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Affidavit of Survivorship
I, Kenneth Borino, being of lawful age and duly sworn according to law, upon my oath, depose and
That under the date of November 10, 1987, for valuable consideration, Eva Borino, by deed of that
date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on November 10, 1987, in
Book 256PR, Page 684, conveyed to Eva Borino and Kenneth Borino, as joint tenants and not as tenants in
common with full right of survivorship, the following described land, in the County of Lincoln, State of
Wyoming, to -wit:
Lot Nine of Block Sixty, Second Addition to the Town of Kemmerer; and a strip of land four feet wide, being
part of Lot Ten of Block Sixty, Second Addition to the Town of Kemmerer, and described as follows, to -wit:
Commencing on the Northwest Corner of Block 51, Second Addition to the Town of Kemmerer, County of
Lincoln and State of Wyoming, and going North 63 °26" East, paralleling Opal Street 160.00 feet, thence
North 26 °34" West and paralleling Pine Avenue, 6o feet to the Southwest Corner of Lot Nine, Block Sixty,
thence North 63 °26" East and paralleling Opal Street 50.00 feet to the point of beginning, which is the
Southeast Corner of Lot Nine, Block Sixty, which is also the Southwest Corner of Parcel A of Lot Ten, thence
North 63 °26" East 4.00 feet, to the Southeast Corner of Parcel A, Lot Ten, which is also the Southwest
Corner of Parcel B, Lot Ten, thence North 63 °26" East a distance of 46.00 feet to the Southeast Corner of Lot
Ten, which is also the Southeast Corner of Parcel B, Lot Ten, Block Sixty, thence North 26 °34" West and
paralleling Pine Avenue 101.40 feet to the Northeast Corner of Lot Ten, which is also the Northeast Corner of
Parcel B, Lot Ten, thence West 51.43 feet and paralleling alley -way to the Northwest Corner of Parcel B, Lot
Ten, which is also the Northeast Corner of Parcel A, Lot Ten, thence West 4.47 feet to the Northwest Corner
of Lot Ten, which is also the Northwest Corner of Parcel A, thence South 26 34" East and paralleling Pine
Avenue a distance of 126.4 feet, to the point of beginning
That by reason of said conveyance aforesaid, the said Eva Borino and Kenneth Borino became the
owners of said real property, and the title thereto vested in them continuously from the date of said
conveyance, to the date of death of Eva Borino, on the 30th day of July, 2010. That by reason of and upon
the death of Eva Borino, title in the above described real property vested in Kenneth Borino.
Affiant avers and certifies that Eva Borino is the identical party named with Kenneth Borino in the
aforementioned deed, whose death terminated her interest, title and estate in said real property; and Affiant
attaches hereto, and makes a part of this affidavit, a copy of the Official Certificate of Death of said decedent,
duly certified by the public authority in which said death certificate is a matter of record.
Dated this 3 u day of
State of tAN'4t.A.A(A
County of ill
ss.
MARGARET R. FARRENKOPF
NOTARY PUBLIC for the
State of Montana
Residing at Hamilton, Montana
My Commission Expires
August 5, 2013
2011.
000788
Kenneth Borino
Subscribed and sworn to before me, a notary public in and for said County and State, by Kenneth
Borino, this day of :pW 2011.
WITNESS my hand and official seal.
My Commission Expires: 1. 2.0 1 S
RECEIVED 10/5/2011 at 12:02 PM
RECEIVING 961266
BOOK: 773 PAGE: 788
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
1
FULL NAME OF DECEASED: Eva Borino
DATE OF DEATH: July 30, 2010
RAVALLI COUNTY
CERTIFICATION OF A DEATH CERTIFICATE
RACE: White
DATEOF BIRTH: November 16, 1922 BIRTHPLACE:`. Oakley, Wyoming
MOTHER'S NAME: Anna Corradin
FATHER'S NAME:. John :Pizzato
MARITAL STATUS: Widowed
SPOUSE:
SOCIAL SECURITY NUMBER: VETERAN OF ARMED FORCES: No
RESIDENCE: Hamilton, Montana
FUNERAL FACILITY: Daly -Leach Memorial Chapel
PLACE OF DISPOSITION: .Daly- Leach Crematory
Hamilton
METHOD OF >DISPOSIT1ON Cremation
MANNER OF DEATH: Natural DATE FILED: August 02 2010
CAUSE OF DEATH:: ONSET:
a: Parkinson's Disease 10 yrs
OTHER SIGNIFICANT CONDITIONS:
Hyperthyroidism Hyperlipidemia
NAME AND ADDRESS OF CERTIFIER:
Gary L. Smith 1224 W Main St, Hamilton, Montana 59840
DATE ISSUED: August, 03, 2010 BY:
Uf
This certifies that this document is a true duplication
;:of the original information on file with the Department
305212 O Public Health and Human Sefvices, Clerk and Recorder. 94'
Not Valid Unless Raised Seat:Is Present W
FILE 201041- 004980:
SEX: Female
PLACE OF DEATH: HAMILTON
I V. 1 VA1 UPLIJ MO LIAlr vs�►Y:!
CERTIFICATION OF VITAL RECORD