HomeMy WebLinkAbout9582009
6 011119808:
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
I, David Wayne Despain being of lawful age and first duly sworn according to law,
upon my oath, depose and state:
Dated
AFFIDAVIT TERMINATING ESTATE
1. That I am of adult age, a resident of Lincoln County, Wyoming, and the
Affiant herein.
2. That by virtue of the conveyance which is recorded in the office of the
County Clerk for Lincoln County, Wyoming, located at Kemmerer,
Wyoming is recorded a Quit Claim Deed in Book 682PR on page 577.
The Quit Claim Deed dated the 27th day of December, 2007 conveys
unto the David Wayne Despain- Bessie Ann Despain Family Trust, Dated
November 10, 2007, David Wayne Despain and BessieAnn Despain,
Trustees, the following described property, to -wit:
See attached Exhibit "A"
RECEIVED 2/18/2011 at 3:30 PM
RECEIVING 958200
BOOK: 762 PAGE: 753
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
000753
3. That said Bessie A. Despain died on the 19th day ofFebruary, 2010 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 of said Bessie A. Despain 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 David Wayne Despain, Successor Trustee_continuously
since the death of the said decedent.
FURTHER AFFIANT SAYETH NOT.
State of Wyoming
)ss.
County of Lincoln
Witness my hand and official seal.
My Commission Expires:
The foregoing instrument was subscribed and sworn to me by David Wayne
Despain this f b day of Lt. 2007 .2.e>/)
9- /5- /J
r�
David a
ne D �fes 4
Y P
Notary Public
My Commission Expires September 15, 2011
Exhibit A
File 6011119809TD Description
000754
The land referred to in this document is situated in the State of Wyoming, County of Lincoln, and is
described as follows:
Beginning at the Southwest corner of Lot 2 in Block 8 of the Afton Townsite, and running
thence North 110 feet; thence East 167 feet; thence South 110 feet; thence West 167 feet to the
place of beginning.
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Facility:
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
Decedent: 7 State File Number: 2010- 000444.
Name: Bessie A. Despain
Gender: Female Social Security Number:
Date of Birth: October 16, 1929 Age at the Time of Death: 80 years
Date and Place of Death:
Date of Death: February 19, 2010
City of Death: Afton
Location: Star Valley Medical Center 110 Hospital Lane.
Additional Decedent Information:
448718
This is a true certification of the document on file in the office of Vital
Records Services, Cheyenne, Wyoming.
DATE ISSUED: Thursday, February 25, 2010
Evanston, Wyoming
Afton, Wyoming
Married'- David Wayne Despain
Burial
Evanston Cemetery, Evanston, Wyoming
Schwab Mortuary, Afton, Wyoming
No
James C Turner
Bessie Maud Danks.
Alice Ann Shaffer Relationship Daughter
uses.
Lincoln
Time of Death: 00:10 (Actual)
This copy is not valid unless prepared on paper with an.engravedborder.
Cause of Death:
The immediate cause is listed on the first line followed' by any underlying c
(a) colon cancer
Physician
Allen D. Carter,M.D.
110 Hospital Lane, PO Box 579, Afton, Wyoming, 8311.0
February 24, 2010
Gladys K. Breeden
Deputy State Registrar
was
c
eY
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CERTIFICATION OF VITAL RECORD'