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HomeMy WebLinkAbout959301IN THE DISTRICT COURT OF THE THIRD JUDICIAL DISTRICT IN AND FOR THE COUNTY OF LINCOLN, STATE OF WYOMING IN THE MATTER OF DETERMINATION OF HEIRSHIP OF LINDA LOUISE RUDDY, Deceased. STATE OF NEVADA ss. COUNTY OF C-\ 04' AFFIDAVIT FOR DISTRIBUTION OF ESTATE 000687 Probate No. I, Dorothy A. Haliburton, being first duly sworn, on oath depose and states as follows: 1. That I am over the age of twenty -one (21) years. 2. That Linda Louise Ruddy was my mother. 3. That my mother, Linda Louise Ruddy died on February 12, 2011 in Littlefield, Mohave County, Arizona. 4. That my mother, Linda Louise Ruddy was divorced at the time of her death. 5. That my mother, Linda Louise Ruddy did not have a Will upon her death and accordingly died intestate. 6. That the heirs of Linda Louise Ruddy are Dorothy A. Haliburton and Edward C. Lane. 7. That Edward C. Lane has disclaimed any interest in the property of the Linda Louise Ruddy Estate and agrees that the property in said estate shall be distributed as though he did not survive Linda Louise Ruddy as is shown by the Disclaimer of Interest in Property of Edward C. Lane attached hereto as Exhibit 1. 8. That attached hereto as Exhibit 2 is an opinion of value on the 2006 Pontiac Grand Prix. 9. That the value of the entire estate of Linda Louise Ruddy, wherever located, does not exceed one hundred fifty thousand dollars ($150,000.00). 10. That thirty (30) days have elapsed since the date of the death of Linda Louise Ruddy. 11. That no application for appointment of a personal representative is pending or has been granted in any jurisdiction regarding Linda Louise Ruddy. 12. That I am entitled to delivery of the 2006 Pontiac Grand Prix of Linda Louise Ruddy and there are no other distributees of the Decedent having a right to succeed to the RECEIVED 5/17/2011 at 10:34 AM RECEIVING 959301 BOOK: 766 PAGE: 687 JEANNE WAGNER 2006 Pontiac Grand Prix under probate proceedings. 13. That the personal property owned by Linda Louise Ruddy is as follows: a. 2006 Pontiac Grand Prix; VIN 2G2WP552661236277 14. That if any other personal property of Linda Louise Ruddy is located, I am entitled to that property. Dated this AL, day of STATE OF NEVADA ss. COUNTY OF C,I0 X V DENIELLE BELANGER NOTARY PUBLIC STATE OF NEVADA My Commission Expires: 05.03.2014 Certificate No:10-2224-1 2011. \A2A1 000688 DOROTHY A. HL URTON I, Dorothy Haliburton, being first duly sworn, state that I am the affiant noted above, that I have read the same, know the contents thereof, and that the statements contained therein are true. Subscribed and sworn before me this day of ACA A. HA URTON 2011. NOTARY PUBLIC My Commission Expires: 05 -0 20V STATE OF WYOMING COUNTY OF .franc? DISCLAIMER OF INTEREST IN PROPERTY )ss. 1 EXHIBIT NOTARY IC My mission Expires: 2 3 l CARMODY AXLUND STATE OF WYOEdiiNG COUNTY OF NATRONA Commission Expires Mar 31, 2013 000689 I, EDWARD C. LANE of Casper, Wyoming hereby disclaim for myself and my heirs, legatees, devisees, and legal representatives, any and all claims on my part to any of the property in the estate of my mother, Linda Louise Ruddy, deceased; specifically, the following property: 2006 Pontiac Grand Prix; VIN #2G2WP552661236277 I further disclaim and renounce that this item or any portion thereof belong to me nor should it be left to me by any last will of the deceased. I further disclaim and renounce any interest in or right thereto even under the intestacy statutes of the State of Wyoming I hereby agree for myself and my heirs, legatees, devisees, and legal representatives that the property described above belongs to said deceased and shall be distributed in accord with the Wyoming intestacy statutes and shall go to my sister, Dorothy A. Haliburton. This disclaimer is made pursuant to Sections 2 -1 -401 through 404 W.S. (Lexis 2001) with the intent being that I hereby in writing and irrevocably, without qualification refuse to accept any interest in said property and accordingly, am aware that my disclaimed interest would pass as though I did not survive my dear mother, Linda Louise Ruddy. Dated this 6 day of 14 2011. V t i Subscribed and sworn before me this t- day of r M /e_zj 2084 by Edward C. Lane. Kelley Blue Book THE TRUSTED RESOURCE the1.! in:Dot= sales event January 4,2011 February 28, 2011 2006 Pontiac Grand Prix Sedan 4D BLUE BOOK® SUGGESTED RETAIL VALUE Vehicle Highlights Mileage: 43,021 Engine: V6, 3.8 Liter Transmission: Automatic D rivetrain: FWD Selected Equipment Standard Air Conditioning Tilt Wheel Power Windows AM /FM Stereo Power Door Locks CD (Single Disc) Cruise Control OnStar Power Steering Dual Air Bags Optional ABS (4- Wheel) Blue Book Suggested Retail Value Kelley Blue Book Suggested Retail Value is representative of dealers' asking prices for a used car, and the starting point for negotiation between a consumer and a dealer. This Suggested Retail Value assumes that the vehicle has been fully reconditioned and has a clean title history, but has not been certified in accordance with any Certified Pre -Owned (CPO) program the automaker may offer (for which it may or may not qualify, according to factors such as vehicle age and mileage). This value also takes into account the dealers' profit, costs for advertising, sales commissions and other costs of doing business. The final sale price will likely be less depending on the vehicle's actual condition, popularity, type of warranty offered and local market conditions. Vehicle Condition Ratings Excellent (Selected) ®C L oo k s new, is in excellent mechanical condition and needs no recond ii g00 Never had any paint or body work and is free of rust. Clean title history and will pass a smog and safety inspection. Engine compartment is clean, with no fluid leaks and is free of any wear or visible defects. Complete and verifiable service records. Less than 5% of all used vehicles fall into this category. Nevada 03/25/2011 advertisement Condition Value f Excellent $12,700 (Selected) Suggested Retail Value Assumes Excellent Condition More Power Seat Rear Spoiler Alloy Wheels Close Window P Send to Printer advertisement theNQ WORRIES sales event January 4, 2011 -March 31.2011 for well qualified buy on select vehicles, inc LEAR 000690 EXHIBIT 2 http: /wvwv.kbb.com/used- cars /pontiac /grand- prix/2006 /retail- value /pricing- report?id 139... 3/25/2011 •1/4. .a. =b- 6. 1. DECEDENT'S LEGAL NAME (FIRST, MIDDLE, LAST) LINDA LOUISE RUDDY .JtaLc rim i'4 1/40. I 2. AKA'S OF ANY) ',Y,';: 3 DATE(OF,DEATH i-,,■ FEBRUARY 12, 2011 4 SEX FEMALE 5 SOCIAL SECURITY NUMBER 6. DATE OF BIRTH 10-28-1943 7 AGE 67 UNDER 1 YEAR UNDER 1 DAY 8. MONTHS 3. DAYS 10 HOURS 111. MINUTES 12 PLACE OF DEATH HOSPITAL: 1111 INPATIENT III E.R./OUTPATIENT DEAD ON ARRIVAL 13 PLACE OF DEATH- OTHER THAN HOSPITAL. 111 b OR LONG TERM PI RESIDENCE RESIDENCE MI HOSPICE FACILITY MOTHER 14. FACILITY NAME (OR STREET ADDRESS IF NOT A FACILITY): 3965 BIG BEND RD 15 CITY, TOWN ZIP CODE OR LOCATION OF DEATH. LITTLEFIELD 86432 16, COUNTY OF DEATH: YPH/V,,,, 17 BIRTHPLACE (CITY AND STATE OR FOREIGN COUNTRY) ST. PAUL MINNESOTA 18 MARITAL STATUS AT TIME OF DEATH. DI DIVORCED 19. NAME OF SURVIVING SPOUSE,(MAIDEN NAME 18,3 M,FE,0 20. DECEDENT'S USUAL RESIDENCE STREET ADDRESS 3965 BIG BEND RD, 21. CITY AND COUNTY. LITTLEFIELD, MOHAVE 22. STATE ARIZONA 23 ZIP CODE 86432 24, EVER INTPIE ARMED FORCES NO 25. WAS DECEDENT OF HISPANIC ORIGIN? el NO, NOT SPANISH, FIISPANIO OR LATINO 0 YES, MEXICAN, MEXICAN AMERICAN, CHICANO 0 YES, PUERTO RICAN 0 YES, CUBAN El YES, OTHER (SPEC/FY) 26. DECEDENT'S RACE(5). la WHITE 0 OTHER ASIAN (SPEC FY) CI BLACK, AFRICAN AMERICAN r=1 NATIVE HAWAIIAN 27,, IF sPECIFY PRIMARY ADDITIONAL ADDITIONAL ALIBI AMERICAN INDIAN OR ALASKA NATIVE. UP TO 4 TRIBES OR ENROLLED TRiBE 0 ASIAN INDIAN CI OTHER PACIFIC ISLANDER (SPECIFY) ID CHINESE ID FILIPINO TRIBE 0 'JAPANESE El GUAMANIAN OR CHAMORRO 13 OTHER (SPECIFY) 0 KOREAN TRIBE 1„1 ,L.'11., 0 UNKNOWN k;..t., 28. OCCUPATION HOTEL-RESTAURANT MANAGER El NnETNAMESE LI SAMOAN ID UNKNOWN 0 AMERICAN 11101811 011 ALASKA NATIVE tUNAL TFthiE 29. FATHER'S NAME (FIRST, mippLE, LAST( ALTON CLIFFORD RUDDY 30, MOTHER'S NAME (FIRST, MIDDLE, LAST NAME PRIOR TO FIRST MARRIAGE) DOROTHY FRANCES DUGAN 31. INFORMANT'S NAME DONALD DUGAN RUDDY 32.RE.LATIONSHIP BROTHER 33, INFORMANT'S MAILING ADDRESS.: PO BOX 1210,, LITTLEFIELD, ARIZONA 86432 4 I, 34. NAME AND ADDRESS OF FUNERAL FACILITY VIRGIN VALLEY MORTUARY 320 E. OLD MILL RD. MESQUITE, NV 35. FUNERAL DIRECTOR: ROBB PULVER FUNERAL DIRECTOR 39 LICENSE NUMBER: 6675890-0902 37. METHOD(5) OF DISPOSITION: REMOVAL/CREMATION 38.518145 AND LOCATION OF 1M DISPOSITION FACILITY METCALF MORTUARY, ST. GEORGE, UTAH 39 NAME AND LOCATION OF 2nd DISPOSITION FACILITY NONE MEDICAL CERTIFICATION .SECTION CAUSE OF DEATH 'PART 1 IMMEDIATE CAUSE OF DEATH 40. A HYPERTENSIVE CARDIOVASCULAR DISEASE 41, APPROXIMATE INTERVAL: YEARS DUE TO OR AS A CONSEQUENCE OF 42 13 43 APPROXIMATE INTERVAL. DUE TO 011 86 A CONSEQUENCE OF: 44. C 45 APPROXIMATE INTERVAL: DUE TO OR AS A CONSEQUENCE OF 45.0 47. APPROXIMATE INTERVAL. CAUSE OF DEATH PART II i;- 48. OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH BUT NOT RESULTING IN THE UNDERLYING CAUSES GIVEN ABOVE 49. INJURY? NO 50 INJURY AT WORK? NO 51. MANNER OF DEATH NATURAL DEATH 1040,.... 52,7IME OF:DEATH:4 53 WAS AN AuTOPSY PERFORMED NO 54. WERE AUTOPSY FINDINGS AVAILA8t.E 40 COMPLETE 1I4E CAUSE OF DEATH/ CAUSE AND MANNER OF DEATH cERTIFICATION, :4 7, 7 El Certifying Physician/Nurse Practitioner/Physician's Assistant To the best of my knowledge, death occurred due to the cause(s) and manner Sated 04 Medical Examiner7nbal Law Enforcement Authority On the basis of examination, andfor investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner stated. 55. NAME OF PERSON COMPLETING AUSE OF DEA: REXENE WORRELL, M.D. 56. DATE CERTIFIED. 02-15-2011 57 CERTIFIER'S ADDRESS: 1145 AVIATION DRIVE #A LAKE HAVASU CITY, AZ 86404 58. NAME OF REGISTRAR: PATTY MEAD 59 DATE REGISTERED 0? 172011 VII ANY ALTERATION OR ERASURE VOIDS THIS DOCUMENT .%)7 Arizona Department of Health Services Date Issued: 02-17-2011 a a so*NO. azal ssoNit s CERTIFICATION OF VITAL RECORD STATE OF ARIZONA STATE OF ARIZONA 000691 DEPARTMENT OF HEALTH SERVICES OFFICE OF VITAL RECORDS CERTIFICATE OF DEATH This is a true certification of the facts on file with the OFFICE OF VITAL RECORDS, ARIZONA DEPARTMENT OF HEALTH SERVICES, PHOENIX, ARIZONA. Revised 04/2010 PATRICIA ADAMS ASSISTANT STATE REGISTRAR This copy not valid unless prepared on a form displaying the State Seal and impressed with the. raised Tel i of the issuing agency. 4110