HomeMy WebLinkAbout961629File No.: 116270
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
1, j&c 1 >1_ I c 5
upon my oath, depose and state:
1. That I am of adult age, a resident of cf.- I
herein.
Joan T. Passey
State of Wyoming)
)ss.
County of Lincoln)
,4itha2 /y
Notary Public
My Commission Expires:
AFFIDAVIT TERMINATING ESTATE
Witness my hand and official seal.
9- /5
GLORIA K. BYERS NOTARY PUBLIC
County of State of
Lincoln Wyoming
My Commissen Expires September 15, 2015
000313
RECEIVED 10/28/2011 at 11.04 AM
RECEIVING 961629
BOOK: 775 PAGE: 313
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
being of lawful age and first duly sworn according to law,
and the Aftiant
2. That by virtue of the conveyances which are recorded in the office of the County Clerk for
Lincoln County, Wyoming, located at Kemmerer, Wyoming is recorded a Warranty Deed dated
the th day of May 2011 in Book 767 PR on page 188
conveys unto Eugene J. Toland Living Trust dated 5/11/11 the following described
property, to-wit:
2011 died
3. That said Eu Toland on the _16th day of _m
and a copy of the original certificate of death. certified to as true and correct by public authority
in which the original of said certificate is a matter of record, is attached hereto as Exhibit "A".
4. That by reason of death of said Eugene J. Toland by reason of 2-9-102 W.S.
(1980), the decedents interest and title in said conveyance has terminated and title to the real
property conveyed thereby has vested absolutely in Eugene J. Toland Living_ Trust
continuously since the death of the said decedent.
FURTHER AFFIANT SAYETH NOT.
The foregoing instrument was subscribed and sworn to me by Joan T. Passey, this day
of October, 2011
AND A 'OF L TAMAN
CORNELISON-HENDERSON FUNERAL HOME, POCATELLO, IDAHO
A OF EATH
MAY 16, 2011
TIME OF DEATH
1130 P.M.
CfreTOWN OR LOCATION OF DEATH
POCATELLO, IDAHO
COUNTY OF DEATH
BANNOCK
CAUSE OF DEATH Notiertyine ca..
CARCINOMA OF UNKNOWN PRIMARY 3 MONTHS
b
DUE TO (ot mut con.q.me• 0)
d
OTHER SIGNIFICANT CONDITIONS CONTRIBUTING Ti DEATH tad not rdwAbrtfi irt dv. underlyiAd mad dwed atm*
NONE STATED
WAS AN AUTOPSY
PERFORMED'?
NO
MANNER OF DEATH
NATURAL
NAME OF CERTIFIER
DAVID W. RIRIE, M.D.
TITLE
PHYSICIAN
CORONER SUBSEQUENT CERTIFICATION IF NECESSARY
DATE I titer
TI PLATE OF I,
IklASWAT
LOCATION WHERE iNJURK OCCu D
'Or
vv
CERTIFICATE OF DEATH
Date illed MAY 20 2011
EUGENE J TOLAND
MARITAL STATuS Ai TI VIE OF DEATH
FATHER Name
DLJE 10 (11 oen 01
ME
DESCRIPTION OF ON INSAW [IMAM°
MARTEL GARLAND TOLAND
REMOVAL FROM STATE
STATE OF IDAHO
0 0 0 3 I 4 v
IDAHO DEPARTMENT OF HEALTH AND WELFARE
BUREAU OF VITAL RECORDS AND HEALTH STATISTICS
PLACE OF RESIDENCE
This ,s a true and correct reproduction of the document officially reg:stered and placed
on file with the IDAHO BUREAU OE VITAL RECORDS AND HEALTH STATISTICS
DATE ISCUFD•
Tree copy not veld unless prepared on engraved bo
state seal and signature of the Registrar
?ATE OF EviRTH
AUGUST 27, 1935
(4.h
JAMES B. AYDELOTTE
ST Al E REGISTRAR
BIRTHPLACE
WYOMING