded in the office of the Lincoln County, Wyoming, Clerk and Recorder in Book 28, Page 127 and thereafter Ralph A. Izatt and Verla W. Izatt, husband and wife, became owners of the property by entireties. 3. Verla W. Izatt died on June 1, 1997. Attached is a copy of her official Death Certificate certified to by the Vital Records Services, Division of Health and Medical Services, Wyoming Department of Health and Social Services, the public authority with which the original Death Certificate is of record according to law. 4. By reason of the death of Verla W. Izatt, Ralph A. Izatt became the sole owner of the above described real estate interest on June 1, 1997. 5. Ralph A. Izatt died on March 8, 2008. Attached is a copy of his official Death Certificate certified to by the Vital Records Services, Division of Health and Medical Services, Wyoming Department of Health and Social Services, the public authority with which the original Death Certificate is of record according to law. 6. By reason of the death of Ralph A. Izatt, pursuant to Order Granting Application for Summary Decree of Distribution of Personal and Real Property filed on June 2, 2009 by the District Court of the Third Judicial District and recorded on June 17, 2009 at Book 725, Pages 574 and 575 in the records of the Lincoln County, Wyoming Clerk and Recorder, Eileen I. Burton, Brad W. Izatt, Len W. Izatt and Eddie Ralph Izatt became the sole owners of the above described real property. Eileen I. Burton 44 Subscribed and sworn to before me by Eileen I. Burton, this -a d ay of 2010. Witness my hand and official seal. My commission expires: Cat..$ 3,7)71 Corey R. Miles Notary Public County of State of Lincoln d Wyoming SEAL My Commission Expires October 12, 2011 Notary Public RECEIVED 7/16/2010 at 3:02 PM RECEIVING 954417 BOOK: 750 PAGE: 572 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY 048829 Wiz/ TYPE OR PRINT N PERMANENT BLACK INC FOR INIFIRUCTIONS SEE WOK 21m. LOCAL FILE NUMBER 1. DECEDENT-NAME FIRST -A 2•. MANNER OF DEATH y VFI 2-89 444 16M VERLA 4. SOCIAL SECURRY NUMBER a PLACE OF DEATH (Chock any one) 0 Npatlent 0 ER /0obadnt 0 DOA 7b. FACILITY NAME (I not hearties OAe sksat and 00020) 199 FIRST WEST S. STATE OF BIRTH (I not is U.S.A. none reeky) WYOMING 11. WAS DECEDENT EVER. IN U.S ARMED FORCES? (Sassily ms or no) 130 RESIDENCE STATE WYOMING (3e. INSIDE CfY UNITS? (Away Liss a` no) NO 17. FATHERS NAME Flat WILLIAM ammi 1NLNFORMMTT -NAME rno. or Ales) RALPH A. IZATT 200 axial, Ooa tka LS Rsmyal acm Shea. DMr pedfy) P. 0. BOX 184 225 DATE WED, Se6anNtly Nit ardAka, N atm leading b IAmedlele aced. Enter INIDEELYIq CAUSE IDlease a weeny Nat Ny8aled monis 010(Abg In b.8) LAST Y. ElPenerf Accident Waldo Q OMennined Herniae* NO This is a true and exact reproduction of the document on file in the office of Vital Records Services, Cheyenne, Wyoming. 13b COUNTY LINCOLN 16c MAILING ADDRESS STREET OR REM. NUMBER IOW 2. To The bat my b the cw(0) staled. (Aran and 1161 I. a Date Issued: ,JUL 1 2 2010 This copy is not valid unless it bears a raised seal and is produced on multicolored security paper. 5. AGE -Last Siren (leas) 6? 14. WAS DECEDENT OF HISPAWO maw? (Specify no or yss b yes, apwa1V Cuban. Mexican, Rano Rican. Eta) L)( Ys. 0 (Away/ LYLE 200. DATE (Ma, Dy, .11) JUNE 5, 1997 26s. (EGRTRAR STATE OF WYOMING DEPARTMENT OF HEALTH CERTIFICATE OF DEATH 0 Nur.ar6 T MARRIED, NEVER MARRIED, WIDOWED, DIVORCED (SP•o6Y) MARRIED 124. USUAL OCCUPATION' (Oar Nod of auk done Wring most •d< working Wa, wan I need) NURSE 130 CITY, TOWN OR LOCATION AUBURN WALTON LAST IZATT 6b. UNDER 1 YEAR Month Days CITY OR TOWN AUBURN 200. CEMETERY OR CREMATORY -NAME 20d. LOCATION CfTY OR TOWN AUBURN WYOMING Acting Number 215, NAME Of FACILITY Number 21c..AODRESS OF RACIUTY SCHWAB,MORTUARY 45 44 EAST FOURTH AVE., AFTON .rtl plea and due 230 On the 68* at eronrrlton end /or snnetlplIn, M my *Moo death occurred at the time, date and place and dab The muss(*) staled. (S7pek s w7 Tltls) P 2 c.. -JR OF 4EATH 236, DATE MINED let, Gay, YrJ u.. HOUR. CF 0051; I 1r AUBURN CEMETERY Hoes Ohwra Spedh) 7c. CRY. TOWN, OR LOCATION OF DEATH AUBURN 10. SURVIVING SPOUSE (6 MN, NMI neidsn n RALPH A. IZATT (5. RACE-American Wan, Whir, Eta WHITE 18. MOTHER'S NAME First NETHIE STATE WYOMING 11:15 24. NAME AND ADDRESS OF CE1' 1F(ER (PHYSICIAN OR CORONER)R)P. a Mee) O. D. PERKES MD. 110 HQSPITAL LANE MA'F I. E,Mr the dMmss, Nunes, or oanpb8bms 6W awned bath. Do NT enter The nods of dyip, pall es cardiac 26, at espksbry an0M, shock, so heart awe. Lid Billy ana sae an MA Nn. ANN. BNROIIRE CAUSE (FAN �j ntmalno m cadbn ,l a Ve(e_ VL V -e_ In drM) M a DUE TO (OR AS A CONSEQUENCE OFT DUE TO (OR AE A CONSEQUENCE OF): DUE 1O (OR AS A CONSEQUENCE OF): HINT N, ME 9ENMf1CANT GO)ATTIO NS•CadJbn. contributing b dank but not rslehd b.uuse Own .b PART L 300. DATE OF INJURY (Month, Del 14*) 306.130E OF INJURY M 30a. PLACE Of INJURY -AT home, term, .heat, Imlay. take Mulling, do; NOM* 23d. PRONOUNCED DEAD (RIO., Day, riJ 30c. INJURY AT WORI(? (,lent/ yes or no) 2. SEX 6e. UNDER 1 DAY Minutes 00 573 Gladys K. Breeden Deputy State Registrar 3d. STREET AND NUMBER 199 FIRST WEST 91 -01b42 STATE )RINGER 3. DATE OF DEATH (Ma, Day, 1y) FEMALE JUNE "I- 199? e. DATE OF BIRTH (MO., Day, W.1 JULY 29, 1929 12b: KIND OF BUSINESS Oil INDUSTRY HEALTH CARE 16. DECEDENT'S EDUCATION (SPsd(y only NWrf Fade canpleled) Td. COUNTY OF DEATH LINCOLN Efemantuy /SecaNvy (0 -12) WIN* (1 -4 or 601. 12 2 16b RELATIONSHIP TO DECEDENT HUSBAND ZIP COOS 83111 LEAVITT AFTON WYOMING 83110 260. DATE RECEIVED By REG131RAR (A(a. Day, (0) Malden Surname STATE 23.. PRONOUNCED DEAD (Her) M !Marvel Onset ad 11.04*. #71.034.Y4.5 ye 0707 27. AUTOPSY (Beady/ 20. YANSGASE REFERRED TO CORONER we or MN) 1 oral/ w cur M) NO NO SOd. DESCRIBE HOW INJURY OCCURRED SD. LOCATION Mese and McMr Or Rune AOde Number, City or 1bwn, SAM.) CERTIFICATION OF VITAL RECORD'; ....vu,..n .1.N ..v..............s., vb'v vv •v 1... v'vmr.. •t v ::'v.. ..r.a „s... .t..,. t .r....,tas. v..it rtr•vxt: DECEDENT, INFORMATION Date of Death: March 8, 2008 City of Death: Age: Place of Birth: Armed Services: Spouse's Name: Industry/Business: Residence: Mother's Name: Facility or Address: INFORMANT INFORMATION Name: Cora Lois -Izatt Relationship: Mailing Address: 1633 West 980 South, Orem, Utah 84058 DISPOSITION INFORMATION Method of Disposition: Burial Place of Disposition: Auburn Cemetry Auburn, Wyoming FUNERAL HOME INFORMATION Funeral Home: Berg Mortuary of Provo. Address: PO Box 1468, 185 East Center Street, Provo, Utah 84603 Funeral Director: J Todd Jenkins MEDICAL CERTIFICPI.TION Certifying Physician: Keith Hooker MD, 1034 North 500 West, Emergency Room, Provo, Utah 84604 CAUSE OF DEATH Cardiac Arrest 'Metastatic Cancer of Colon Tobacco Use: Non -user Medical Examiner Contacted: No Autopsy Performed: No Manner of Death: Natural Date Issued: March 12, 2008 G AfA This is an exact reproduction of the document registered in the State Office of Vital Statistics. Security features of this official document include: Intaglio Border, V R images in top cycloids, ultra violet fibers and hologram image of the Utah State Seal, over the words "State of Utah This document displays the date, seal and signature of the State Registrar and the County /District Health Officer. e Barry E. Nangle, State Registrar Office of Vital Statistics 41.11 1 ip Provo 83 Afton, Wyoming Yes Cora Lois Sucher U.S. Soil Conservation Service Orem, Utah Annie Elizabeth Anglesey Utah Valley Regional Medical Center CERTIFICATE OF DEATH State File Number: 2008002873 wife Date of Disposition: March 14, 2008 Ralph A Izatt .IJJJJ Time of Death: County of Death: Date of Birth: Sex: Marital Status: Usual Occupation: Education: Father's Name: Facility Type: ;3R�a }/'�tl¢y7. %;F','.% Z':t2 i ;v`i3j�llN 04:30 Utah October 13, 1924 Male Married Civil Engineer Some College but No Degree Ira Deloss Izatt Hospital ER "4594 11111 1 flu1Ui 1111 1 Joseph Miner, MD, 0 6 1 -7 9 9 9 3 1* Director /Health Officer County /District Health Department pop I I