HomeMy WebLinkAbout965277WHEN RECORDED MAIL TO:
J. Russell Point
1415 Antelope
Kemmerer, WY 83101
STATE OF WYOMING
COUNTY OF LINCOLN
I, J. Russell Point, of lawful age, being first duly sworn an oath, deposes and says:
1. That by virtue of a Warranty Deed, dated December 5, 1979 and recorded December 5,
1979, in Book 162PR, Page 194, Instrument No. 533527 in the Office of the County Clerk and Ex-
Officio of Register of Deeds of Lincoln County, Wyoming, wherein Richard D Fagnant and Elizabeth
M. Fagnant, husband and wife, conveyed to J. Russell Point and Judy K. Point, husband and wife, the
following described real property, to wit:
Lot Numbered Nineteen (19), Block Numbered two (2), Lincoln Heights Fourth Subdivision,
Town of Kemmerer, County of Lincoln, State of Wyoming, as the same are laid down,
platted, described and of record in the Office of the County Clerk and Ex- officio Register of
Deeds of Lincoln County, Wyoming, together with all improvements thereon situated.
2. That Judy K. Point, one of the Grantees, died on January 28, 2012 at her Aransas Pass, Texas,
home and as a result her previous estate in the above- entitled real property terminated and the entire fee therein
vested in the Affiant and co- tenent, J. Russ Point, to whom she was married at the time of her death.
3. That attached hereto marked Exhibit "A" a by this reference made a part hereof, is an original
Certificate of Death for Judy K. Point, the decedent, which was issued by the State of Texas Department
of Health, which is the certified public authority in which the official death certificate is a matter of
record, and that the decedent named in the attached Certificate of Death is the one and the same person
as Judy K. Point, one of the Grantees named in the aforementioned conveyance.
DATED thisjfay of Ali, 2012.
4v,ve
(SEAL
ss
SAVANNA L. KRAIL NOTARY PUBLIC
COUNTY OF r STATE OF
LINCOLN i;r c
WYOMING
M) Commission Expires. ll 5
RECEIVED 6/25/2012 at 11:27 AM
RECEIVING 965244
BOOK: 788 PAGE: 206
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER
AFFIDAVIT OF SURVIVORSHIP
SUBSCRIBED AND SWORN to before me this
Cl tsaPIMA 14_
ay of- 4p i1 -2012.
RECEIVED 6/26/2012 at 1:39 P
RECEIVING 965277
BOOK: 788 PAGE: 319
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMM
0)
My Commission Expires: t4 121 ltD
Residing at: el 2,5 e �V-
Kemmer.e 1 W' X3101
00319
JUDITH KAY POINT ,il.i- I.SCHAECHTERLE
3.
-ACTUAL'OR PRESUMED
01/28/2019'
SEX
FEMALE
4. DATE OF BIRTH
11/01/1946
5. AGE-Last Birthday
Years)
65
IF I ;NOE 1.YR
IF I N FR RAY
6. BIRTHPLACE (CIty&State or Foreign Country)
KEMMERER, WY
MO' Days
HoUrs
Mi n
7. SOCIAL SECURITY NUMBER
10e. RESIDENcE
B. MARITAL STATUS AT TIME OF DEATH KMerne
o Widowed 0 Divorced -LI NeVerfvairted 0 linknoWn'
9. SURVIVING SPOUSE'S NAME (9 w9., give name prior to first marriage)
JAMES-RUSSELL POINT
STREET ADDRESS
1500 W. MATLOCK LOT 56
100 APT/NO,
100. CITY OR TO
ARANSAS PASS
10d. COUNTY
SAN PATRICIO
10e. STATE
TEXAS
10f. ZIP CODE
78'336
10g. INSIDE CITY LIMITS?
12.1 Yea 0 No
11. FATHER'S NAME
ALBERT SCHAECHTERLE
12. MOTHER*NqMEPR OFITO FIRST MARRIAGE
:sokiiit mA
13. PLACE OF DEATH (CHECK ONLY ONE)
IF DEATH OCCURRED IN A HOSPITAL:
El Inpatient Ll ER/Outpatient 0 DOA
IF DEATH OCCURRED SOMEWHERE OTHER THAN A HOSPITAL:
0 Hospice Fasility ::1 Nursing Home 1:1_10:4 cedent's Home p Other (Specify)
14. COUNTrOF DEATH
NUECES
15. CIROTOWN, ZIP (IF NO),::
CORPUS CHRISTI, 7404
FACILITV.NAME-(If not institution, give street address)
CHRISTUS SPOHN HOSPITAL SHORELINE
17. INFORMANTS NAME RELATIONSHIP TO DECEASED
J. RUSSELL POINT HUSBAND
18. MAILING ADDRESS OF INFORMANT (Street end Number,City,State,Zip Code)
'1415.ANTELOP,E ST...KEMMERER-WY 83101
19. METHOD OF DISPOSI
Et Burial El brat-nation 0 boriation
o Entombment 0 Removal from state
0 Other (Specify)
ATUREANDLICENSEINUMBERiORFUNERAL DIRECTOR OR PERSON
ACTING As sUckr 1
0 1!.; .'l■ i!',
P.
•tViAtsil-tEl- bt SIGNATURE
8258
-217 pp,
161 Unknown
S005
Block
22. PLACE OF DISPOSITION (Name of cemetery, crematory, other pace)
CHARLIE MARSHALL CREMATORY
23. LOCARON (City/Town, and Slate)
.ARANSAS OfAss,z,tx
Lot
Space
24. NAME OF FUNERAL FACILITY
I
CHARLIE MARSHALL FUNERAL HOMES ARANSAS
25. COMpLETE•ADDRESS 0E-,FUNERAL FACILITY (Street and Number, C (ty, State, Zip Code)
2CiO3k WHEELER. ARANSAS PASS, TX 78336
26, CERTIFIER (Check only one)
El Certifying physidan-To the best of my knowledge, death occurred due to Om cause(s) and manner stetted.
J Medical Exentiner/Justice 01 15. peace- On the bests of exandnetion, entlior Inyeallgaliondin my 46114, death oceurred ttirne,dele end pl.* end dUdeO the cetsee(s) end manner slated.
27SIGNATURE OF CERTIFIER
ARVIND MODAK, BY ELECTRONIC SIGNATURE
8' DATE c EBTREI:!;( p/Doixo
i`,... 01169/9019.;i'.i!ii
2?..1,1,cqNs NUMBER
LI397(
s
30. TIME OF DEATH(Actual or presumed)
'D5:92 Pm
31. PRINTED NAME, ADDRESS OF CERTIFIER (Street end Number, city,Stale,zip Code): '•',1,
ARVIND MODAK 7006 CHISWICK DRIVE CORPUS CHRISTI, TX 78413
32 TITLE OF- CERTIFIER
MD
1.-
Li.•
.0
W
LO
0
33. PART-l. ENTER THE CHAIN OF EVENTS DISEASES, INJURIES, OR COMPLICATIONS THAIDIRECTLXCAUSED THE DEATH. Po NOT ENTER
TERMINAL EVENTS NOT S A U BTRAW R E. TIVETW R Okr 41)ARUNJEDgM CR VENTRTU
GLARABRILIATIWWITHOUTStiOVVING THE
H.
IMMEDIATE CAUSE (Final
disease or condition
resulting in death) a. SEPSIS
Approximate Interval
Onset to death
4 DAYS
Due to (or as a consequence of):
Sequentially list cOnditions,
If any, leading td the caUse s. COLON CANCER
listed on line a. Enter the
3 MONTHS
UNDERLYING CAUSE Melo (ores a consequense ofts-
(disease oc,Injury that
(nitiated, the events resulting
in death) LAST
Due to (or ate consequence of):
PART 2. ENTER OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TOREATH `:"213UT NOT RESULTING-9/ THE tiNDERLythfr
CAUSE GIVEN IN PART I. f
34,WAS AN AUTOPSY PERFORMED?
0 Vas El 'No
35. WEI4E AVAILABLE TO
COMPLETE THE CAUSE OF DEATH?
0 Yes 0 No
36. MANNER OF DEATH
El NatUral
0 Accident'
o 511! de
'0 Homicide
r3 Pending Investsgation
o Could not be determined
37. DID TOBACCO USE
TO DEATH?
N 0 Yes
ES)
0 Probably
0 Unknown
38. IF FEMALE:
•I''' 1 g .1,„ ,,t,P,',
3•ZI N t lxignent
11 l■ st„ A
'0 Pe 0 NO tttfilent atAltl'iltAtdiet 1 I iilli biti
?Op netliiit pl!ebiiiini)ttirt!iz.zieys of death('
0 Not lifegraint, but preVin vlhiC to one year befe4death
0 Unknown f pregnant within the past year
39. IF TRANSPORTATION INJURY,
Y:
SPECIFY .'piivio0ptor
01,edestrien
0 oth..
408. DATE OF INJURY
40b. TIME OF INJURY
400. INJURY ATNORK?
E Yet' El N.
4I:XL,RLACE 01ANJURyls.g. Decedent's Some, construction silo, restaurant, wooded area)
40e. LOCATION (Street and Number, City,Stele,Zip Code) •r`'
40f, COUNTY OF INJURY
41. DESCRIBE HOW INJURY OCCURRED'
,i itilIT
42e. REGISTRAR FILE NO.
020172
42b. RATE RECEIV BY LOOM. REGISTRAR
01/31/2012
42osiI0 1 )t
.REGISf RAR,4 CORPUS:CHRISTI:ELECTRONICALLY FILED
OCH
c
NI E o
z
0
5
0
'W Is. 41,
DEPARTMENT OF STATE HEALTH SERVICES 00 0
VITAL STATISTICS UNIT
TRAI SIETRTMENT OF STATE HEALTH SERVICES VITAL STATISTICS
STATE OF TEXAS CERTIFICATE OF DEATH STATE FILE NUMBER 142-12-008923
This is a true and correct reproduction of the original record as recorded in this office. Issued under
authority of Section 191.051, Health and Safety Code.
SA ISSUED
FEB 01 2012 GERALDINE R. HARRIS
)11 WARNING: THIS DOCUMENT HAS A DARK BLUE BORDER AND A COLORED BACK STATE REGISTRAR