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AFFIDAVIT OF DISTRIBUTION
PURSUANT TO W.S. 2 -1 -201
I, Janice G. Schapiro, being first duly sworn, do hereby state and allege as follows:
I am an adult, competent to testify, and the surviving spouse of Joseph Schapiro, Jr.;
(2) I make the following affirmations based upon my own best investigation, information and beliefs, and on
behalf of the distributees of the Estate of Joseph Schapiro, Jr.;
The value of the entire probate estate of the Decedent Joseph Schapiro, Jr., wherever located, less liens and
encumbrances, does not exceed one hundred fifty thousand dollars ($150,000.00);
(4) Decedent Joseph Schapiro, Jr. passed away on the 8th day of May, 2011, in the State of Wyoming, and the
place of last residence of said decedent was the County of Lincoln, State of Wyoming. See Attached Death
Certificate;
Thirty (30) days have elapsed since the death of the decedent;
000854
(6) No application for appointment of a personal representative is pending or has been granted in any
jurisdiction;
(7) Joseph Schapiro, Jr. died testate, and pursuant to the terms of Article IV the Last Will and Testament of
Joseph Schapiro, Jr., dated the 15 day of August, 1998, Joseph Schapiro, Jr. bequeathed his personal
property to Janice G. Schapiro;
(8) Pursuant to Article V of the Last Will and Testament of Joseph Schapiro, Jr., dated the 15 day of August,
1998, Joseph Schapiro, Jr. devised and bequeathed the residue of his estate to Janice G. Schapiro.
(9) There are no other distributees of the decedent having a right to succeed to the residue of the estate of
Joseph Schapiro, Jr. under probate proceedings;
(10) Pursuant to W.S. 2- 1- 201(b), the transfer agent for any security shall change the registered ownership on
the books of a corporation from the decedent Joseph Schapiro, Jr. to Janice G. Schapiro;
(11) Pursuant to W.S. 2- 1- 201(c), the county clerk of the county in which any vehicle is registered, when
presented with a copy of this Affidavit of Distribution, shall transfer title of any vehicle from the decedent
Joseph Schapiro, Jr. to Janice G. Schapiro;
(12) Pursuant to W.S. 2- 1- 201(d), any bank, savings and loan institution, credit union or any other like
depository', when presented with a copy of this Affidavit of Distribution, shall pay any deposit titled in the
name of the Joseph Schapiro, Jr., together with interest and dividends thereon, to Janice G. Schapiro.
FURTHER AFFIANT SAYETH NAUGHT.
Dated this day of
RECEIVED 7/5/2011 at 11:28 AM
RECEIVING 959941
BOOK: 768 PAGE: 854
JEANNE: WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
2011.
Jani G. Schapiro
AFFIDAVIT OF DISTRIBUTION
Page 1 of 2
STATE OF WYOMING
County of Teton
ss.
The foregoing Affidavit of Distribution Pursuant to W.S. 2 -1 -201 was subscribed and sworn to before me
by Janice G. Schapiro, on this 9 day of q A 2 2011.
Witness my hand and official seal.
M. Jason Majors Notary PubUC
County of s State of
Teton gi p, Wyoming
My Commission Expires May 15, 2015
r• or the State of W g
mission Expires: 1r —�2 0/ S-
Notary
My
AFFIDAVIT OF DISTRIBUTION
Page 2 of 2
IC
000855
0
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of Death:
Date of Death: May 08, 20
City of Death: Afton
Location: Star Valley Medical.Ci
Additional Decedent Information:
Place of Birth: Chicago, Illinois
Residence: Star Valley Ranch, Wyoming
Marital Status: Married Janice Gertrude Webb
Armed Forces: Yes
Name of Father: Joseph' Schapiro:
Name of Mother:
Informant:
Esther Sexton
Janice Gertrude Schapiro;
Place of Disposition:
Funeral Home or Facility:
Facility:
Cause of Death:
(b) Arteriosclerotic Cardiovascular Disease
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
4, 527383
tQ� This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming.
DATE ISSUED: Thursday, May 19, 2011
a
This copy is not valid unless prepared on a r with an engraved .border.
r }Y P P e
P P
ViVir
F: CERTIFICATION OF VITAL RECORD
DEPARTMENT OF HEALTH
Joseph Schapiro Jr'
Male Social Security Number,
September 24, 1940 Age, at the lime of Death:
tnter.110 Hospital Lane
Disposition:
Method of Disposition: Cremation
Schwab Mortuary Crematory, Afton, W omin
Schwab Mortuary, Afton, Wyoming,
CERTIFICATE OF DEATH
Natural Death Tim
Coroner
Michael Richins, Coroner
274 N St, Box 57, Grover, Wyoming, 83122
May 18, 2011
State File Number:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Acute Myocardial Infarction,.
Gladys K. Breeden
Deputy State Registrar