HomeMy WebLinkAbout9663001
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RECORDING REQUESTED BY
Hemb Law Office
AND WHEN RECORDED MAIL TO
Corliss R. Scott
28907 Burrough Valley Rd.
Tollhouse, California 93667
STATE OF CALIFORNIA
COUNTY OF FRESNO
says:
Space above line for Recorder's Use
NO TAX DUE
AFFIDAVIT RE DEATH OF TRUSTEES
OF THE
1995 ARAVE FAMILY TRUST
DATED MARCH 17,1995
0000!
RECEIVED 8/20/2012 at 11:58 AM
RECEIVING 966300
BOOK: 792 PAGE: 5
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
We, Corliss R. Scott and Connie Y. Clark, of legal age, being first duly sworn, deposes and
That William L. Arave and Dorothy E. Arave executed a Revocable Living Trust Agreement,
dated March 17, 1995, as the named Settlors of the trust. William L. Arave and Dorothy E. Arave
are the named Co- Trustees of the trust. Said Trust in known as the "1995 Arave Family Trust."
That said Trust, at Section 7.7, provides that upon the death, resignation or incapacity of the
Settlors, Corliss R. Scott and Connie Y. Clark shall become Successor Co- Trustees.
That William L. Arave, one of the Co- Trustees of said Trust, died on June 24, 2011 and that
he is the same person as "William L. Arave" who is the decedent named in the certified copy of the
"Certificate of Death" which is attached hereto and incorporated herein by this reference.
That Dorothy E. Arave, one of the Co- Trustees of said Trust, died on July 13, 2012 and that
she is the same person as "Dorothy E. Arave" who is the decedent named in the certified copy of
the "Certificate of Death" which is attached hereto and incorporated herein by this reference.
That Corliss R. Scott and Connie Y. Clark, as the nominated Successor Co- Trustees, do
hereby accept the trusteeship and consents to serve as Successor Co- Trustees thereunder effective
as of July 13, 2012.
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Parcel No. 35183110306200
Parcel No. 35183110310200
Dated: Alai
State of California
County of Fresno
ss
Richard E. Hemb, Notary Public
Mail tax statements to party shown on following line;
if no party shown, mail as directed above.
(Seal)
2
OOuu
That said trust holds title to certain real property in the County of Lincoln, State of Wyoming,
as more particularly described as follows:
1. Grant Deed executed on September 20, 1995, recorded on October 23, 1995 as Document
No. 810332, involving real property described as Lot 39 Star Valley Ranch Plat 9 as platted
and recorded in the Official Records of Lincoln County, Wyoming.
2. Warranty Deed executed on January 29, 2004, recorded on February 7, 2004, as
Document No. 897037, involving real property described as Lot 5 Star Valley Ranch
Plat Eleven (11) as platted and recorded in the Official Records of Lincoln County,
Wyoming.
Subject to any easements, reservations, restrictions or right -of -ways of record of sight
or in use.
P.
Corliss R. Scott, Successor Co- Trustee
1995 Arave Family Trust
f� t>r) r a ►h�
Connie Y. Clarld,lSuccessor Co- Trustee
1995 Arave Family Trust
Subscribed and sworn to (or affirmed) before me on this 9th day of August 2012, by Corliss R. Scott and
Connie Y. Clark, proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
RICHARD E. HEMS
COMM. 01917825
NOTARY PUULIC CALIFORNIA 3
FRESNO COUNTY
Comm. Exp. JAN. 14, 2015
fir
?kw
Decedent:
Name:
Gender:
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
William Lloyd Arave
Male Social Security Number:
Date of Birth: August 21, 1925 Age at the Time.of Death:
Date and Place of Death:
Date of Death: June 24, 2011 County of Death:
City of Death: Star Valley Ranch
Location: 203 VistarEast
Additional Decedent Information:
Place of Birth: Alhambra, California
Marital Status: Married Edris Gulliver
Residence: Tollhouse California Dorothy
Armed Forces:
Name of Fath
Name of Mother:
Informant:
Disposition:
Metho d of Disposition:
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
535546
Ves
Lloyd Elmer Arav
Lavinia lierniinia' Ttlede'
Dorothy EdrisAraVe Relationship:
Cremation
Place of Disposition: Schwab Mortuary CrP•-••••"/ Afton
Funeral Home or FaCilitY:
Facility: Schwab mortuary, Afton, Wyoming
Cause of 1)eath:
The immediate cause is listed on the first line follower] by any underlying‘caoses:
(a) Arteriosclerotic Cardiovascular Disease
i
2011-0019
85 years
Lincoln
Wife
Interval:
Years
Natural Death Time of Death: 10:32 (Actual)'
Coroner
Michael Richins, Coroner
274 N St Box 57 Grover, Wyoming, 83122
July 01, 2011
k
r4 This is a true certification of the document on The in the office of Vital
A Statistics Services, Cheyenne, Wyoming.
(t54
1 DATE ISSUED: Wednesday, July 06, 2011
This copy is not valid unless prepared on paper with an engraved border,
Gladys K. Breeden
Deputy State Registrar
01)007
4 1420NN
4r2p/eypeld:
IF.
/CERTIFICATION OF VITAL RECORD
-1
Z UT
8 8
1, NAME OF DECEDENT -FIRST )GIVen). 2. MIDDLE 3. LAST (Family)
DOROTHY IEDRIS ARAVE
AKA. ALSO KNOWN AS- held. WI AKA (FIRST. MIDDLE, LAST) 4. DATE OF BIRTH mmidNecyy 5. AGE Yr 1 PUN0(00NE YEAR
IFUNDER /HOURS
ASE,
F
08/21/1926 85 Monroe 08/21/1926 De
N eer. Mmm,.
0. BIRTH STATE/FOREIGN COUNTRY 1' e001AL SECURITY NUMBER 11. EVER 19 U.S. ARMED FORCES/ 1Z MAROALSTATUS/SRDP'(dT aloeW( 7.. DATE OF DEATH mmAld/ceyy
S, HOUR IN HORN)
1625
II1'E ND. um( WIDOWED 07/13/2012
13. EDUCATION -NSal l0NYpepw 14/15. WAS DECEDENT HISPANICAAT INO(A)/SPANISH7 III yea eww0MSel on MA 18. DECEDENT'S RACE- Uplo 3 races may be 66(64 (en Pores
on GC10
°wwl°""'mbed
HS GRADUATE YES No CAUCASIAN
17.. USUAL OCCUPATION.. Type of wod1 for moat 0191e, D0 NOT USE RETIRED M. KIND OF BUSINESS DR NDUSTRY (c9, (gamy Marc 100d0016100401, employmN6 avow. etc)
TEACHERS AID EDUACATION
19. YEARS M OCCUPATION
10
0
21 017
TOLLHOUSE
22. COUNTYIPRDWNCE
I FRESNO
23.21P CODE
93667
24, YEARS IN COUNTY
53
25. STATE/FOREIGN COUNTRY
CA
Z
26:1NFORMANT NAME;RELATIONSHIP
CORLISS SCOTT, DAUGHTER
27. IFIFORMANPS MAIUNG ADDRESS Sl,. nd number. or mule amber, d w 2 l0NA,IN(63. dp
28907 BURROUGH V ALLE Y wd RD., TOLL CA 9 3667
2
Pg G
H
o 1
y t
24 NAMEOFSURVNINGSPOUSE/SRDP' -FIRST
29. MIDDLE
*LAST (BIRTH NAME)
31, NAME OF FATHEWPARENT -FIRST
RODNEY
32. MIDDLE
FRED
32. LAST
GULLIVER
34, BIRTH STATE
ENGLAND
35. NAME OF .MOTHER/PARENT-FIRST
CARMEN
36. MIDDLE
EDRIS
37. LAST BIRTH NAME).
JENSEN
36. BIRTH STATE
UTAH`
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g
2 01
-I p
8
39,DISPOS(RONDATE IMRId40W
07/27/2012
40, PEACE OF FINALDISPOS6ON RES OF: CORLISS SCOTT
28904 BURROUGH VALLEY RD., TOLLHOUSE, CA 93667
41. TYPE OF DISPOSmON(S)
CR /RES
42. SIGNATURE OF EMBALMER
NOT EMBALMED
Al LICENSE NUMBER
NE TUNE SOCIETY OF CENTRAL
CAI IFORNIA
45. LICENSE NUMBER
FD1332
46. SIGNATURE OFLOC
EDWARD•L MORENO, MD o CtY
A7. DATE mMdd/o0W
07/.19/2012,
W F
101. PLACE OF DEATH
OWN HOME
102, IF HOSPITAL, SPECIFY. ONE
IP;' S Ewa' ®°Q^'®
102. IFOTHER THAN MOBPI,TAL, SPECIFYONE
HOWER i Hp H BIL te a Other
104. COUNTY
FRESNO
1E15. FACILITY ADDRESS OR LOCATION WHERE FOUND (5omltw mm00. or 1000433
29213 SEMINOLE RD
106.077
TOLLHOUSE
S.
W
0
G
107. CAUSE OF DEATH Enter ONchah063. ras dbedtes, III, Met, W nmpl0M4a., Ea1 9x0/ nosed desk DONOT enterbmnd news a0d1
ee dsc'aded,' eagrNOry aml,w em Mee 404 nxV p ..nowsa6aa hhp. DO NOT ABBREV ATE.
IMMEDIATE CAUSE 'w CONGESTIVE HEART FAILURE
e o alebeneor
1001.07466.1.09
0033433() WO
'1010ABIRBWI®TDO63T407
YES 13 NO
ew.+nl
WD
11ee00 Rn
Sep4Mlelly, PM
Combos, Reny
108. BIOPSY PERFORMED?
S YES la N°
(03210210 EMer cause N7),
Lna A
UNDERLYING
CAUSE Idlaebaw
110. AUTOPSY PERFORMED?
YES El nn
V,M 0?I (D1)
INII Wed ON Gems l..
moulting N Maln) LAST
116 USED ND T
EDM6)ANGCNISE7
El yEs
112. OTHER SIGNIFICANT CONDMONSCONTRIBUTINGTO DEATH BUT NOT RESULTING IN THE UNDERLYING CAUSE GRIN IN 107
NO`
11E AS OPERATION PERFORMED FOR ANY CONDITION IN ITEM 1070R 1121)2yes, RMtype0l°Pew,oCwddele.),
1134 IF FEMALE, 17EENNITINUSTYFM7
S YES NO SUM(
2
m F
H
8
110 I CER1FY1140101PEEESFCF MY IPDALECGEEEASICCCUSIED
ATTEHDUi OWE NO R/CESRIEDFFOWIE CIEESSWSD
Deceder1 Mended 9nce Decedon,u. aw,AWe
115. SIGNATURE AND TITLE OF CERTIFIER
F
SUE SOO -YUN YIE,M.D.
116. LICENSE NUMBER'
A80793
117. DATE' mm/dd/ccyy
07/19/2012
A) mrrJddccyy 03) mMdO/ceyy
07/07/2012. 07/12/2012
119. TYPE ATTENDING PHYSICIAN'S NAME, MAILING ADDRESS. 6000 SUE SOO -YUN YIE M.D.
1616 W SHAW AVE B -6, FRESNO, CA 93711'
O
N
g 120.
0
11B1CISpIFY11MTMM/CRNCNOECHC ATTIEF0.ROVE, AND PULE SMIEDRO'1TE CAFES S132111
MANNER OF DEATT 0 NMute1 S An29Rt S H.dtdde S 50000 E ns II lt ad
120. INJURED AT WORK?
S 1 S NO II 104<
121, INJURY DATE 03/431/30yy
122, HOUR (H Houw)
123. PLACE OF (9716,7 N.01, hems, 00nalnmll0n 1116, W00ded area, 3104
124, DESCRIBE HON MAURY OCCURRED (Events when resulted Inln47Y)
LOCATION OF MJURY ($110.1 and Runner, or 101elion. end 011y, and Sp)
126. SIGNATURE OF CORONER DEPUTY CORONER
127. DATE mm/d0007
128.1YPE NAME, TIE OF CORONER /DEPUTY CORONER
STATE
REGISTRAR
A
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C
D
E
III11111(IIII 111011(( 11111111(( pIIIIIIIIIIIIlIII18IlIIlIIIIIIIIINIIII
'0108010112112888•
FAX AUTH.A CENSUS TRACT
LOCAL REGISTRATION NUMBER
(Q;
u
r.
•STATE FILE NUMBER
20. DECEDENT'S RESIDENCE (Slreel 30700,7x, or Io13303)
29213 SEMINOLE RD
COUNTY of FRESNO
DEPARTMENT OF PUBLIC HEALTH
FRESNO, CALIFORNIA
CERTIFICATE OF DEATH
SE USE BLACK WI( MY /NO ES WWIFOUTS OR WHOM
3201210003661
CERTIFIED ALI V R FRESNO IDR S JIF N 1111 111.1M
This is a true and exact reproduction of the document officially registered and placed g 0626
on file in the Vital Records Section, Fresno Co, Department of Public Health,
PBNCO (Rol 0015 DATE ISSUED p��
This copy n I s repared on engraved border displaying: date,
COUNTY HEAL H OFFICER
REGISTR O AL. STATISTICS
seal and signature of Registrar.
4 1
00008
;liI