HomeMy WebLinkAbout872612RECEIVED
r t_II'dCO ..N COUNTY CLERK
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AFFIDAVIT OF COLLECTI'O1a 2 I Da STRIBUTION Oat PR 1 I Ali 8 29
46 PR PAGE
3 8 DECEDENT'S PERSONAL PROPERTY
BOOK_ J g� E A gy N1 �ypy,{ C y tt r'''ii iN1ER
KEMMERER, t*II I�OMiUG
The undersigned, being first duly sworn, on oath depose and
state that we are making this affidavit pursuant to Section
2 -1 -201, W.S.A. (1977), on behalf of ourselves as distributees,,as
hereinafter set forth, and that we make the following statements in
connection therewith:
.Philip F rent.chak, Jr., a /k /a Philip FCieiii: died on
July 24, 1996, in Lincoln County, Wyoming, and was a
resident of Lincoln County, Wyoming, at the time of his
death; that said decedent died intestate; that we are the
sole and only parties entitled to the property of the
decedent pursuant to the laws of the State of Wyoming.
2. That the value of the entire estate subject to
administration wherever located, less liens and
encumbrances, does not exceed $70,000.00.
3. That more than thirty (30) days have elapsed since the
date of death of the decedent.
4. That no application or petition for the appointment of a
personal representative of said decedent is pending or
has been granted in any jurisdiction.
5. That the only personal property in Wyoming owned solely
by said decedent and not otherwise disposed of is the
following:
Wyoming Brand No. A0414400
6. The undersigned request that Wyoming Brand No. A0414400
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THE STATE OF WYOMING
COUNTY OF
L C 0 I ry
The above and foregoing instrument was acknowledged before me
-pri') 2001, by Paula Ferentchak.
this '10. day of
WITNESS my hand and official seal.
Notar Public
My Commission Expires:
li -Ile
ss
3
STACY A. WEAANER
Notary Public State of Wyoming
County of Lincoln
My Commission Expires 11/16/2003
383