HomeMy WebLinkAbout965927A of Successor Trustee
I, Patrick Shane Olsen, being of lawful age and duly sworn according to law, upon my oath,
depose and state:
That under the date August 7, 2006, Ronald Schwab and Josephine Schwab, by deed of
that date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on August
10, 2006, in Book 629 on Page 752, conveyed to Larry R. Olsen Trust Dated June 26, 2006, Larry
R. Olsen, Trustee, the following described property situate in Lincoln County, Wyoming, to -wit:
Lot 397 in Star Valley Ranch RV Park Plat 1, Lincoln County, Wyoming as described on the official
plat thereof
That by reason of said conveyance aforesaid, Larry R. Olsen Trust Dated June 26, 2006,
Larry R. Olsen, Trustee, became the owner of the above described land, and title thereto vested
continuously in said trustee from the date of conveyance described in said deed to the date of
death of Larry R. Olsen, also known as Larry Ray Olsen, on the 27th day of January, 2012. That by
reason of and upon the death of Larry R. Olsen, and pursuant to the Administrative Provisions of
the Trust, title to the above described real property vested in Patrick Shane Olsen, Successor
Trustee of Larry R. Olsen Trust Dated June 26, 2006.
Affiant avers and certifies that Larry R. Olsen, also known as Larry Ray Olsen is the
identical party named as trustee in the aforementioned deed, whose death terminated his interest,
title and estate in said real property; and Affiant attaches hereto and makes a part of this affidavit,
the Official Certificate of Death of said decedent, duly certified by the public authority in which
said death certificate is a matter of record.
Dated this day of
State of 2 >n
)ss.
County of S k-
My Commission Expires:
RECEIVED 8/3/2012 at 2:35 PM
RECEIVING 965927
BOOK: 790 PAGE: 692
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
OAS 1 to o i S
2012.
Patrick Shane Olsen
Subscribed and sworn to before me, a notvy public in and for said County and State, by
Patrick Shane Olsen, this 1 day of /ivy 2012.
WITNESS my hand and official seal.
Notary Public
NOTARY PUBUC
SUSAN P EVANS
812547
my Commission Expires
AUGUST 16, 2015
STATE OF UTAH
00692
4
IC I
DECEDENT INFORMATION
Date of Death:
City of Death:
Age:
Place of Birth:
Armed Services:
Spouse's Name.
industry/Business:
Residence:
Mother's Name:
Facility or Address:
CERTIFICATION OF VITAL RECORD::,-,
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January 27, 2012 (Found)
Herriman
62
Salt Lake City, Utah
Yes
Pamela Bunker
Salt Lake County Fire Department
Elmo, Utah
CERTIFICATE OF DEATH
State File Number:. 2012001299
Larry Ray Olsen
(Betty Enid Rowdy
13763 South -7530 West
INFORMA
NT INFORMATION
Name: Pam Olsen 5 Relatiobstip
Mailing Address: 505 E Mai Utah845 1
DISPOSITION INFORMATIOUV a
Method Ot Disposition: Bu I
Place Disposition: SouthWordan_City Cemetery; South Jordan
Date of Disposition: ebruar 2,4012 k
FUNERAL HOME INFO114MATIQN
Funeral Home: Goff Muary 4 a
P,iddress: 8090 SAuth State,
Funeral Director: Chad M Anderson r
MEDICAL CERTIFIqAtION c
Medical Professional:1
Jose K White DO
ak
CAUSE OF DEATH
Hypertensive and at ib '.oscleroti cardiovasc
Other significant conot •ns: To ccoism;i-tl
Tobacco USe FrobalD ontributed pk
Medical Examiner Coned: Yes= Autopsy°
Date Issued February .1, '612
w is p
Janice'L H ousto State Registrar
O ffice of VltafStatistic$_
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erfori ie
Time of Death:
County of Death:
Dat_of Birth:
Sex:
Marital Status:
Usual. cupat on
Education:
Father's Name:
Facility Type:
North MaridYC pe iO C rive
us ,post ventric d urinal sh
la., lyla ii ei cf Deeth: Natural
11 11 i1tjIJ 11 II i� 1111111
a
LakeCi
rat
14:00 (Found),
Salt Lake
July 12, 949
Male
Married
Battalion C hief
S
John Hubbard Olsen
ome
Coltege,but No Degree
Son's Residence
tah 84
This is an exact reproduction of the document registpre he StateOffice of Vita! Sta7tiistics,
Security features of this official document include intagli4oer,
a V =.R imagesan top cycloids,
uitra violet fibersnd hologram i Br_d
mage of the Utah StateS_eal�ver the_vi ords 'State ofUttah' This
ocument displays the date, seal and signature_ of r__a
f` the StateRegistrand-the County/Drstnict Health,Officer:
Gar_ Edwards
Director /Health Officer
County/District-Health Depa
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