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HomeMy WebLinkAbout959130I, Florence Varney Wignall, being of lawful age and duly sworn according to law, upon my oath, depose and state: That under the date of June 1, 1995, for valuable consideration, Leisure Valley, Inc., by deed of that date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on June 14, 1 995, in Book 369PR, Page 355, conveyed to Parley Varney and Florence Varney, Joint Tenants, the following described land, in the County of Lincoln, State of Wyoming, to -wit: Star Valley Ranch RV Park Plat One (1) Lot Three Hundred Ninety Four (394) as platted and recorded in the Official Records of Lincoln County, Wyoming That by reason of said conveyance aforesaid, the said Parley Varney and Florence Varney, became the owners of said real property, and the title thereto vested in them continuously from the date of said conveyance, to the date of death of Parley Varney, on the 25th day of November, 2007. That by reason of and upon the death of Parley Varney, title in the above described real property vested in Florence Varney. Affiant avers and certifies that Parley Varney, also known as Parley Eugene Varney, is the identical party named with Florence Varney in the aforementioned deed, whose death terminated his interest, title and estate in said real property; and Affiant attaches hereto, and makes a part of this affidavit, a copy of the Official Certificate of Death of said decedent, duly certified by the public authority in which said death certificate is a matter of record. Dated this State of Ufa dl f ss. County of ioa5ht Ivj+OK ubscribed word to before me, a notary public in and for said County and State, by Florence Varney ignall, this ?.4 day of 2011. WITNESS my hand and official seal. ANN B. MARSHALL Newry MSc *State of Utah Commission #605393 COOKUP.02424011 My Commission Expires: day of This Document is beih9 recorded by Rocky Mountain Title Insurance Agency of Lincoln County as a COURTESY only Affidavit of Survivorship a/o a o 2011. e_ loren2' arney Wignall Notary Public RECEIVED 5/2/2011 at 12:25 PM RECEIVING 959130 BOOK: 766 PAGE: 164 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY la o• 61E4 up CERTIFICATION OF VITAL RECORD 5.,.. r:A.. .A ....A. u........rJrrv... !ttvt °rvr:vR•rwv:v::..r v ...........i Manner of Death: Natural David W. Blodgett Director /Health Officer County /District Health Department :AAA .1 AA':l,fIAAA AI _Y 11Af54j4 A*. AAAAAAAAktAAMA DECEDENT INFORMATION Date of Death: November 25, 2007 City of Death: Washington Age: Place of Birth: Armed Services: Spouse's Name: Industry/Business: Residence: Mother's Name: Facility or Address: INFORMANT INFORMATION Name: Florence Virginia Varney Relationship: Mailing Address: 2108 N. Silver Stone Way, Washington, Utah 84780 DISPOSITION INFORMATION Method of Disposition: Burial Date of Disposition: November 29, 2007 Place of Disposition: Washington City Cemetery, Washington, Utah FUNERAL HOME INFORMATION Funeral Home: Heideman Mortuary Address: 170 S Mall Drive, St George, Utah 84790 Funeral Director: Brien K.Heideman MEDICAL CERTIFICATION Certifying Physician: Robert Lemon MD, 544 S. 400 E., St George, Utah 84770 CAUSE OF DEATH Cardiorespiratory Failure Acute Myelogenous Leukemia [Onset: 2 Months] Tobacco Use: Did not Contribute Medical Examiner Contacted: No Autopsy Performed: No J u�wa Nzst° Jdi f\ b1 iii i 1 December 4, 2007 83 American Fork, Utah. Yes Florence Virginia Greer Petroeum Washington, Utah Lovina Conder 2108 N. Silver Stone Way u III O�.�r:�i CERTIFICATE OF DEATH State File Number: 2007013053 Parley Eugene Varney Time of Death: County of Death: Date of Birth: Sex: Marital Status: Usual Occupation: Education: Father's Name: Facility Type: uiu 21:45 Washington March 22, 1924 Male Married Engineer High School or GED Jacob Earl Varney Home Wife', 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, ��uu�`qunl y hi ultra violet fibers and hologram image of the Utah State Seal, over the words "State of Utah". This document displays the date, seal and signature of the State Registrar and the County /District Health Officer. ve 0 /7 4 IN. IN Qr�� U r aei A `1 q sct is /1 Barry E. Nangle, State Registrar Office of Vital Statistics f "RAW r.;