Loading...
HomeMy WebLinkAbout967987I, Steve Ray Stevens, being of lawful age and duly sworn according to law, upon my oath, depose and state: That under the date of August 30, 1984, for valuable consideration, Ruth H. Roberts, a widow, by deed of that date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on September 4, 1984, in Book 218PR, Page 148, conveyed to Ruth H. Roberts, a widow, and LaRue Stevens, a married woman, as joint tenants with full rights of survivorship, the following described land, in the County of Lincoln, State of Wyoming, to -wit: Beginning at a point 65 rods North of the Southwest Corner of the Southwest Quarter of the Northwest Quarter (SW1 /4NW1/4) of Section 11, Township 35 North, Range 119 West of the 6th P.M., Wyoming, thence North 8 rods; thence East 4o rods; thence South 8 rods; thence West 4o rods to the point of beginning, together with improvements and water rights thereon That by reason of said conveyance aforesaid, the said Ruth H. Roberts, a widow, and LaRue Stevens, a married woman, as joint tenants with full rights of survivorship, became the owners of said real property, and the title thereto vested in them continuously from the date of said conveyance, to the date of death of Ruth H. Roberts, also known as Ruth Hokanson Roberts, on the loth day of March, 1987. That by reason of and upon the death of Ruth H. Roberts, title in the above described real property had vested in LaRue Stevens, a married woman. Affiant avers and certifies that Ruth H. Roberts, also known as Ruth Hokanson Roberts, is the identical party named with LaRue Stevens in the aforementioned deed, whose death terminated her interest, title and estate in said real property; and Affiant attaches hereto, and makes a part of this affidavit, a copy of 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 WITNESS my hand and official seal. My Commission Expires: RECEIVED 11/15/2012 at 4:38 PM RECEIVING 967987 BOOK: 798 PAGE: 301 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY Affidavit of Survivorship 2012. State of ss. County of \IAA Subscribed and sworn to befo�me, a notary public in and for said County and State, by Steve Ray Stevens, this day of t) 'k, 2012. R F \s teve Ray Stevens Notary Public 00301 1 CERTIFICATI DECEDENT NAME MOTHER FULL MAIDEN NAME DUE TO (or as a consequence of): DUE (or as a :consequence of): d. PUAOE: OF. INJURY STATE OFIDAHO IDAHO DEPARTMENT OF HEALTH .AND WELFARE BUREAU OF VITAL RECORDS AND HEALTH.: STATISTICS; RUTH HOKANSON ROBERTS DATE OF DEATH` SEX F EMALE WAS DECEDENT EVER IN MARITAL STATUS U.S. ARMED FORCES7 NO WIDOWED RESIDENCE STATE CITY, TOWN OR LOCATION :OM ING ETNA FAT HER }.NAME HOKAN HQ:K'ANSQN' EL: :I ZA:BET..H ,ANN _MICHAELSON NAME AND FLAMM .FUNERAL HOME, INC z. r.' ,REXBURG IDAHO FUNERAL SERVICE LICENSEE: GARTH E. FLAMM METHOD .OF: DISPOSITION TIME OF DEATH REMOVAL 12:06 A.M. CAUSF OF:DATH.:(unde(iying cause'last) METASTATIC CARCINOMA :OF COLON= OTHER SIGNIFICANT; CONDITIONS CONTRIBUTING TO DEATH but not resulting in the underlying cause given above NONE LIS'T (oMROF CERL(FI ER LAVAR M. WITHERS, M: DESCRIPTION OF HOW.I W URY OCCURRED DATE OF'INIURV rr,. :::r, HOUR OFI(ORY SOCIAL SECURITY NUMBER LOCATION OF INJURY. LATE OF BIRTH This is a true:and correct reproduction of the document officially regi$tered and placed on file with the IDAHO BUREAU OF VITAL.RECORDS AND H ALTH STATISTICS. SEPT. 10, 1905 AyANNEROF DEOH NATURAL State File No 1987 -01441 BIRTHPLACE WYOMING CITY, TOWN .OR LOCATIONOF DEATH. RE.X BOO G, IDAHO BIRTHPLACE TITLE OF CERTIFIER PHYSICIAN Approximate Between Onset and Death a 2.. YEARS: INJURY.AT WORK? •Mel WSW ■bILJJI UIJ:•iLIMP VITAL RECORD Loy`_ "f E n ll Ll, pyL DATE ISSUED: T 7 R=+' ca A V A L p LpD p yndd.vrtr. °AV Si Fhls copy no valid unless prepared on engraved borde :TAIVIES,B AYDEL©TTE r y V displaying state gea) and signa o f th R egistrar S TAT E REGISTRAR o A y r ..n...VV.....' llini V. ..V....V..u. V. ai:M1. .Viii.... .n.......i