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1andrptle0
SINCE 1904
RECEIVED 10/30/2012 at 4:40 PM
RECEIVING 967673
BOOK: 797 PAGE: 193
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
AFFIDAVIT
I ANNMARIE WILSON, being first duly sworn on oath, depose and say:
That I am a citizen of the United States of America over the age of 21 years, and a
resident of WYOMING
That I was well and personally acquainted with GLYDA E. L. GADDO in that certain
Warranty Deed dated APRIL 1, 1981 and recorded in Book 182 at Page 262 as Filing No
568125. in the office of the Recorder of LINCOLN County, WYOMING.
That I know of my own knowledge that GLYDA E. L. GADDO in the said deed and
GLYDA ELOUISE GADDO mentioned in the attached Certified Copy of Certificate of Death
was one and the same person.
This affidavit is intended to terminate the JOINT TENANTS, WITH FULL RIGHTS OF
SURVIVORSHIP in the following described property:
THE WHOLE OF LOT SIX (6), BLOCK THREE (3), IN THE HEUETT ADDITION TO THE
TOWN OF COKEVILLE, WYOMING.
.LEGAL DESCRIPTION
Dated this day Of Oct 2012 A.D.
00191
Gk-- c a W Pau Oc4` IS 2.0
ANNMARIE WILSON DATE
STATE OF Hop( rt
County of CtoSke.il
On the )5 day of October A.D. 2012 personally appeared before me
A v►V► /V\ e 1 1 S 0ro
the signer(s) of the within instrument, who duly acknowledged to me that he /she /they executed
the same.
Commission expires: L i 15 2015
Residing in: -11::F:1-t -em
INDIVIDUAL ACKNOWLEDGMENT
Notarylblic
Decedent: State Fite Number: 2009- 002574
Name: Glyda Elouise Gaddo\
Gender: Female Social Security Number:
Date of Birth: January 17, 1936 Age at the Time of Death: 73 years
Date and Place of Death;
Date of Death: August 25, 2009 County o f Death: $weetwater
City of Death: Rock Springs
Location: Mem Hospital of Sweetwater County PO Box 1359
Additional Decedent Information:
:place of Birth: 13ock Springs, Wyoming
Residence: Rock Springs. Wyoming
Marital; Status: Married Barney Ray Gaddoa
Armed Forces: No
Name of Father: Harold Leslie Laughter
Naive of Mother: Ruth Rosetta Race
Informant: Barney Ray Gaddo Relationship: Husband
Disposition:
Method of Disposition: `auriat
Place of Disposition: Riverview Cemetery, Green River, Wyoming
Funeral Home or Facility:
Facility:
Cause of Death:
The immediate cause is listed; on the first line followed by any underlying causes.
(a) Dissecting Aortic Aneurysm
Other Significant
.Conditions:
Manner of Death: Natural Death
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
Fox Funeral Horne, Rock Springs Wyoming
Coroner
Travis. Sanders, Deputy Coroner
421 B Street, Rock Springs, Wyoming, 82935
This is a true certification of the document on file in the office of Vital
Records Services, Cheyenne, Wyoming.
Thursday, September 10, 2009
5 DATE ISSUED:
This co i not valid unless prepared on a cr with an en
copy raved border. P P P P B
Gladys K. Breeden
Deputy State Registrar
Interval:
Minutes.
t
CERTIFICATION OF VITAL RECORD
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