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STATE OF WYOMING
COUNTY OF LINCOLN
I, Shannon Renee Critzer, being of lawful age and first duly sworn according to
law, upon my oath, depose and state:
1. That I am of adult age, a resident of Lincoln County, Wyoming, and the
Affiant herein.
2. That said Kathryn R. Kulinski died on the 24th day of September, 2011
and a copy of the original certificate of death, certified to as true an
correct by public authority in which the original of said certificate is a
matter of record, is attached hereto as Exhibit "B
3. That by reason of death of said Kathryn R. Kulinski and 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 Gary Baumer and Connie Baumer continuously since the
death of the said decedent.
FURTHER AFFIANT SAYETH NOT.
Dated W a j 2
State of Wyoming
County of Lincoln
)ss.
SS.
AFFIDAVIT TERMINATING ESTATE
The foregoing instrument was subscribed and sworn to me by Shannon
Renee Critzer as Successor Trustee of the Kulinski Family Trust this •3 day
of April, 2012
Witness my hand and official seal.
My Commission Expires:
RECEIVED 5/7/2012 at 3:00 PM
RECEIVING 964431
BOOK: 785 PAGE: 715
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Shannon enee Critzer,
Successor Trustee
Notary Public
My Commisson Expires September 15, 2015
00715
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of Death:
Date of Death:
City of Death:
Location:
Additional Dccedcnt !nfo: matte^:
Place of Birth: San Gabriel, California
Residence: Etna, Wyoming
Marital Status: Widowed
Armed Forces: No
Name of Father: David Whitcomb Rewick
Name of Mother: Virginia Mae Jones
Informant: Shannon R. Critzer
Disposition:
Method of Disposition: Cremation
Place of Disposition:
Funeral Home or Facility:
Facility:
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Gastrointestinal Hemorrhage
Other Significant
Conditioris:
Manner of Death:
Certifier:
Type:
Name:
Address:
September 24, 2011 (Approx)
Etna
445 Pinto`Lns
Schwab Mortuary. Afton. Wyoming
History of Alcoholism
Date Filed: September 29, 2011
552614
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
Kathryn Mae Kulinski
Female Social Security Number:
December 22, 1947 Age at the Time of Death:
Schwab Mortuary Crematory, Afton, Wyoming
Natural Death Time of Death:
Coroner
Michael Richins, Coroner
274 N St, Box 57, Grover, Wyoming, 83122
This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming.
DATE ISSUED:
Thursday; September 29; 2011
N5
Joe This copy is not valid unless prepared paper d on a ryithau engraved border.
NY e V'Pt' I•Y
County of Death:
Relationship:
V
Matthew T. Rowe
Interim Deputy State °Registrar
ulaays R. areeaen
Deputy State Regisu
2011 002868
63 years
Lincoln
Daughter_
Interval:
minutes
02:00 (Approximate)
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CERTIFICATION,OF VITAL RECORD
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