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Home My WebLink About967913AFFIDAVIT FOR DISTRIBUTION OF PERSONAL PROPERTY STATE OF WYOMING SS COUNTY OF LINCOLN Dan William Stoker, also known as Dan Stoker, acting Trustee of the Bill and Edith Stoker Trust dated September 11, 2000 and executed on October 23, 2000 (hereinafter the `Bill and Edith Stoker Trust upon oath, deposes and says as follows: 1. I am the Trustee of the Bill and Edith Stoker Trust and the applicant by virtue of the Trust's claim to be the sole distributee of Edith Stoker "the Decedent as set forth hereinafter. 2. The Decedent died on August 25, 2012, a resident of Afton, Lincoln County, Wyoming. 3. The entire estate of the Decedent within the jurisdiction of this court and the purview of Wyoming law, wherever located, less liens and encumbrances, does not exceed $200,000.00. 4. More than thirty (30) days have elapsed since the date of death of the Decedent. 5. No application for appointment of a Personal Representative for the estate of the Decedent is pending or has been granted in any jurisdiction within the meaning of Wyo. Stat. §2- 1- 201(a)(iii). 6. The undersigned is entitled to payment or delivery of the property of the Decedent for the reason that he is the Trustee of the Bill and Edith Stoker Trust, which Trust is the sole distributee named in the Last Will of the Decedent. There are no other distributees of the Decedent having a right to succeed to any property of the Decedent under probate proceedings. 7. All persons indebted to Edith Stoker or having possession of tangible personal property or an instrument evidencing a debt, obligation, stock or chose in action belonging to Edith Stoker shall make payment of or deliver the same to the above described distributee. Affidavit for Distribution of Personal Property Page 1 of 2 00052 RECEIVED 11/13/2012 at 3:21 PM RECEIVING 967913 BOOK: 798 PAGE: 52 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY Dated: October 1 2012. Bill and Edith Stoker Trust dated September 11, 2000 BY: an William Stoker, Trustee AMBER M. ROBERTSON NOTARY PUBLIC SEAL County Of Lincoln State Of Wyoming My Commission Expires May 15, 2013 Subscribed and sworn to before me by Dan William Stoker, also known as Dan Stoker, Trustee of the Bill and Edith Stoker Trust dated September 11, 2000 and executed on October 23, 2000, this ri day of October, 2012 /Witness my hand and official seal. My commission expires: N..i 1 Iri, tij Notary Public Affidavit for Disbzbu1ion of Personal Property Page 2 of 2 00053 CERTIFICATI RECORD r DECEDENT LEGAL NAME EDITH Y. STOKER FEMALE BIRTHPLACE AFTON, WYOMING MARITAL STATUS AT TIME OF DEATH WIDOWED FATHER =:NAME GEORGE WASHINGTON YEAMAN MOTHER MAIDEN NAME MARY ROBERTS METHODOF DISPOSITION REMOVAL FROM STATE NAME ANDADDRESS OF FUNERAL FACILITY NALDER'S FUNERAL HOME, SHELLEY,!I•DAHO' CAU OF:I EATH:- (underlying cause last) INANITION DUE TO (or as a consequence of): DEsMENT;IA. 'DUE TC._(or asa :consequence .c DUE-TO (or as a consequence of): d. MANNER OF DEATH NATURAL DATE OF INJURY LOCATION WHERE I NJURt OCCURRED :DESCRIPTION OF HOWINIURY OCCURRED SOCIAL SECURITY NUMBER TIME OF DEATH 9: 3.0 .A. M. FUNERAL SERVICE LICENSEE, .JA P: MECHAM: TIME OF INJURY STATE F ID:; IDAHO DEPARTMENT OF.,HEALTH.AND WELFARE BUREAU OF VITAL 'RECORDS ANDHEALTN. :STATISTICS C RTIFICAT1 OF DEATH Date Filed AUGUST 2. 2012 NAME OF SURVIVING SPOUSE (It aiife; maiden name):. CITY,TOWN OR LOCATION.OF DEATH' IDAHO FALLS, IDAHO OTHER SIGNIFICANT.CONDITIONS CONTRIBUTING TO DEATH but not resulting in the underlying cause given above ADVANCED. AGE. NAME OF CERTIFIER WAL LACE' >C. BAKER; .M:. PLACE; OF RESIDENCE This is a true and correct reproduction of the document officially registered and placed on file with the IDAHO BUREAU OF VITAL RECORDS AND HEALTH STATISTICS. DATE OF BIRTH CORONER SUBSEQUENT CERTIFICATION`_IF NECESSARY State File No. 2012 07671 PLACE OF INJURY. 'BIRTHPLACE UTAH TITLE ?PHYSICIAN; JAMES:B AYDELOTTE STATE REGISTRAR` WAS DECEDENT EVER'1N U.S. ARMED FORCES? NO' Aoximate Interval Between Onset and Dead1 1. PIo:NTH: 2 YEARS 0 S.7114 VIM UI1JG11 iU! AUGUST 2 2012 DATE ISSUED: This -.copy not valid unless prepared on engraved border displaying state-seal and signature of the Registrar, 1'IINCO(Rsv)0LIY. Date Filed DECEDENT LEGAL NOME CHARLES WILLIAM STOKER BIRTHPLACE THAYNE, WYOMING MARITAL STATUS AT TIME OF DEATH MARRIED FATHER NAME CHARLES RAY STOKER MOTHER MAIDEN NAME SARAH :MARGARET TITNESOR METHOD OFDISPOSITION NAME AND ADDRESS OF FUNERAL FACILITY NALDER'S FUNERAL HOME, SHELLEY, IDAHO DATE OF DEATH MAY 26, 2012 CAUSE OF DEATH (underlying cause last) a PNEUMONIA DUE TO (or as aconsequence ot) b. DEMENTIA' DUE TO (Or es a consequence of): c. DUE TO (or as a consequence of): d: MANNER OF DEATH NATURAL DATE OF INJURY LOCATION WHERE INJURY OCCURRED DESCRIPTION OF HOW INJURY OCCURRED JUNE 06, 2012 TIME OP DEATH 5:00 A.M. SOCIAL SECURITY NUMBER FUNERAL SERVICE LICENSEE CRAIG L. GEARY TIME OF INJURY NAME OF CERTIFIER STATE OF IDAHO IDAHO DEPARTMENT OF HEALTH AND WELFARE BUREAU OF VITAL RECORDS AND HEALTH STATISTICS AGE 93 YEARS NAME OF SURVIVING SPOUSE (If wire, maiden name) EDITH YEAMAN CITY,TOWN OR LOCATION OF DEATH IDAHO FALLS, IDAHO OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH but not resulting in the underlying cause given above ADVANCED AGE WALLACE C. BAKER, M.D. This is a true and correct reprodl ction of the document officially registered and placed on file with the IDAHO BUREAU OF VITAL RECORDS AND HEALTH STATISTICS. r 0 x This copy not valid unless prepaed on engraved border displaying state seal and signature of the Registrar. PBNCO Iaev)07 /10 JUNE 06, 2012 DATE ISSUED: PLACE OF RESIDENCE IDAHO FALLS, IDAHO CORONER SUBSEQUENT CERTIFICATION IF NECESSARY DATE OF BIRTH APRIL 03, 1919 PLACE OF INJURY State FileNo. 2012 BIRTHPLACE WYOMING 441 U 6 JAMES B. AYDELOTTE STATE REGISTRAR. Approximate :Interval Between Onset and Death 5 DAYS 5 YEARS TITLE •PHYS COUNTY OF DEATH WAS DECEDENT EVER IN U.S. ARMED FORCES? NO WAS AN AUTOPSY PERFORMED? NO A ;p DVALI ALID LID IDV M h. "WI VIM III MU r■II11iLI ERTIFICATION OF VITAL RECORD