HomeMy WebLinkAbout956723When recorded, please return this affidavit to:
EDWARDS LAW OFFICE, P.C.
PO Box 5345
Etna, WY 83118
and tax statements to:
Mary Ellen Conine Lichter
PO Box 3150
Alpine, WY 83128
STATE OF WYOMING
SS
COUNTY OF LINCOLN
says:
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RECEIVED 11/15/2010 at 11:09 AM
RECEIVING 956723
BOOK: 757 PAGE: 147
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
AFFIDAVIT OF SURVIVORSHIP OF MARY ELLEN CONINE LICHTER
COMES NOW, Mary Ellen Conine Lichter, first duly sworn, upon her oath, deposes and
1. Mary Ellen Conine Lichter is the widow of Nicholas W. Lichter and has
knowledge of and is competent to testify concerning the facts as stated below.
2. Mary Ellen Conine Lichter and Nicholas W. Lichter were married to each other
on March 11, 1999 in the state of California and they lived together as husband and wife in
Lincoln County, Wyoming for many years and continuously until the death of Nicholas W.
Lichter.
3. Mary Ellen Conine Lichter and Nicholas W. Lichter owned, as Husband and Wife
as joint tenants with right of survivorship, the following real property:
Lot 1, Rees Subdivision according to the official Plat thereof, on file in the Lincoln
County Clerk's Office, Kemmerer, Wyoming (The "Property
AFFIDAVIT OF SURVIVORSHIP OF MARY ELLEN CONINE LICHTER
000147
000148
and as indicated by the Quitclaim Deed recorded as Document No. 920722 at Book 628,
Page 107 in the Lincoln County Clerk's Office, Kemmerer, Wyoming.
4. On October 8, 2010, Nicholas W. Lichter died in Afton, Lincoln County,
Wyoming Attached is a Certified Copy of his official Death Certificate certified to by the State
of Wyoming, Department of Health, the public authority with which the original Death
Certificate is of record according to law.
5. By reason of the death of Nicholas W. Lichter on October 8, 2010, Mary Ellen
Conine Lichter became the sole owner of the Property.
DATED: this 12` day of November, 2010.
Subscribed and sworn to before me by Mary Ellen Conine Lichter this 12th day of
November, 2010.
Witness my hand and official seal.
JACK D. EDWARDS NOTARY Pt;'.s
COUNTY OF A +i'' STATE
S ELEOLN
MY COMMISSION EXPIRES
My commission expires: January 14, 2014.
JACK D. EDWARDS NOTARY PUBLIC
COUNTY OF °Cv;' STATE OF
LINCOLN WYOMING
MY COMMISSION EXPIRES
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Mary Ellen 'Conine- Lichter
NOTARY PUBLIC
AFFIDAVIT OF SURVIVORSHIP OF MARY ELLEN CONINE LICHTER
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of. Death:
Date of Death:
City of Death:
Location:
Additional Decedent Information:
Place of Birth: Chicago Illinois::
Residence: Alpine,'Wyorning
Married Mary Ellen Conine
Yes
'Raymond Richter
Anne H Post
Mary Ellen Lichter
Marital Status:
Armed Forces:
Name of: Father:
Name of Mother:
Informant:
Disposition:
Method of Disposition;
Place of Disposition:
Funeral Home or Facility:
Facility: Schwab Mortuary Afton, W \joming
Nicholas William'Llchter
Male
August 17, 1943.
08, 2010
Afton
Star Valley. Medical Center 1
Date Filed: October, 12 20:10
CERTIFICATE OF DEATH
Cremation
Eagle Rock Crematory, Idaho Falls, Idaho
Trrls is a true certification of the document on file in the office of Vital
Statistics Services, CheyeniW -60a October 13:: 2010
DATE ISSUED:
This copy is not unless prepared on. paper witfi anengrsved border
County of Death:
0 Hospital lane
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Congestive Heart Failure
(b) Arteriosclerdtic Cardiovascular Disease
Other Significant Diabetes
Conditions:
Manner of Death: Natural Death Time of Death
Certifier:
Type: Coroner
Name: Michael Richins, Coroner
Address: 274 N St, Box 57, Grover, Wyoming, 83122
I
STATE OF WYOMING
DEPARTMENT OF HEALTH
State File Number;
Social Security Number:
Age at the Time of Death:
Wife
Gladys K. Breeden
Deputy State Registrar
Lincoln
05:00 (Approximate)
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"SP to t re
CERTIFICATIO 1T_ A L RECORD