HomeMy WebLinkAbout969826Affidavit of Survivorship
I, Debbie Shuman, being of lawful age and duly sworn according to law, upon my
oath, depose and state:
That under the date of July 7, 2009 for valuable consideration, Debbie Shuman,
by deed of that date, which deed was duly filed of record in the Office of the Lincoln
County Clerk, on July 8, 2009, in Book 727, Page 126, conveyed to Debbie Shuman and
Robert O. Granneman, as joint tenants with full rights of survivorship, the following
described land, in the County of Lincoln, State of Wyoming, to -wit:
Lot 7 in Block 34 in the First Addition to the Town of Kemmerer, Lincoln County,
Wyoming as described on the official plat thereof
That by reason of said conveyance aforesaid, the said Debbie Shuman and Robert
O. Granneman, 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 Robert O.
Granneman, also known as Robert Olin Granneman, on the 27th day of May, 2010. That
by reason of and upon the death of Robert O. Granneman, also known as Robert Olin
Granneman, title in the above described real property vested in Debbie Shuman.
Affiant avers and certifies Robert O. Granneman, also known as Robert Olin
Granneman, is the identical party named with Debbie Shuman 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, 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 lo day of 1--L Ld 2013.
State of I-
ss.
County of LI
Subscribed and sworn to before me, a notary public in and for said County and
State, by Debbie Shuman, this loo day of 1-L 2LI4 2013.
`�``����tt111t►1fftt�ITNESS my hand and official seal.
r R0,3
oaocaaoo <s yD J
s "1, 0.
0
mi.. 0
1 4j o i s sion Expires: tF !a i4-
o,, 1 /I1E1I %'t
Debbie Shuman
Notary Public
00381
RECEIVED 3/7/201 at 11:19 AM
RECEIVING 969826
BOOK: 806 PAGE: 381
JEANNE WAGNER
LINCOLN COUNTY CLERK KFMMFRFR �Ary
At e,
Decedent: State File Number:
:Name: Robert Olin Granneman
Gender: Male Social Security Number:
Date of Birth: December 22, 1942 Age at the Time of Death;
Date and Place of Death.:
Date of Death: May 27 2010 County of Death: t Lincoln
City of Death: Kemmerer
Location: South Lincoln Medical Center Po, Box 390
Additional Decedent Information
Place of Birth: Kansas City, Missouri
Residence: Kemmerer, Wyoming
Marital Status: Divorced
Armed Forces: Yes
Name of Father: William Olin Granneman
Name of Mother: Edna Marie Strodtman s'
Informant: Robert Matthew Granneman Relationship: Son
,isposition:
lylethod of Dispdsition: Removal from State
w Place of Disposition: UFD Cremation Center, South Jordan, UT.
Funeral Home or Facility:
Facility:
Cause of Death:
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
G Natural Death
This is a true certification of the document on fife in the office of Vital
Statiaics Services, Wyoming.
o DATE 'ISSUED: Thursday June 17, 2010
•This copy is not valid unless prepared on paper with an engraved border.
Ball_ Family' Chapel, Evanston, Wyoming
The immediate cause is listed on the first line followed by any underlying causes.
(a) Cardio Pulmonary Failure
(b) ACMI
Physician
Vincent Hinshaw, DO
PO Box 390, Kemmerer, Wyoming, 83101:
June 16, 2010
Gladys K. Breeden
Deputy State Registrar
2010- 001732
67 years
00:30 (Actual)
,Ft 7 g�;•tr,}. o'a j{ ,,}}7 tt a
CERTIFICATIO ITAL RECORD