HomeMy WebLinkAbout963769STATE OF WYOMING
COUNTY OF UINTA
CINDY TITENSOR, being first duly sworn on oath deposes and says:
1. That she is of adult age and is the surviving wife of KIM V. TITENSOR, who died
October 21, 2011, in Lincoln County, Wyoming, as hereinafter more fully appears.
2. That by Warranty Deed with Release of Homestead dated July 10, 1975, and recorded
March 4, 1976 in Book 123PR at Page 655 in the office of the County Clerk and Ex- Officio Register
of Deeds in and for the County of Lincoln, State of Wyoming STAR VALLEY LAND
LIVESTOCK, INC., a Wyoming Corporation, conveyed to KIM V. TITENSOR and CINDY
TITENSOR, husband and wife, as tenants by the entireties, the following described real estate
situated in Lincoln County, State of Wyoming, to -wit:
S%NW' of Section 9, T31N, R119W, 6 P.M., Wyoming.
3. That Kim V. Titensor died on the 21st day of October, 2011, in Lincoln County,
Wyoming, and thereupon, the certificate of his death was duly filed with the State of Wyoming and
made a matter of record in said office, and a certified copy of said certificate is attached hereto and
made a part of this Affidavit.
4. That upon the death of Kim V Titensor, as aforesaid, the tenants by the entireties created
by the aforesaid Deed terminated all of his right, title and estate in the above property, and Cindy
Titensor, surviving wife, became vested with any interest in the property owned by Kim V.
Titensor.
DATED this 6, day of
RECEIVED 3/22/2012 at 10:48 AM
RECEIVING 963769
BOOK: 783 PAGE: 549
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
AFFIDAVIT OF SURVIVORSHIP
ss.
2012.
00549
SUB CRIBED AND SWORN to before me Cindy Titensor this J{ day of
2012.
WITNESS my hand and official seal.
Phillips Law, P.C.
822 Main Street P.O. 770
Evanston, Wyoming 82931 -0770
(307)- 789 -9370
Page 2 of 2
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Decedent: State File Number:
Name: Kim V Titensor
Gender: Male Social Security Number:
Date of Birth: March 07, 1951 Age at the Time of Death: 60 years
Date and Place of Death:
Date of Death:
City of Death:
Location:
Additional Decedent Information:
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
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 cauaes.
(a) Arteriosclerotic Cardiovascular Disease
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
591'6
October 21, 2011 County of Death:
Smoot
RD 10382, 2 miles S. E. of Sheep Corrals at White Crk
Afton, Wyoming
Evanston, Wyoming
Married Cindy Bagley
Yes
Von S Titensor
Hilda Anderson
Cindy Titensor
Burial
Afton Cemetery, Afton, Wyoming
Schwab Mortuary, Afton, Wyoming
Natural Death
Coroner
Michael Richins, Coroner
274 N St, Box 57, Grover, Wyoming, 83122
November 01, 2011
This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming.
DATE 'ISSUED: Friday, November 04, 2011.
This copy is not valid. unless prepared on paper with an engraved border.
CERTIFICATE OF DEATH
Relationship:
Time of Death:
2011- 003246
Lincoln
Interval:
Years
13:30 (Approximate)
Thomas 0. Forslund
Director and State Registrar
00554
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s CERTIFICATION OF VITAL RECORD
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