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HomeMy WebLinkAbout954432THE STATE OF WYOMING COUNTY OF UINTA AFFIDAVIT OF SURVIVORSHIP RECEIVED 7/19/2010 at 10:03 AM RECEIVING 954432 ss. BOOK: 750 PAGE: 600 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY BETTIE J. TRIPP, being first duly sworn upon her oath, deposes and states as follows: 1. On the 16th day of May, 2010, my husband, ELDON LAMONT TRIPP, a/k/a ELDON L. TRIPP, a/k/a ELDON TRIPP, died, as is evidenced by the official certificate of death attached hereto and incorporated herein by this reference. 2. At the time of his death my husband jointly owned certain mineral interests with me, said mineral interests being located in the County of Lincoln and County of Sweetwater, State of Wyoming, and more particularly described as follows: The Southwest Quarter of the Northeast Quarter (SW' NE /4) and all of the Southeast Quarter (SEA) of Section Ten (10), and all of Section Fourteen (14), all in Township Nineteen (19) North, Range One Hundred Twelve (112), West of the 6 P.M., located in Sweetwater County, Wyoming, and the Southeast Quarter of the Northwest Quarter (SE /4) and the Northeast Quarter of the Southwest Quarter (NEl SW /4) of Section Ten (10), in the Township Nineteen (19) North, Range One Hundred Twelve (112), West of the 6 P.M., located in Lincoln County, Wyoming. 3. Said mineral interests were originally conveyed to ELDON L. TRIPP and BETTIE J. TRIPP, husband and wife, as tenants by the entireties, by Mineral Deed dated September 20, 2006, and recorded in the Office of the Sweetwater County Clerk and Ex- Officio Register of Deeds on November 14, 2008, in Book 1132 at Page 1488. 4. By reason of my husband's death, I am entitled to sole ownership of the above mentioned mineral interests. DATED this J day of ox- 00,&60(.1 WITNESS my hand and official seal. IVix Commission Expires: tatg/LSA /21 2 Z- 2 PENNY M. ROBINS NOTARY PUBLIC 4 COUNTY OF C6 d' 74" r' STATE OF UINTA WYOMING MY CMIMISSION EXPIRES 08I 11/1.) I SUBSCRIBED AND SWORN to and acknowledged before me this 2- day of cit./ LL 2010, by BETTIE J. TRIPP. Informant: Decedent: Name: Gender: Date of Birth: Date and Place of Death: Date of Death: May 16, 2010 County of Death: City of Death: Evanston Location: Evanston Regional Hospital 190 Arrowhead Dr. Additional Decedent Information: Place of Birth: Rock Springs, Wyomirg Residence: Mo V'eW W h yotning Marital Status: Married Bettie Jean Taylor Armed Forces: Name of Father: Name of Mother: method of Disposi t ion' Place of Disposition: Funeral Home or Fac lity: Other Significant Conditions: Manner of Death: Injury Information: Date Of Injury: Injury At Work? Location: Description: Certifier: Type: Name: Address: STATE OF WYOMING DEPARTMENT OF HEALTH CERTIFICATE OF DEATH S tate File Number. Eldon Lamont Tripp Male Social Security Number April 24, 1943 Age at the Time of Death: Charles Garie.Trip.p... M4rtha HYaell Bettie Jean Tripp Relationship: Removal from State UFD Drernation Center, South Jordan, UT. Crandall Funeral Home, Evanston, Wyoming Cause of Death: The diale cause is li on the first line followed by any underlying causes (a) Multiple Internal Injuries (b) ATV Accident Accident Time of DeatW, May 16,•201.0 (ACtil0) Tirrie Of Injary: No 3 Mi. S. MP 105 Hwy. 414, Mountain View, Wyoming Victim rollect ATV Sustained Internal Injuries Coroner Wililam Ball,'PeOuty.,Coroner 800 Uinta Street, Evanston Wyoming 82930,.. May 20, 2010 This is a true certification of the document on file in the office of Vital Statistics Services, .Cheyenne, Wyoming: Tuesday,' J 2010 DATE ISSUED: This copy is not valid unless prepared on paper with.an engraved. border. Gladys K. Breeden Deputy State Registrar '1 1/.01fr '..41 lit V CERTIFICATION OF VITAL RECORD 1 147Wily 'vep.