HomeMy WebLinkAbout964166RECEIVED 4/19/2012 at 10:02 AM
RECEIVING 964166
BOOK: 785 PAGE: 20
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
STATE OF WYOMING
)ss.
COUNTY OF LINCOLN
Diane C. Izatt, being first duly sworn on oath deposes and says:
1. That Diane C. Izatt is of adult age and is the surviving wife of Brad W. Izatt who
died March 13 2012, in Auburn, Wyoming, as hereinafter more fully appears.
2. That by a Quitclaim Deed dated March 13, 1996, and recorded March 18, 1996, in
the office of the Lincoln County Clerk in and for the County of Lincoln, State of Wyoming, in Book
381 PR, Page 279, Brad W. Izatt and Diane C. Izatt, husband and wife, conveyed to Brad W.
Izatt and Diane C. Izatt, husband and wife as tenants by the entireties, of Auburn, Wyoming
83111, Lincoln County, State of Wyoming, the following described real estate situated in Lincoln
County, State of Wyoming, to -wit:
That property as more fully described on that certain Quitclaim deed attached hereto
marked Exhibit "A" and by this reference made a part hereof.
3. That .Brad W. Izatt died on the 13 day of March, 2012, in Auburn, State of
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 Brad W. Izatt, as aforesaid, the joint tenancy created by the
aforesaid deed was terminated, and Diane C. Izatt, surviving wife, became vested with all of his
right, title and estate in the above property.
DATED this day of April, 2012.
Diane C. Izatt
2012.
SUBSCRIBED AND SWORN to before me by Diane C. Izatt this l Ii\ day of April,
n'" upm,+''w,:+aw4vmw
I Nt'.i,t)F.1\18 NOTARY PUBLIC
County ur State of
Linea's:
Wyoming
My Comfriission Expires y F.ugust 31, 2014
AFFIDAVIT OF SURVIVORSHIP
P u b lic
00020
1 107-877-3101 Lincoln County Clerks
of the County of Lincoln, State of Wyoming
in consideration of Ten and 00 /100's ($10.00) and other good and valuable consideration
to them in hand paid by
Brad W. Izatt and Diane C. Izatt
whose address is Auburn, WY 83111
The receipt whereof is hereby confessed and acknowledged, have remised, released, convey and forever
quitclaimed and by these presents do for my heirs, executors and administrators, remis, release and
forever quitclaim unto the said
heirs and assigns, forever, all such right, title, interest, property, possession, claim and demand as we
have or ought to have in or to all the following described premises, to -wit:
Part of Lot 2 of Block 18 of the Auburn Townsite, Lincoln County, Wyoming more particularly
described as follows:
Beginning at the Northwest corner of said Lot 2 and running thence East, 330 feet;
thence South, 660 feet;
thence West, 330 feet;
thence North, 660 feet to the point of beginning.
Less and Except the following described parcel of land:
Beginning at a point which is 165 feet South of the Northwest Corner of said Lot 2;
thence East, 330 feet;
thence South, 495 feet;
thence West, 330 feet;
thence North, 495 feet to the point of beginning,
Hereby releasing and waiving all rights under and by virtue of the homestead exemption laws of the
State of Wyoming.
TO HAVE AND TO HOLD the said premises unto the said
Brad W. Izatt and Diane C. Izatt
heirs and assigns, to his and their own property use and behoof forever. So that neither we nor any other
person in my name or behalf shall or will hereafter claim or demand any right to title to the premises or
any part thereof, but they and everyone of them shall by these presents be excluded and forever barred.
Dated this L3 day of March, 1996.
STATE OF WYOMING
COUNTY OF LINCOLN
The foregoing instrument was acknowledged be
day of March, 1996.
Wi
IANCe P. 1100INSON
Hoary PutAk State of YPyorrtlne
Con, r'sg
My Commission Expires: 3 8' 9.6
14:37:37 04 -09 -2012
lecorded ma'r 19 rV o.at Q NI
QUIT CLAIM DEED In Book Eag m
Kemerer, WY.
No 8.i.6 0'± Marsha Moe, Clerk
KNOWN ALL MEN THESE PRESENTS, That
BRAD W. IZATT AND DIANE C. IZATT,
Husband and Wife,
BRAD W. IZATT AND DIANE C. IZATT,
Husband and Wife as Tenants by the Entireties
Brad W. Izatt
Dine C. Izatt
Notary Public
1 /1
0.0021
rieM
x�lt�liiin,
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of De
Date of Death:
City of Death:
Location:
Additional Decedent
Place of Rirth�
Residence:
Marital Status:
Armed Forces:
Name of Father:.
Name of Mother:
Informant:
Other Significant
Conditions:
Manner of Death:
Injury Information:
Date Of Injury:
injury At Work?
Location:
Description:
Certifier:
Type:
Name:
Address:
620242
Obesity
Accident
Date Filed: March 28, 2012.
CERTIFICATIO ITAL RECORD
Brad W. Izatt
Male
January 30, 1954
March 13, 2012
Auburn
250 Second West
Information:
Afton,Wynming
Auburn, Wyoming
Married Diane Crapo
No
Ralph A. Izatt
Verla Walton
Diane Izatt
This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming,
DATE ISSUED: Thursday, March 29 20
This copy is not valid unless prepared on paper with an engraved border.
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Facility: Schwab Mortuary Afton, Wyoming
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Prescription Drug Overdose
Burial
Auburn Cemetery, Auburn, Wyoming
March 13, 2012 (Actual)
No
250 Second West, Aubum, Wyoming
Prescription Drug Overdose
Coroner
Michael Richins, Coroner
274 N St, Box 57, Grover, Wyoming, 83122
Social Security Number:
Age at the Time of Death:
County of Death:
Relationship:
Time of Death:
James McBride
Deputy State Registrar
08:0.0. (Actual)
2012- 000836
58 years
Lincoln
Interval:.:
Minutes
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