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HomeMy WebLinkAbout960011Before me, the undersigned a thority, on this day, personally appeared e "Affiant"), wh resides at V90 /,{FA( h A e 7 ad 1/ iN f I<./(J. who, being of lawful age, being first duly sworn, up his er oath deposes and says: That I was personally well acquainted with the Decedent, during his/her lifetime, having known hi and that I bear the following relationship to Decedent, to -wit: personally familiar with the family and marital history of the Decedent and I have personal knowledge of the facts stated in this Affidavit 1. I knew the Decedent from e76 V? until ,e/e)' R 2/ ,4 a t or near E�J160 t L`?i a. Decedent died on t��'(; �t being years of age at the time of death. b. At the time of death, Decedent resided at (2.?/:, j :.7 -s {�E'627 l Ai V 2. Did Decedent leave a will? k/0 (Yes o6). Was the will admitted to probate? tl (Yes or" If yes, give name of the court, city, county /parish, and state in which the will was admitted to probate: 3. Was there an heirship determination proceeding conducted in any court to determine the heirship of Decedent? fU (Yes or No). If yes, give name of the court, city, county /parish, and state in which the heirship determination proceeding was conducted: 4. If no estate administration proceedings have been conducted, are there any plans to have Decedent's estate administered? /d (Yes or No). 5. Did Decedent leave any unpaid taxes or other debts? /.4 (Yes or No). If yes, describe the manner in which all taxes and other debts will be paid: 6. Were there any lawsuits pending or judgments rendered against Decedent at the time of death? X (Yes or No). 7. Did Decedent own an interest in the real property described on the attached "Exhibit A" (the "Property (Yes or No). a. Was the Property occupied as the homestead of the Decedent? __AO (Yes or No). iti P (Yes or No). b. c. d. e. AFFIDAVIT OF HEIRSHIP Is the Property now occupied as the homestead of Decedent's surviving spouse? Is the Property community property? How did Decedent acquire the Property? When did Decedent acquire the Property? RECEIVED 7/11/2011 at 12:50 PM RECEIVING 960011 BOOK: 769 PAGE: 213 1NE WAGNER I INCOLN COUNTY CLERK, KEMMERER, WY 12Morgyq g. Ern AL "Decedent" 8. What was the marital status of Decedent at the time of death? (Yes -A Al- A e. Was Decedent ever married to anyone other than person listed above? complete the following information in order of marriage: 9. If Decedent left a surviving spouse, please provide: j a. Name of surviving spouse: 0A/ A. C, t 6-6 6- i'r b. Address of surviving spouse: 6 7 '0 `7 e`rte ye F c. Date of Marriage: /VA' d. If not living, give date of death: 067 a' 0 /1 4 4 .f' 000213 her, orrs, t t ry �t Iam ca t (Yes or No). If yes, please 1 Rev. 03/09 Name of Deceased Son or Daughter Name of Child of Deceased Son or Daughter Age Address Living or Dead If Dead, Give Date of Death L U 1 R A i dZa& e r, /As 1/Ep s ,(/1. f5'/'-/2 C� 6 0/ /'f BCf C k h1r a ct a /4 /6:-70 d'Z o frr, 4 tU- l r 1 /f /S d 'OS:2 F v :Aft' ‘1 igefrA dz.c..A Ll A1L 6 CA. -o4d 6/3 7 e. a Z. r �lI',cr' 7 e 3 5 -2 C�©2r� /4� :Dd<.. _'Y' l 6 Lt' /,(is, d 9 /7 Z0, ,Fes Name of Deceased Son or Daughter Name of Child of Deceased Son or Daughter Age Address Living or Dead If Dead, Give Date of Death Name of Child/ Address Date of Birth t Living or Dead If Dead, Give Date of Death l ,2S 4-19-go i- D F', Ce L4_141-,JJ ed, ,-0S-.2.c- L U 1 R A i dZa& e r, /As 1/Ep s ,(/1. f5'/'-/2 C� 6 0/ /'f BCf C k h1r a ct a /4 /6:-70 d'Z o frr, 4 tU- l r 1 /f /S d 'OS:2 F v :Aft' ‘1 igefrA dz.c..A Ll A1L 6 CA. -o4d 6/3 7 e. a Z. r �lI',cr' 7 e 3 5 -2 C�©2r� /4� :Dd<.. _'Y' l 6 Lt' /,(is, d 9 /7 Z0, ,Fes /d he/ f Name of Brother or Sister/ Address Date of Birth Date of Death ter.. El/C4 Y ic( LAO/ z_L LA 4,0 A Are 0 2. -e vhf �,�i. /CIA 7/ 000214 0 Name of Spouse/ Address Living or Dead Date of Marriage Date of Death Date of Divorce 10. Provide the following information on the Decedent's natural born and adopted children: (If there are none, please state that below. If additional space is needed, please provide information as an attachment) 11. Provide the following information for any deceased children of Decedent: (If there are none, please state that below. If additional space is needed, please provide information as an attachment) 12. If Decedent never married and did not have any children, provide the following information on the Decedent's Parents: Decedents Parents Mother Father Parent's Name/ Address Parent's Date of Death 13. Provide the following information on the Decedent's brothers and /or sisters: (If there are none, please state that below. If additional space is needed, please provide information as an attachment) 2 Rev. 03/09 14. Provide the following information on the Decedent's nieces and /or nephews born only to the deceased brothers /sisters in Item 14 above: (If there are none, please state that below. i fadditional space is needed, please provide information asanattachment) Name of Niece or Nephew/ Address Date of Birth Name of Deceased Parent of Niece or Nephew State of County /Parish of /l4 SUBSCRIBED AND SWORN to before me this My ,L3 ommission expires: day of Yeg( Signature of Affiant ,20// 000215 SHERRIE L. WOLF Notary PUblic State of Nevada No. 05- 1014421 My Appt. Exp. October 23, 2013 (To be signed by someone other than the person making the foregoing affidavit. Corroborating Affiant may not be an heir named above) State of gd 4 County/Parish/District of (A4 ,r a /71/ of lawful age, being first duly sworn, upon his oath states: The information given i the above and foregoing affidavit is true, and accurate, to the personal knowledge of this affiant. SUBSCRIBED AND SWORN to before me this My commission expires: /a )3/3 CORROBORATING AFFIDAVIT (1l Signatur Corroborating Affiant ':pry P lic day of LIU/ IIC 20 SHERRIE, L. WOLF Notary Public State of Nevada No. 05- 1 01442.4 My Appt. Exp. October 23, 2013 3 Rev. 03/09 Exhibit A OPAL 32-34 NE4 SECTION 34, T22N T112W Lincoln, WY 000216 4 Rev. 03/09 478479 STATE OF WYOMING IN THE DISTRICT COURT SS: COUNTY OF LARAMIE r U FIRST JUDICIAL DISTRICT IN THE MATTER OF THE ESTATE OF DONALD E. ALLEN, Deceased. Clerk of District Court filing Petition for Probate 10.00 filing Inventory and Appraisement 30.00 Cheyenne Newspapers, Inc. Notice to Creditors 26.78 Notice of Probate 60.20 Notice of Final Settlement 42.70 Appraisers' Fees 75.00 Photocopies 31.50 Certified Mail Fee 1. TOTAL $277.73 Book 508 of Photos, Page 472 000217 Probate No. 27 335 ORDER APPROVING FINAL ACCOUNTING AND DECREE OF DISTRIBUTION The Final Accounting and Petition for Distribution in the estate of Donald E. Allen, deceased, having been presented to the Court, and it appearing that all debts of the estate have been paid, that all requirements for the administration of the estate have been complied with according to law, that the Waiver of Election of Surviving Spouse and Affidavit of Acknowledgement signed by Dorothy J. Cain, widow of Donald E. Allen, deceased, have been filed herein, that the inheritance tax due the State of Wyoming in the amount of $24.39 has been paid (Receipt No. 14449 from the Inheritance Tax Division, State of Wyoming, has been filed herein), and that there are no Federal estate taxes due the United States of America; and it further appearing to the Court that the only matters remaining to be done are to approve the Final Accounting, pay the attorney's fee and costs of administration, and close the estate; IT IS, THEREFORE, ORDERED, ADJUDGED AND DECREED that the Final Accounting in the estate of Donald E. Allen, deceased, be, and it hereby is approved; IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Kevin Allen, Executor of the estate of Donald E. Allen, deceased, has waived his fee as such Executor, and that Dennis M. Grant, attorney for the estate of Donald E. Allen, deceased, should be paid the sum of $1350.00 as his fee and be reimbursed for costs of administration advanced by him as follows: IT IS FURTHER ORDERED, ADJUDGED AND DECREED that after payment of all debts, taxes, fees and costs of administration of the estate of Donald E. Allen, deceased, the remaining assets of said estate, as set out in Exhibit "A," attached hereto and made a part hereof by this reference, together with any property belonging to the deceased that may be discovered after filing this Decree, be, and they hereby are, set over, transferred, and distributed in accordance with the terms of the Last Will and Testament of Donald E. Allen, as follows: All right, title, and interest in and to any oil or other mineral rights, royalties or other interests that Donald E. Allen, decedent, owned at the time of his death: NAME AND RELATIONSHIP DISTRIBUTIVE SHARE Jann Richmond daughter of decedent One-Fourth Betty Allen daughter of decedent One Fourth Kevin Allen son of decedent One- Fourth Jeri Pechtel daughter of decedent One Fourth AND Ge:A`tn8.t2C C H fiw ofi is v tress my ha r_ All remaining property, real and personal, wheresoever situate: NAME AND RELATIONSHIP DISTRIBUTIVE SHARE Patricia Legerski daughter of decedent One -Fifth Jann Richmond daughter of decedent One -Fifth Betty Allen daughter of decedent One -Fifth Kevin Allen son of decedent One -Fifth Jeri Pechtel daughter of decedent One -Fifth IT IS FURTHER ORDERED, ADJUDGED AND DECREED that a Supplemental Report be filed, showing compliance with all matters ordered in this Order Approving Final Accounting and Decree of Distribution, and ?cppe r c,NDer,pre, af. E ii,x}.l,.,Discharge be entered. o f "F"et ua ry 1980 n;. of Book 508 of Photos, Page 473 JUDGE OF THE DIST CT COURT i 000218 01111AA21011'-.1Kit USUAL imsettici WARM INCINDMI rf NAAS OMAN* tN INSIORRION, GNI INSIMMKt MODS MIMMISON. 050372 11,.. "TY22 ameim:,rat: tow ga ANDINS. MMITICNS NOON', ITIVTIRIPAT TRAILS) 54. 49 Defoe*. 14A6 '.katett. PASS ANSON CDS ••4011. NIGNI Oa h. Yes CITIZEN OF WHAT COUNTRY ,Untjed States COY, TOWN, Oa toCAViON 0 DIAN k Cheyenne STATE Of EITIM ut NOT MUSA, NAND t. ..04•011, Wyoming SOCIAL SECURITY MANE* RESIOt+ICE—STATE 146 Wyoming 15. PR. PART I. 11. ."-•N CONDITIONS. If ANY, WINCH OARS MS* SO IIAMIDIAW CADS* ISN, STATING THR VTR'S& WINO GMISS'SAST ACCIDENT, SUICIDE. HOMICIDE. 0* UND(TERNIPIED I Meow Ik WIRY AT WORD 1 SPROTT TIS Of NO) COUNTY (c) DEATH WAS CAUSED This is a true and exact reproduction of the document on file in the office of Vital Records Services, Cheyenne, Wyoming. Date Issued: APR 14 2011 This copy is not valid unless it bears a raised seal and is produc9d on multicolored security paper. EATHEE—NAME 004, Maurice Donald Allen DI41 TO, OR AS A G0.4SKIUN+CI of. DATE OF MOUNT .o.rot, kr, TSAR! CERTIFICATION— (MY AT PHYSIOAN: •4 1 Armoweo No .3 L I SERTIFtC.ATiON--mebtAt. tkAmarielt OR COOONS* ON NI MIN Of 1011 *LAMINATION or Toe not 87.0/0* 7111 mwstmAtioro, m tot opmx.m. .*A77, °CGS/IMOD ON TIN OMR. AND DIN TO MS GRATIIIISI STAND., —NAME ow* 0* mom „Interna1 Medicine Group mmuNG AoDOESS—CTIMM PINET Dalt. SAST Verarugee HOUR 5' Ssq0.0FWA44''-' WOMAN) UN, „0* if WNW I Secretary 1M. NOUNS AM SC I HOSPC'Al. OR OTHER INS Alemorial MAID, P4EYER MARNE May 31 1922 LaraMie NAME /If NOT IN SINOP. DIN MOST AND' MAWR I Hos?ital i i suRvivING spouse t� w1*. ONS AskOIN (4AN* IT. Donald E. Alien USUAL OCCUPATION tOrYt OND 0 wORD DONS WONG- MOM Of OM TOWN, OR LOCATION IMO Of OUSINESS OR INDUSTRY IA. Education ...1.01,8.07*1 ismerr AND NUMSEN 4 VICUT VII 04 *10 ll Laramie 14,..Cheyenne 144.Yes 1$4.. 216 West 27thS treet PART R. OTHER SIGNIFICANT CONDITIONS, comomoNs commumHo To Do” mit moi *NANO TO GAUSS Olvtft PAW I 1•1 *7*14 7744 DATE /40•111.• MSS ROAR ALLEN 2 Female Oe...tober:-...23 M. SSW!, MICTON., _LOCKNOM.'. STAIN OR CIO, NO., CNT OR TOwN, STAN! 00401 INNS_ ITC MOON imv..ifti.4 e DAY 04. 2 7/ 014774', 1111 DISCOINIT4T ■WS.9 2.I. Gladys K. Breeden Deputy State Registrar NONONNOISI D1AD DAT TSAI 0 MCRWEE—MA DEN NAME MS( 070011 16 Geraldine "AXING ADDRESS tufty Cl No, cm oe SOWN, SUN, RN, ,,216 West 27th Street Cheyenne, Wyoming 870.01,, IENTECONIY-ONE CAUSE Pet LINE FOR fat (b), *NO mma 05 in it ??....14 hVir 7 2 CM AS CONSICMINet 1 (b) ANNOMMATS INTWERN'OMCIFT ••••0,0•MW. 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