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HomeMy WebLinkAbout959802STATE OF WYOMING COUNTY OF LINCOLN I, JOHN P. KRABBENHOFT, SR., being first duly sworn, on oath depose and state that I am making this Affidavit pursuant to W.S. 2 -1 -201, on behalf of myself, as distributee, as hereinafter set forth, that I make the following statements in connection therewith: 1. That MARJORIE KRABBENHOFT became deceased on April 8, 2011 in Afton, Lincoln County, State of Wyoming, and was a resident in Lincoln County, State of Wyoming, at the time of her death; that said decedent left JOHN P. KRABBENHOFT, SR., as spouse; that the sole and only person entitled to the items of property of the estate of said decedent at the time of her death is the distributee hereinafter named; a copy of the Certificate of Death of decedent is attached hereto as Exhibit "A 2. That the value of the entire estate of said decedent, wherever located, does not exceed $350,000.00. 3. That more than thirty (30) days have elapsed since the date of death of the decedent. 4. That no application for the appointment of a personal representative of said decedent is pending or has been granted in any jurisdiction. 5. That the following named distributee is the sole and only party entitled to the estate of the decedent, that there are no other distributees of the decedent having a right to succeed to any of the property of the decedent under probate proceedings, and that therefore, the following named claiming distributee is entitled to payment or delivery of all of the decedent's property: Name Relationship JOHN P. KRABBENHOFT, SR. Spouse RECEIVED 6/27/2011 at 10:48 AM RECEIVING 959802 BOOK: 768 PAGE: 438 JEANNE WAGNER AFFIDAVIT OF DISTRIBUTION OF DECEDENT'S PERSONAL PROPERTY PURSUANT TO W.S. 2 -1 -201 ss =MI! IZChA11ACI7GR \A/V Affidavit of Distribution Page 1 of 3 000438 6. That among the asset owned by said decedent is the following: ITEM LOCATION APPROX. VALUE 2005 Dodge Pickup Grover, WY 5,751.00 VIN 1D7HU18D55S325216 TOTAL 5,751.00 List of real property, location, and estimated value: Beginning at a point where the North boundary line of the SE1 /4 of Section 32, T33N, R118W, 6th P.M., Wyoming, intersects U.S. Highway 89 on the East edge of said Highway, said point of intersection being approximately 2097 feet West from the Northeast corner of said SE1 /4 of said Section 32, and running thence Southeasterly along the East right -of -way boundary of said Highway, 885.6 feet to the point of beginning, and running thence East 280 feet, thence Northwesterly 165 feet, on a line parallel to the East right -of- way boundary of said U.S. Highway 89, thence West 280 feet, more or less, to said East right -of -way boundary, thence Southeasterly 165 feet, more or less, along said East right -of -way boundary, to the point of beginning, and containing one acre, more or less. ALSO A tract of land lying in the NW1 /4SE1 /4 of Section Thirty two (32), Township Thirty -three (33) North, Range 118 West of the 6th P.M., Wyoming, more particularly described as follows: Beginning at a point which is North 2279.47 feet and West, 1823.00 feet from the S.E. Corner of said Section 32 and proceeding thence East, 291.10 feet; thence North 41 °34' West, 200.00 feet; thence East, 121.34 feet; thence South 23 °04'East, 232.50 feet; thence South 30°16' East, 129.15 feet; thence West, 280.00 feet; thence North 41°34' West, 235.00 feet to the point of beginning, said tract containing 1.54 acres more or less. Together with all water rights, mineral rights, improvements and appurtenances thereon situate or in anywise appertaining thereunto. Subject, however, to all reservations, restrictions, exceptions, easements and rights -of -way of record or in use. 000439 7. That an executed copy of this Affidavit is being presented to the transfer agent for the above listed asset in compliance with W.S. 2 -1 -201. Affidavit of Distribution Page 2 of 3 Name and Address John P. Krabbenhoft, Sr. P.O. Box 187 Grover, WY 83122 EXECUTED this of of May, 2011. STATE OF WYOMING COUNTY OF LINCOLN ss. SCRIBED AND SWORN to before me by JOHN P. KRABBENHOFT, SR. this /6 day of May, 2011. TRACY MATTHEWS NOTARY PUBLIC County of Lincoln State of Wyoming M Commission Expires September 26, 2013 My Commission Expires: .)073 Affidavit of Distribution Page 3 of 3 Date of Birth March 29, 1944 000440 4: CERTIFICATION OF VITAL RECORD Decedent: Name: Gender: Date of Birth: bate and Place of Death: Date of Death: April 08, City of Death: Location: Add Decedent. Information Place of Birth: McKeesport, Pennsylvania Residence: Grover Wyoming Marital Status: Married =John P. Krabbenhoft Armed Forces: Name of Father: Name of Mother: Informant: Disposition: Method of Disposition: Place of Disposition: Funeral Home or Facility: Facility: Cause of Death: The immediate causes (a) Gastric Carcinoma Certifier: Type: Name: Address: Date Filed Other Significant Conditions: Manner of Death: Cremation Schwab Mortuary Cr listed on the first line folio Physician Allen D. Carter, M.D. 110 Hospital Lane,..P0 Box..579, Afton, Wyoming, 8311 April 25, 2011 522450 This is h true certification of the document on file in the office of Vital: Statistics Services Cheyenne, Wyoming, DATE ISSUED Thursday, May I 2011 is not valid unless prepared on paper with an en aged border. This copy Y P P P R 13r No Robert E. Sauer Dorothy Miller. John P. Krabbenho DEPARTMENT OF HEALTH CERTIFICATE OF DEATH State File Number Marjorie E. Krabbenhoft Female Social Security Number: December 04, 1945 Age at the Time of Death: 65 years 2011 eliry t f E ea#ft Afton Star Valley Medical Cef)tet 110 Hospital 'mate ry,'Afton Wyomin on, Wyoming' ed by,any underlying ca 2011- 001153 iterval: months" Gladys K. Breeden Deputy State Registrar