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HomeMy WebLinkAbout955495STATE OF WYOMING ss. COUNTY OF LINCOLN AFFIDAVIT OF SURVIVORSHIP 00 619 We, PHILLIP J. KRALL and M. BRANDON KRALL being of legal age and first duly sworn, depose and say as follows: 1. That Robert Wilhelm Krall, the decedent mentioned in the attached certified copy of the certificate of death, is the same person as Robert W. Krall named as one of the parties in that certain Quitclaim Deed dated October 12, 2004, executed by Robert W. Krall and Matthew W. Krall to Robert W. Krall, Phillip J. Krall and M. Brandon Krall, as joint tenants with rights of survivorship, recorded as Instrument Number 904491, on November 10, 2004, in Book 572PR at Page 196, of the Official Records of Lincoln County, State of Wyoming, concerning the real property situated in the County of Lincoln, State of Wyoming and described as follows: Lot 40 of Block 27, Town of Diamondville, Lincoln County, Wyoming, as surveyed, platted and recorded in the Office of the Lincoln County Clerk and Ex- Officio Register of Deeds. TOGETHER WITH all improvements and appurtenances thereon situate or in anywise appertaining thereunto, SUBJECT, HOWEVER, to all reservations, restrictions, protective covenants, exceptions, easements and rights -of -way of record or in sight or use. 2. That Robert Wilhelm Krall, the decedent mentioned in the attached certified copy of the certificate of death, is the same person as Robert W. Krall named as one of the parties in that certain Quitclaim Deed dated October 12, 2004, executed by Robert W. Krall, Florence B. Krall, n/k/a Florence B. Shepard, Kathryn Ann Krall Morton, Matthew W. Krall, Mary Elyse Krall Prus, n/k/a Mary Elyse Krall and Robert C. Krall to Robert W. Krall, Phillip J. Krall and M. Brandon Krall, as joint tenants with rights of survivorship, recorded as Instrument Number 904492, on November 10, 2004, in Book 572PR at Pages 197, 198, and 199 of the Official Records of Lincoln County, State of Wyoming, concerning the real property situated in the County of Lincoln, State of Wyoming and described as follows: Lots 38 and 39 in Block 27 of the Town of Diamondville, County of Lincoln, State of Wyoming, together with all buildings, improvements and appurtenances thereon situate or in anywise appertaining thereunto. SUBJECT, however, to all restrictions, easements, reservations, and rights of -way of record or in use. RECEIVED 9/14/2010 at 2:26 PM RECEIVING 955495 BOOK: 753 PAGE: 619 JEANNE WAGNE I inirni ni rani INTY (1 PRK KFnnnni —m—R WY 000620 3. That we are the same Phillip J. Krall and M. Brandon Krall mentioned in the above referenced Deeds and thereby are a person interested in the effective property or the title thereto and pursuant to 2 -9 -102 W.S. (1980) hereby make the death a matter of record and certify that upon the death of Robert W. Krall, his previous estate in the property was terminated. 4. That the certified copy of the certificate of death indicates that Robert Wilhelm Krall died on August 6, 2010 in the City of Salt Lake City, County of Salt Lake, State of Utah. Dated this S 34- day of September, 2010. STATE OF WYOMING ss. COUNTY OF LINCOLN JOSEPH B. BLUEMEL NOTARY PUBLIC COUN1Y OF STATE OF LINCOLN. WYOMING MY COMMISSION EXPIRES 2 2010. STATE OF WYOMING COUNTY OF LINCOLN ss. JOSEPH B. BLUEMEL NOTARYPUBLIC COUNTY OF STATE OF LINCOLN .asr; WYOMING MY COMMISSION EXPIRES 2 2e 2 PHILLIP J. KRALL MBRANDON KRALL Subscribed and sworn to before me by Phillip J. Krall, this 131 day of September, 2010. N. ary ublic My Commission Expires: f-e 'ks,, Subscribed and sworn to before me by M. Brandon Krall, this 1 day of September, tary ublic My Commission Expires: DECEDENT INFORMATION Date of Death: City of Death: Age: Place of Birth: Armed Services: Spouse's Name: Industry/Business: Residence: Mother's Name: Facility or Address: Name: Kathryn Morton Mailing Address: 223 East,4th Avenue, N DISPOSITION INFORMATION Method of Disposition: Cremation August 6, 2010 Salt Lake City 92 1 Sublette, Wyoiqing' Yes Wyoming Dept. of Transportation Diamondvilie, Wyoming Elise Saxe. Brighton Gardens Of Salt Lake CERTIFICATE OF DEATH State File Nurnber: 2010009049 Robert Wilhelm Kral! Time of Death: County of Death: Date of Birth: Sex: Marital Status: Usual Occupation: Education: Father's' Name:.? Facility Type: Relationship Salt Lake City, ;Utah 8410,3 Place of Disposition: LarkinSunset Lawn Crematory ,,Salt Lake City Utah Date of Disposition: August 6, 2010 FUNERAL HOME INFORMATION Funeral Home: Larkin Sunset Lawn Address: 2350 East 1300 South, Salt Lake City,; Utah 84108 Funeral Director: Travis Greenwood 1 w3 MEDICAL CERTIFICATION Medical Professional: Kathryn Morton, 223 East 4th Avenue; Salt Lake City ;(Salt Lake), Utah 84103 CAUSE OF DEATH Gastrointestinal bleed [Onset: 7 Hours] Due to (or as a consequence of): Pulmonary hypertension [onset: 3 Years] Tobacco Use: Probably Contributed Medical Examiner Contacted: Yes Autopsy Performed: No Manner o, Dea h: Natural Date Issued: August 9, 2010 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 disp la y s the dat seal and signature g of the State Registrar and the County/District Health Officer. 13 :59 Salt Lake May 1,1, 1918 Male Widowed Highway Engineer Some College but No.Degree William Krall Nursing Home /Assisted Living aught 12.049621 Gary( Edwards Director /Health Officer County /District Health Department p I`0P E -itik r 4,0' �y�k� �1J/ Barry E. :Nangle, State Registrar r -4 44. r -ra Qtfi ce.of..YitaL.Statistics..... �y1 VeV11DR131 Ng Vial I lip CERTIFICATION OF VITAL RECORD