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HomeMy WebLinkAbout960192Larry D. Osmond, being first duly sworn upon my oath deposes, and states as follows: 1. That I am a successor trustee of the J.D. Osmond Revocable Trust dated the 30 day of October 1992. 2. That on October 30, 1992 in Book 320PR on page 505 of the records of the Lincoln County Clerk was recorded a Quitclaim Deed from J.D. Osmond, aka John D. Osmond and Wyoma Osmond to J.D. Osmond as Trustee of the J.D. Osmond Revocable Trust dated the 30 day of October, 1992 conveying the following described land: Lot 30 of Block 37 of the Glen Kennington EtAI Addition to the Afton, Wyoming Townsite, according to the plat thereof recorded in the Office of the Lincoln County Clerk on September 13, 1977, Recorder's No. 498185. 3. That J.D. Osmond died on November 18, 2009 as shown on the certified copy of the decedent's death certificate attached to this Affidavit and, pursuant to the provisions of said Trust, Larry D. Osmond and Wyoma Osmond are the successor Trustees. State of Wyoming )ss County of Lincoln ubscribed and sworn to (or affirmed) before me this t day of U LL 2011 by Larry D. Osmond. Witness my hand and official seal. My commission Espires: AFFIDAVIT j.4--(-Lt4 Notary Public 00,0698 Larry i. Osmond RECEIVED 7/22/2011 at 2:22 PM RECEIVING 960192 BOOK: 769 PAGE: 698 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY Coroner STATE of WYOMING DEPARTMENT OF HEALTH CERTIFICATE OF.DEATH Burial Thayne Cemetery, Thayne, Wyoming Schwab Mortuary, Afton Wyoming Maryanne Christensen, Deputy Coroner 274 N St, Box 57,.Grover, Wyoming, 83122. November.25, 2009 Time of Death: 11:56 (Actual). Gladys K. Breeden Deputy State Registrar SP: *p natrxxv-, Decedent: State File Number: 2009 003459 Name: John Darwin\Osmond Gender Male Social Security Number Date of Birth: September 28, 1918 Age at the Time of Death: Date and Place of Death Date of Death: November 16, 2009 City of Death: Afton Location: 286 E. 8th Ave Additional Decedent Information: Place of Birth: Etna, Wyoming Residence: Afton, Wyoming Marital Status: Married Wyoina <Roos Armed Forces: Yes Name of Father: Vasco Osmond Name of Mother Mary Anna Moser Informant: Wyoma Osmond f Disposition: Method of■Disposition: Place of Disposition: Funeral Home or Facility: Facility: Cause: of Death: The\immediate cause is listed on the first line followed by any underlying causes.` (a)espiratory Failure (b) Chronic Respiratory Disease Other Significant Conditions: Manner of Death: Type: Name: Address: Date Filed: 433126 ��s rl strik7%s k ntdo This is a true certification of the document on file in the office of Vital Records Services, Cheyenne, Wyoming. 5 DATE ISSUED: `Monday, November 30, 2009 G This copy is not valid unless prepared on paper with an.engraved border. 71 71I,II1I II,.I.I.I IJ.I.I.. III.I.I.I.WJ.W.41 ss