HomeMy WebLinkAbout971504When Recorded, Return To:
Sharon Beeson
6720 E. Encanto Street, Unit 53
Mesa, AZ 85205
STATE OF ARIZONA
ss.
County of Maricopa
AFFIDAVIT OF SURVIVORSHIP
The undersigned, being first duly sworn, says:
1. I, SHARON BEESON "Sharon am the
For Information Purposes Only:
Property Address:
3522 S. Muddy String Road #83
Thayne, WY 83217
RECEIVED 6/17/2013 at 10:25 AM
RECEIVING 971504
BOOK: 813 PAGE: 762
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
surviving spouse of ROBERT D.
BEESON "Decedent who died on September 1, 2009 (the "Decedent
2. At the time of death, Decedent was the owner in joint tenancy with Sharon of the
following described real property:
STAR VALLEY RANCH RV PARK PLAT 1 LOT 83 as platted and
recorded in the Official Records of Lincoln County, Wyoming.
RESERVING THEREFROM all rights, title, and interest in and to any and
all minerals right appertaining thereto.
Subject to all declarations of covenants, conditions and restrictions of
record.
3. The status of joint tenancy property with right of survivorship was created by
Warranty Deed recorded on November 14, 1997, in the Recorder's Office of Lincoln County,
Wyoming, recorded in Book 404, Page 181 as instrument number 846752.
BEESON.
OFFICIAL SEAL
CINDY A. KIRALY
NOTARY PUBLIC ARIZONA
MARICOPA COUNTY
My Commission Expires July 5, 2016
3940279.1 \June 5, 2013
111077.001
4. This Affidavit is made from my own knowledge, and I will testify positively to
the truth of the same in any court whenever called upon for that purpose.
5. A certified copy of the Certificate of Death of Decedent is attached hereto.
6. This affidavit is made for the purpose of furnishing a recordable document
showing the termination of the estate and the ownership of said property interest in Sharon
Beeson.
Date: June 45 2013.
0
SHARON BEESON, Affiant
SUBSCRIBED AND SWORN TO before me on /3 day of June 2013, by SHARON
a•
Notary Public
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of Death:
Date of Death: September 01, 2009
City of Death: Afton
Location: Star Valley Medical Center 110 Hospital Lane
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: Schwab Mortuary, Afton, Wyoming
Cause of Death:
The immediate cause is listed on the firs: line
'(a) Cardiac Arrest
(b) Myocardial Infarction
Other Significant
Conditions:
Manner of Death:.
Certifier:
Type:
Name:
Address:
:Date Filed:
4203.14
CERTIFICATIO
STATE OF WYOMING
Robert David Beeson
Male Social Security Number:
October 03, 1938 Age at the Time of Death:
Saginaw, Michigan
Mesa, Arizona:'
Married Sharon Wilson
Yes
Ivan David Beeson.
Emma Elizabeth Pratt
Sharon Beeson Relationship:
Removal from State
Mesa City Cemetery, 1212 N. Center St; Mesa, AZ 85201
Natural Death Time of Death:
Coroner
Dain Schwab, Deputy Coroner
274 N St, Box 57, Grover, Wyoming, 83122
September 16., 2009
This is a true certification of the document on file in the office of Vital
Records Services, Cheyenhe, Wyoming.
BATE ISSUED: Wednesday; September 16 „2009
This copy is not valid unless prepared on paper with an engraved border.
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
ITAL RECORD
County of:Death:
followed by any underlying causes.
Gladys K. Breeden
Deputy State Registrar
2009 002633
70 years
Lincoln
Wife
Interval:
Min
hr...... x!1`1....,......
91
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