HomeMy WebLinkAbout964088AFFIDAVIT OF COLLECTION AND DISTRIBUTION OF
DECEDENT'S PERSONAL PROPERTY
The undersigned, being first duly sworn, on oath deposes and states that I am making this
affidavit pursuant to Section 2 -1 -201, W. S.A. (2011), on behalf of the Donald G. Larson Revocable
Trust u/a March 4, 2003 (the "Trust as distributee, as hereinafter set forth, and that I make the
following statements in connection therewith:
1. That DONALD G. LARSON, died on or about February 19, 2012, in Salt Lake
County, Utah, and was a resident of Lincoln County, State of Wyoming, at the time
of his death; that said decedent died testate; that the Trust is the sole and only party
entitled to the hereafter mentioned property of the decedent pursuant to his Last Will
and Testament dated November 26, 2007.
2. That the value of the entire estate, wherever located, less liens and encumbrances,
does not exceed Two Hundred Thousand Dollars ($200,000.00).
3. That more than thirty (30) days have elapsed since the date of death of the decedent.
4. That no application for the appointment of a personal representative is pending or has
been granted in any jurisdiction in this state.
5. That the claiming distributee is entitled to payment or delivery of the property
described below; that the distributee is a trust established by the decedent; and that
there are no other distributees of the decedent having a right to succeed to the
property under probate proceedings.
6. That the property that is the subject of this Affidavit is described as follows:
RECEIVED 4/13/2012 at 11:06 AM
RECEIVING 964088
BOOK: 784 PAGE: 643
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
The decedent's undivided one quarter (1/4) interest in State of
Wyoming Brand A0111400.
7. The undersigned requests that the decedents one quarter (1/4) interest in the above
mentioned brand be transferred to the Donald G. Larson Family Trust created under
the Donald G. Larson Revocable Trust u/a March 4, 2003.
DATED this i day of a 2012.
BONNIE R. LARSON, as Successor Trustee of
the Donald G. Larson Revocable Trust u/a
March 4, 2003
00643
THE STATE OF WYOMING
ss.
COUNTY OF Y Ian( n
The above and foregoing instrument was acknowledged before me this 1 day of
a .L4 2012, by BONNIE R. LARSON, as Successor Trustee of the Donald G. Larson
Revocable Trust u/a May 4, 2003.
My Commission Expires:
2