HomeMy WebLinkAbout970751STATE OF WYOMING
County of Fremont
ss.
AFFIDAVIT ESTABLISHING TERMINATION OF TENANTS BY THE ENTIRETIES
The undersigned, CLARA A. LEHMAN, being of lawful age, being first duly
sworn upon her oath, deposes and states as follows:
1. That she is the surviving wife of HERBERT K. LEHMAN, who died February
21, 2013 in Riverton, Fremont County, Wyoming; that there is a copy of the official Death
Certificate attached hereto as Exhibit A, certified to by the public authority in which such
original death certificate is now a matter of record..
2. That the Affiant and the deceased, HERBERT K. LEHMAN, were, at the time
of his death, the owners, as tenants by the entireties with the right of survivorship and not as
tenants in common, of the following described real estate, to -wit:
Lot 10 in Star Valley Ranch Plat 7, as platted and recorded in the
official records of Lincoln, County, Wyoming
3. That said tenancy by the entireties was vested in Affiant, and the deceased by a
Warranty Deed from HERBERT K. LEHMAN, as Grantor conveying said real property to
HERBERT K. LEHMAN and CLARA A. LEHMAN, husband and wife, as tenants by the
entireties with the right of survivorship and not as tenants in common, Grantees, dated November
22, 1993, and recorded in the office of the County Clerk and Ex- Officio Register of Deeds of
Lincoln County, Wyoming on December 2, 1993, Book 341PR, Page 559, Document No.
775379.
4. That said estate by the entireties was terminated by the death of the said
HERBERT K. LEHMAN and the Affiant, CLARA A. LEHMAN, as the surviving spouse of
the deceased, is now the sole owner of the above described real property, and that this Affidavit
is made and placed of record for the purpose of establishing Affiant's sole ownership and interest
as aforesaid, in compliance with and according to the provisions of W.S. §2 -9 -102.
DATED this,) ,La day of April, 2013.
Subscribed and sworn to before me thiss -ay of April, 2013, by Clara A. Lehman.
WITNESS my hand and official seal.
Tina L. Davis N otary Public A V 7, k
County of s State of Notary ublic
Fremont 1 Wyoming
my Commission Expires 12123115
RECEIVED 5/1/2013 at 9:54 AM
RECEIVING 970751
BOOK: 810 PAGE:421
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
C ara A. Lehman, Affiant
00421
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of Death:
Date of Death:
City of Death:
Location:
Additional Decedent Information:
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Facility:
Cause of Death:
The immediate cause is listed
(a) COPD
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
685118
CERTIFICATI
VITAL RECORD
STATE OF WYOMING
Herbert K Lehman
Male
August 21, 1928
February 21, 2013
Riverton
3911 Spy Glass Circle
Broadwater, Nebraska
Riverton, Wyoming
Married Clara A Blakeman
Yes
Else E Lehman
Lottie C Ruby
Clara A Lehman
Burial
Mountain View Cemetery, Riverton, Wyoming
Davis Funeral Home, Riverton, Wyoming
on the first line followed by any underlying causes.
ADVANCED ARTHRITIS
Natural Death
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
County of Death:
Relationship:
Time of Death:
Physician
Mike Miller, M.D.
1620 Riverview Road, Riverton, Wyoming, 82501
February 27, 2013
1.1, This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming.
V DATE ISSUEDFriday, March 01, 2013
r
This copy is not valid unless prepared on•paper with an engraved border.
1 1°° °9 a1 'ANY ALTERATION OR ERASUR V.ID
Social Security Number:
Age at the Time of Death:
2013- 000535
84 years
Fremont
07:00 (Actual)
J ames McBride
Deputy State Registrar
00422