HomeMy WebLinkAbout955309STATE OF WYOMING
Affidavit of Survivorship
Estate of Larry Wynn Meeks
Page 1 of 5
COUNTY OF LINCOLN
We, Justin Wayne Meeks, Paul Wynn Meeks and Sonja Marie Meeks Cassidy, being of
full age and first duly sworn upon oath, depose and say:
1. Larry Wynn Meeks, died at Salt Lake City, Utah upon May 5, 2009. A certified copy if
the certificate of death of said Larry Wynn Meeks is attached hereto as Exhibit "A
2. At the time of his death, Larry Wynn Meeks was a resident of Kemmerer, Lincoln
County, Wyoming.
3. Said Larry Wynn Meeks died testate. A Holographic Will was located and filed with the
Third Judicial District Court, Lincoln County, Wyoming
4. Pursuant to W.S. §2 -1 -205 all real property held by the decedent, Larry Wynn Meeks has
been distributed.
5. The heirs of Larry Wynn Meeks are:
Paul Meeks
59 County Road 4380
Blanco, NM 87412
Sonja Cassidy
4306 N 2600 E
Filer, ID 83328 -5171
Justin Meeks
P.O. Box 561
Diamondville, WY 83116
AFFIDAVIT OF SURVIVORSHIP
Son
Daughter
Son
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RECEIVED 9/2/2010 at 3:19 PM
RECEIVING 955309
BOOK: 753 PAGE: 138
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
and are named as heirs in the will filed with this Court.
6. This Affidavit of Survivorship for the Estate of Larry Wynn Meeks is made pursuant to
W.S. §2 -1 -201.
7. The value of the entire estate does not exceed one hundred fifty thousand dollars
($150,000.00).
8. Thirty (30) days have elapsed since the death of the decedent.
9. No application for appointment of a personal representative for the estate of Larry Wynn
Meeks is pending or has been granted in any jurisdiction.
10. At the time of his death, Larry Wynn Meeks has a bank account with 1 Bank in
Kemmerer, Wyoming.
16. We hereby request that new title be issued for the 1973 Ford Pickup owned by Larry
Wynn Meeks in the name of Justin Meeks.
17. We hereby request that title to the 2006 Nissan Frontier which has been paid for, be
transferred to the name of Justin Meeks.
Affidavit of Survivorship
Estate of Larry Wynn Meeks
Page 2 of 5
[Three separate signature pages follow.]
11. At the time of his death, Larry Wynn Meeks owned a 2006 Nissan Frontier with a lien
held by Bank of America.
12. At the time of his death, Larry Wynn Meeks owned a 1973 Ford Pickup
13. At the time of his death, Larry Wynn Meeks held clear title to a 1991 Dutchman 22 foot
Travel trailer, and a 2008 Polaris 500 4x4 ATV.
14. At the time of his death, Larry Wynn Meeks owned assorted personal property.
15. We hereby request that the money in the 1 Bank account be used to pay our attorney
herein and that the remainder be divided equally and paid out to the heirs named herein.
18. We hereby request that title to the 1991 Dutchman 22 foot Travel trailer be transferred to
the name of Paul Meeks.
19. We hereby request that title to the 2008 Polaris 500 4x4 ATV be transferred to the name
of Sonja Cassidy.
2010.
(SEAL
DATED thi2 day of S d p1 p 2010.
Subscribed and sworn to before me by Paul Wynn Meeks this day of
WITNESS my hand and official seal.
Affidavit of Survivorship
Estate of Larry Wynn Meeks
Page 3 of 5
OFFICIAL SEAL
THELMA JO RICHARDS
NOTARY PUBLIC STATE OF NEVI MIXICJ00
My commission expires c: /f
My commission expires: ieuy,,n -07s
aul Wynn Meeks
40
Subs and sworn to before me by Sonja Marie
2010.
(S E A
DATED this ow
osqb
day of J (j,le, 2010.
WITNESS my hand and official seal.
JOSHUA 0 ROSE
Notary •Public
$t* of Idaho
Affidavit of Survivorship
Estate of Larry Wynn Meeks
Page 4 of 5
My commission expires: /0 27- Zvi 5:
Sonja
arie Meeks Cassidy
Meeks Cassidy this
Notar 'r .lic
day of
41
DATED this 23 dd\-
ay of.r 2010.
J tin Wayne Meeks
Subb cribed 4nd sworn to before me by Justin Wayne Meeks this c23 day of
i}liri 2010.
(S E A L)
WITNESS my hand and official seal.
My commission expires:
Affidavit of Survivorship
Estate of Larry Wynn Meeks
Page 5 of 5
\0 'fib
Notary Public
1.42 2
DECEDENT INFORMATION
Date df Death: May 5, 2009
City of Death: Salt Lake City
Age: 65
Place of Birth: Evanston, Wyo C ing
Armed'' Services: No
Spouse's Name:
Industry Business.
Residence:
Mother's Narne:
Facility 'or Address:
I NFORMANT INFORMATION
Name J
Mailing Address P. O. Boxo561,
DISPOSITION INFORM
Method of Pisposition::
Place of Disposition
Date/of Disposition:
FUNERAL HOME IN
Funeral Home:
Address:
Funeral Directory
Coal mmmg
Diamondvilie, Wyoming
Myrna Jean Rounds'
Intermountain Medical ,Center,
MEDICAL CERTIFICATIO
`Medical" Professional Cho! Zuraskyl
CAUSE OF DEATH
Intracerebral bemor h ge
"Due to (or as a.conseque ,pc of
To acco Use Did nottontnbut
Me�dical'Examiner Contacte
RMATI
randall Funeral Home,
PO Bb 6, 105 East Center
WilliamWBall
ERTIFICATION OF VITAL RECOR
CERTIFICATE OF DEATH
State File Number: 2009017833
Larry Wynn Meeks
Time of Death:
County pf Death:,
Date of Birth:
Sex:
Marital Status:}
Usual Occupation:
Education:
Father's`' Name:
Facility Type
12:22
Salt Lake
December 10 1943
Male
Widowed
Welder,
9th Through 12th Grade
William Joseph Irleeks
Hospital Inpatient
ermountain Medical,Certter 5121 South Cottonwood' Street; Murray, Utah
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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 lologramimage of the Utah State, Seal over the words` State of Utah''. This
document displays_the date, seal and signature of State. Registrar and the County /District Health Officer:
Barry E. Nangle State Registrar
Office'of Vltal.Statistics;
11 111 101 11 II
aryl Edwards
Director/Health Officer
County /District�Health Department