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HomeMy WebLinkAbout959607RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: Wayne H. Thomas, Jr. Attorney at Law 2660 W. Shaw Avenue, Suite 100 Fresno, CA 93711 STATE OF CALIFORNIA SS COUNTY OF FRESNO SUSAN S. DOHERTY, being of legal age, first being duly sworn, deposes and says: That JAMES J. DOHERTY was a Co- Trustee of The Doherty Family Revocable Trust dated May 14, 1998; that as a Co- Trustee of said Trust he held an interest in that certain real property located in the County of Lincoln, State of Wyoming, described as follows: That JAMES J. DOHERTY died on January 13, 2011 as shown in the certified copy of the decedent's death certificate attached to this Affidavit and, pursuant to the provisions of said Trust, SUSAN S. DOHERTY is the successor Trustee and has consented to act as such; and that, as a result of the change in Trustee, she is the sole Trustee now in office of The Doherty Family Revocable Trust dated May 14, 1998. STATE OF CALIFORNIA COUNTY OF FRESNO DATED: —/4 2011. Subscribed and sworn to (or affirmed) before me on this 10 day of JACtA' 2011, by SUSAN S. DOHERTY, proved to me on the basis of satisfactory evidence to be the person who appeared before me. AFFIDAVIT OF CHANGE OF TRUSTEE (By Successor Trustee) Section 18105 California Probate Code SS LINDA D. BENNETT COMM. #1754441 8 NOTARY PUBLIC CALIFORNIA FRESNO COUNTY My Comm. Expires July 27, 2011 RECEIVED 6/10/2011 at 11:09 AM RECEIVING 959607 BOOK: 767 PAGE: 801 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY 000801 SEE EXHIBIT "A" ATTACHED HERETO AND BY THIS REFERENCE INCORPORATED HEREIN SUSAN S. DOHERTY EXHIBIT A DESCRIPTION FOR DOHERTY FAMILY REVOCABLE TRUST Lot 302 of Bridger Forest Ranches Amended 3` Filing, Lincoln County, Wyoming as described on the official plat filed October 24, 2001 as Instrument No. 876835 of the records of the Lincoln County Clerk. 000802 ITAL RECoRD 3052011006497 N!.. STATE OF 1 ORIVKA 9.91AME OF DEC ELIENIFIRS 9. BIRTH STATE/FOREIGN COUNTRY 13. EDUCATION /that Lesel/Dacrae OF.V.Y0 00 3 2.1:1,1' :AS.S.00IATE 1 12. SOCIAL SECURITY NUMBER 11. EVER IFF.LIZE;ARmED FORCES/ NO 20. DECEDENT'S RESIDENCE ($treet and number, or Iodation) 21857 ROAD 211 ::FRIANT 28. NAME OF SUROINGSROUSE/SRDP SUSAN PLAc :21857:ik0Ab211, HYPERTENS) UNDERLYING CAUSE Idlesese or Iniury That n9llet1M1M1 PI resulting in ds1010 LAST.: 114. CERTIFY THATTOTHE BEST OF MY KNOWLEDGE DEAN OCCURRED M THE HOUR, WOE, AND STATED FRON THE CAUSES STATED. Decedent Attended S4e. Decedent Lest Seen Allya 11 9 .1.CERRFV.Tha IN RYCPINION DEATH OCCURRED AT THEHOUR DATE;AND MACE STATED9,13084111E,CMMES STATEDe.v....111, 3399NER DEATI-I N.; Acadent H014o4lo RiscIda 19. DECEDENT'S RACE— Up to 3 races may b. listed (see workeheet on beck)....: .WHITE FRESNO 24,yep,9s IN COUNTy: :11111131111111111E1M111111110011 111001111114:: '1000100185078* 71:PRTS OF DEATH 01 /1 812011 2EINFORMANT's MAILING ADDRESS et and number or rural route number, city or town, stabs and YIP) 21857: ROAD 211 CA...93626 41. TYPE OF DISPOSITIONS) CR/RES 44. NAME OF FUNERALESTABUSHMENT 45. LICENSE NUMBER 411, SIGNATURE OF LOCALlIEGISTRAR DATE..rnaVdd/con. T LE ERAL C INKRFUNHAPEL 8(•:: FD281 EDWARD L MD 01/1.812011 Wei* caused chsallvD0 rinleelartnInel even e AVM hileMaRimen °F 1 m 0 rid FRO icuso ROBABLE MYOCARDIAL INFARCTION INFARCTON HR 19. YEARS IN OCCUPATION 103. IF OTHER THAN HOSPITAL SPECIFY ONE rj VI: D 0. 109. BIOPSY PERFORMED? 190 NO 915.14OSNSE NUMBER 1 1 7 :RFE 1 0 9 cIFFPF: 6 118.'TYPE ATTENDING PHYSICIAN'S NAME, MIALING ADDRESS. ZIP CODE MICHAEL WAYNEDAYTOtSt:M. $STE 102, FRESNO, CA 93720 122.HOUR (24 Hours) 123. MACE OF INJURyiemi..homo, construction sIts,i3vmscled area. etc.)