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SINCE 1904
I, MARK ALAN CADY being first duly sworn on oath, depose and say:
That I am a citizen of the United States of America over the age of 21 years, and a
resident of ALASKA
That I was well and personally acquainted with GORDON VIRGIL CADY in that
certain Warranty Deed dated SEPTEMBER 14, 1998 and recorded in Book 417, at Page 268
as Filing No.853245 in the office of the Recorder of LINCOLN County, Wyoming.
That I know of my own knowledge that GORDON VIRGIL CADY in the said deed and
mentioned in the attached Certified Copy of Certificate of Death was one and the same person.
This affidavit is intended to terminate the JOINT TENANCY of GORDON VIRGIL
CADY in the following described property:
LEGAL DESCRIPTION
:Lot #8, Riverview Ranchettes Subdivision according to that plat filed in the Office of the
Lincoln County Clerk, Lincoln County, Wyoming
Subject to all covenants, restrictions, easement rights and rights -of -way of sight and or of
record.
EXCEPTING THEREFROM all oil, gas or other mineral rights.
Tax Roll No. 3419 253 -02- 008.00
Dated this
1
AFFIDAVIT
day of �Jt cX 12013 A.D.
RECEIVED 6/14/2013 at 2:51 PM
RECEIVING 971485
BOOK: 813 PAGE: 715
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
M
6f/ MA' ALAN C DY
60715
LH
STATE OF Wyoming)
SS
County of Lincoln
INDIVIDUAL ACKNOWLEDGMENT
On the ";Q day of A.D. 2013 personally appeared before me
the signer(s) MARK ALAN CADY of the within instrument, who duly acknowledged to me that
he /she /they executed the same.
Coininission expires: ineur i/ 6,2617
Residing in: l>wcaiw
LISA HATCHER NOTARY PUBLIC
County of State of
Lincoln Wyoming
My Commission Expires: 6 March 2017
Notary Public
lY 7 h O
LH
-c
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of Death:
Date of Death: March 27, 2013 County;' of Death Lincoln,
City of Death: Afton
Location: Star Valley Medical Center 110, Hospital Lane
Additional. Decedent Information:
Place of Birth: Daly City, California;
Residence: Thayne, Wyoming;!
Marital Status: Widowed
Armed Forces: Yes
Name of Father: Virgil Albert Cady
Name of. Mother: Frieda Anna Hesemann
Informant: Mark Alan Cady Relationship:
Disposition:
Method of. Disposition: Cremation
Place of Disposition: Schwab Mortuary Crematory, Afton, Wyomin
Funeral Home or Facility:
Facility: Schwab Mortuary, Afton, Wyoming`
Cause of Death:
The immediate cause is' listed on the first line followed by any underlying I nterval:
Date Filed: April 01, 201 3
Thais a true certification of the document on file in the'office of Vital
Statistics Services, Cheyenne, Wyoming.
DATE ISSUEt+Nednesday, April i 03, 20 13=
4IEALT
State, File Number:`:
Gordon Virgil Cady
Male Social _Security Number::,
December 02, 1929 Age atthe Timetof,Deatl:• 83 years
Other Significant Parkinsons disease COPD
Conditions:
Manner of Death: Natural Death Time of,Dea
Certifier:
Type: Physician
Name: Allen D. Carter, M.D.
Address: 110 Hospital Lane, PO Box 579, Afton, Wyoming 83110
amteS
James McBride
Deputy State Registrar,
ies
py is not: valid unless prepared on' paper with an engraved` border.'