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HomeMy WebLinkAbout970600NTL -62934 When recorded mail to: Linda R. Nate PO Box 152 Cokeville, WY 83114 Comes now the undersigned Linda R. Nate aka Linda Rae Nate and Marilyn Nate Cragun and being on oath first duly deposes and says: 1. That they are citizen's of the United States of legal age and capacity, and competent to make this affidavit. 2. That we were personally acquainted with the deceased, Alva N. Nate 3. That said deceased is one in the same person as Alva N. Nate who acquired title to the property thru the Affidavit Recorded February 11, 2008 Entry No. 936871 Book 686 page 369 and listed in that certain document as recorded on April 26, 2006 at Entry No. 917776 in Book 617 at Page 809 in the office of the Lincoln County recorder, State of WY. 5. That the purpose of this affidavit is for Linda R. Nate aka Linda Rae Nate, and Marilyn Nate Cragun to accept the Trusteeship of the Orson A. Nate and Alva N. Nate Family Trust, Dated the 18th day of April 2006 and hereby agree to act as Trustee of said Trust on all the terms, provisions and conditions specified in said Trust. 6. That a certified death certificate of the deceased is hereby attached. Legal description: Lots 10, 11, 23, 24, 25, 26 and 27; the SE' /<NW' E1/2SW1/4 all situate in Section 7, Township 23 North, Range 119 West, 6th P.M., County of Lincoln, State of Wyoming. State of WY County of Uinta ss: On April 22, 2013 personally appeared before me Linda R. Nate aka Linda Rae Nate and Marilyn Nate Cragun and the signer(s) of the within instrument, who duly acknowledged to me that They executed the same. SHAWN R UNGER COUNTY OF UINTA MY COMMISSION EXPIRES RECEIVED 4/24/2013 at 4:10 PM RECEIVING 970600 BOOK: 809 PAGE: 824 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY AFFIDAVIT AND ACCEPTANCE OF TRUSTEESHIP STATE OF WYOMING MAY12,2013 Lind R. Nate aka Lin ae Nate Marilyn Na e Cragun 4..e Nota P blic Expi S= 10-,-(Z DECEDENT LEGAL NAME ALVA NORA DIMOND NATE NAME AND ADDRESS OF FUNERAL FACILITY MATTHEWS MORTUARY, INC., MONTPELIER, IDAHO STATE OF IDAHO DEPARTMENT OF HEALTH AND WELFARE BUREAU OF VITAL RECORDS AND HEALTH STATISTICS CERTIFICATE OF DEATH SIX SOCIAL SECURITY NUMBER AGE LATE OF BIRTH FEMALE 95 YEARS AUGUST 03, 1913 BIRTHPLACE PLACE OF RESIDENCE SALT LAKE CITY, UTAH COKEVILLE, WYOMING MARITAL STATUS AT TIME OF DEATH NAME OF SUFNNING SPOUSE (deify, maiden name) WAS DECEDENT EVER IN US. ARMED FORCES? WTDQWED NO FATHER NAME BIRTHPLACE WALTER DIMOND ENGLAND MOTHER MAIDEN NAME BIRTHPLACE NORA TURPIN UTAH METHOD OF DISPOSITION FUNERAL SERVICE LICENSEE REMOVAL FROM STATE LEONARD H. MATTHEWS DATE OF DEATH TIME OF DEATH CITY TOWN OR LOCATION OF DEATH COUNTY OF DEATH DEC. 30, 2008 10:50 P.M. MONTPELIER, IDAHO BEAR LAKE CAUSE OF DEATH underlying 08859 1881) Approximate Interval Between Onset and Death PNEUMONIA 24 HOURS DUE TO (or es a. consequence W): b. DUE TO (or as 9 consequence Or DUE TO (or 88 a consequence. of)' OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH but not resulting in the underlying cause given above WAS AN AUTOPSY PERFORMED? NONE STATED NO MANNER OF DEATH NAME OF CERTIFIER TITLE CERTIFICATION OF VITAL RECORD NATURAL VASHU DEOOMAL THAKUR, M.D. PHYSICIAN CORONER SUBSEQUENT CERTIFICATION IF NECESSARY 13 AL UvrsFx LI' TIME OF INJURY PLACE OF INJURY �iwuRY Af WORK? LOCATION WHERE INJURY OCCURRED DESCRIPTION OF HOW INJURY OCCURRED 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. JANUARY 12, 2009 DATE ISSUED• This copy is not valid unless prepared on engraved border displaying state seal and signature of the Registrar. JANE S. SMITH STATE REGISTRAR State File No 2008 -10722 Y O_ ��7 MI.• V<IIJIM MIN 1 LI�