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I, Shirley Allred, being of lawful age and first duly sworn according to law, upon my oath, depose and
state:
0
STATE OF
That I am Successor Trustee of the Charles Newell Brown Family Trust
dated September 20, 1987
1. 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 750PR on page 348 is recorded a QuitClaim Deed. The
QuitClaim Deed, dated the 22`h day of June 2010 conveys unto
James L. Smart and Irene B Smart, Husband and Wife, and Maxine Orton, a single woman,
and Martin L. Allred and Shirley Allred, Husband and Wife, as Tenants in Common
the following described property, to wit:
See attached Exhibit "A"
2. That said Elinor Millward Brown on the 13' day of March, 2005, died 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 `B
4. That by reason of death said Elinor Millard Brown 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 James L. Smart and Irene B. Smart husband and
wife, Maxine Orton, a single woman, Martin L. Allred and Shirley Allred, husband and wife,
as tenants in common continuously since the death of said decedent.
FURTHER AFFIANT SAYETH NOT.
Dated: 9 -/G- ,2010
State of Wyoming
)ss.
County of Lincoln
Th foregoing instrument was subscribed and sworn to me by Shirley Allred,
This 6 day of 2010
Witness my hand and official seal.
My Commission Expires: 9 -/5
AFFIDAVIT TERMINATING ESTATE
RECEIVED 10/5/2010 at 3:54 PM
RECEIVING 955849
BOOK: 755 PAGE: 19
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
GLORIA K. BYERS
Shir y Allred
County of
Lincoln
NOTARY PUBL.I e
State of
Wyoming
My Comm! i n i 4 �:k- i i ii; l 15 2011
000019
EXHIBIT A
000020
Commencing at a point which is 40 rods West and 20 rods South from the Northeast corner
of the NE- %N of Section 10, T31N R119W of the 6th P.M,, Lincoln Coimty, Wyoming,
and running thence South 14 rods; thence West 15 rods; thence North 14 rods; thence East
15 rods to the place of b eginning, being a part of what is Lot 5 in Block 2 of the Fairview,
Wyoming Townsite.
1. DEDEDENTSLEGAL NAME (onclude 015 dany) (First,Middle,last)
":',:t t:t: :'S t
ELINOR* t4IL LWARD BROWN:.
2.688
t:t t:
FEMALE
D. DATE OfDEATH (M0/0011717) (M0/0011717) (Spell Monlh).
MARC1t 13 2005
4:SOCIAL sEcurwri NUMBER
Si:AGE Leit'Bileiday
(Yews)
8 9
PP UNDER'S YEAR
DENtriD
9 1 DAY'''
D. DATE OPSIRTH (Mo/DayNrf'
OCTOBER 27, 1915
&Note
Days
600'
5160(510
7P:SLAGE OF DEATH (Cheeli One) t;
IF 050111 ODGURRED INA HOSPITab:
0 Iribblient 0 ER iOuipatierd 0 DIA:.,.,,
W DEPTH OCCURRED SOMEWHESTROTHER THAM81HOSPITA4
0 H5ipica Facility 0 NunsindHome Long TenSre 0F0040. MD00dent0Reme4 0 OlheiIS2
781.6.81411.171 NAME (11 not insiitution, give street and number)
169 FIRST WEST
70. CITY. TOWN. OR LOCATION OF DEATH
FAIRVIEW
75. COUNTY OF DEATH
LINCOLN
Ts:BIRTHPLACE (difisend 5140 oSinseign 000 0)
FAIRVIEW, WYOMING
:S. MARITAL STATUS ASFTIME CR DEATH
0:Ma11ed 0 mribio. but 5eparaled :112mlenved
Miikqcod'' N.4iNgnid IIKVP■mn
10 SURVIVING SPOUSE (11 001 gitibparnebrlor IsMnitinartiagej:;::
it. EVER IN U.S.
ARMED FORCES?
0 yEs.... N)
120. RESIDENCE STATE
WYOMING
120. COUNTY
LINCOLN'
We. CITY, TOWN OR LOCATION
FAIRVIEW
1281 STREE1'AND NUMBER :t 1
169 'FIRST WEST
12e ZIP CODS tld 121. INSIDE CITY ISMITS?:
83119
6 b i 1 0
13. FATHER'S NAME (FPM. Middle, Last)
LIONEL H NIT,I,WARD..
14. MOTHER'S NAME P9109 10 FIRST MARRIAGE (First, Middle, Last)
MARY' REED JOHN S
1 5 INFORMANT'S NAME t" t
.SHIRLEY ALLRED
S1817AELATIESISHIPITO DECEDENT
DAUGHTER 'i:
MAILINDIADDRESS (poet hq Num*, CIA Sleted:!S‘°° 84169
2867 MQ.UNTAIN VIEW DR. SALT LAKE GITY UTAK:::
16 METHOD OF DISPOSITION
1'3 Burial 0 Donation 0 R moval Rom Wyoming
0 ChIlirelion 't:t aEhlderiboant
17a. PLACE OF DISPOSITION (Name of.
FA7ErTEVCEMETEEY
170. LOCATION- 40101 09 TOWN AND STATE
fAIRVIEW WYOI
NG
M
ISIDWIGNATURE OF e
(or person
1802LICENSE No•
M- 426
iieia. NAME OF FACILITY l::. St:: :t
MORTUARY
,19b. ADDRESS OF FACIL)TY
44' EAST •OtiliTit AVE ::•:',AFTON
20. ACTUAL ESUMEDNME OF DEATH
,035:2
21. DATE
PRONOUNCED 0002 (5101007710)
islARcii .0. 2.005
22. TIME PRONOUNCED DEAD
03-Q...
23. WAS CORONER CONTACTED?
0 YE$.' .,:b NO::
ts dAUSt0PbEAt t:.
24 PART I. Enler OW chain 00 000010 •s- dissase8 Inpuies or complications that directly mused 59 50081 DO NOT enter terminal eeents such as cardiac Approximate Interval:
00001, resecratory amst. or ventiicular fibrillation without showing Ma etiology DO NOT ABBREVIATE. Enter only 0000a000 on a line: Add additional lines Onset to death
CtiC '....(:.i ',...:1 '' 1b
.l•'''
IMMEDIATE CAUSE (Final disclaim or
diiOn resuliew In &MIN PuE r(56 m r 't:' t t .'ltts .:t ''S
Sequentially list conditions, if any,
leading to the muse haled or' One a. 1 Eit 5 i 4 (1.-eiti-r5.
Entef the UNDERLYING CAUSE b.
(disease of rnjuly thati000I45 me DUE TO,Sor as a consequen00.0D
ivents de* LAST. S' 'S S.S :S. :S' S S'
":t.. SS t'•.t. t*,l ••S. .:t: t M. .S
tt'. :St
c.
DUE TO (or es a condequence
"Ss StS S
d..••.; t 1
PARTILEnler other jiimilicanii.onditiens conitioutMo bul deloforiftlng in the smderlying caikee given In Pad 1,:,.
28:10AS ANAUTOSEY
PERFORMED?
OYES 0 NO
28..WEREAUTCWSY FINDINGS AVAILABLE TOCOMPLETE THE CAUSE OF DEATH?
ts.
OYES O 140J:
27. DID TOBACCO USE CONTRIBUTE TO DEATH?
tS "S: St S:S.
OYES NS 't t 059:78ABLY 0 UN4lOWN ttt• 1.: ,'tt
P114
20, IF FEMALEAGED 10.54
0 Not pregnant within peat year 0 Not pregnant, but pregnant 43 days lo 1 year bolero death
0 Piedoem or Hwe of deur, 0 Unkne If propbors with- Ms pa.sl ,991.
17.NOtp 42 days ol depth
29. MANNER OF D
0 eletmai 0 Homicide
"A"1.13,1; 0 Pendirls Mr oaligabbn
01uI015e (7 Cou9 notim determined
30 DATE OF INJURFIMo/DardW)
31. TIME OF INJURY
32. PLNCE OF INJURY.: cOnstruMon Me, Soma efd)
3INJU911IM WORK?' S
OYES 0 NO
34. LOCATION OF INJURY (Skeet and number. City or Town, Mate)
35. IF TRANSPORTATIONACCIDENT. SPECIFY:
0 Driver °meals,' 0 Pedestrian
0 r....witi 0.0tPe' (Speqliy)
:•86. DESCRIBE HOW.INJURYpCCURRED.80) IF TRANSPORTATION IMIURY, THE TYPf(S) OF VEHICLi(S) INVOLVES(Atmothle bicysie Me)
370 CERTIFIER (Check only one)
0 PHYSICIAN --:r•To the peel bl my knowledge, deatli lic deci(iiie. date16n0tplace.Dre1 Melo the came(s) cied memierisleled ss:
o CORTER --pn the MsIs ol ehamination, a y r or in in nijf opiIdp.dbeih I Pre time, 5eea,,6 place*d cluiSo the Muse()ebd mares* stated.
Signature 40011101
01
370 DATE CERTIFIED (Mo/Day/Yr)
3 /0. '7.7
370.14015E, TITLE AND ADDRESS OF CERTIFIER (Type or print)
0D .••••"•FERKBS MO. "410 HOSPITAL LANE:: AFTON WYOMING 83110
REGIST..ARS SIGN
380 DATE RECEIVED BY REGISTRAR IM04Dey(Y5
NSW
LOCAL FILE NUMBER
DEPARTMENT OF HEALTH
This is a true and exact reproduction of the document on file in the office of Vital
Records Services, Cheyenne, Wyoming.
MAR 2-00')
DATEISSUEL):
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
This copy is not valid unless prepared on paper with an engraved border displaying the date, seal and signature of the Deputy State Registrar.
01)021
STATE FILE NUMBER
Lucinda McCaffrey
Deputyttate Registrar
Ir g
CERTIFICATION OF VITA
fpg Ito