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HomeMy WebLinkAbout971552The State of Wyoming ss. County of Sweetwater AFFIDAVIT SHOWING TERMINATION OF ESTATES BY THE ENTIRETIES Laura Anne Wilson, of lawful age, after first being duly sworn upon her oath according to law, deposes and says: 1. Algot F. Wilson, died on the 2nd day of October, 2012, in Opal, Lincoln County, Wyoming, as evidenced by the certified copy of Certificate of Death which is attached hereto, marked Exhibit "A and by this reference made a part hereof. 2. Affiant, Laura Anne Wilson, is the surviving spouse of Algot F. Wilson. 3. The said Laura Anne Wilson and Algot F. Wilson were married to each other on the 21st day of December, 2002, and said parties from that date on continued to be husband and wife until the date of death of said decedent. 4. On June 15, 2004, Algot F. Wilson and Laura Anne Wilson, conveyed by Mineral Quitclaim Deed and Assignment of Oil and Gas Leases in favor of Algot F. Wilson and Laura Anne Wilson, husband and wife, as tenants by the entireties, thereby creating a tenancy by the entireties, which Mineral Quitclaim Deed was recorded in Book 559PR, Pages 706 -707, in the Office of the County Clerk and Ex- Officio Register of Deeds of Lincoln County, Wyoming, on June 23, 2004, all right, title and interest in and to all of the oil, gas and other minerals in and under and that may be produced from the following described real property and premises, to wit: TOWNSHIP 19 NORTH, RANGE 112 WEST, 6 P.M., LINCOLN COUNTY, WYOMING: Section 4: Lot 1, SE /4NE /4, S /2S/2, NW /4SE /4 Section 10: S /2SW /4, NW /4SW /4, SW /4NW /4 Less 1.95 acre parcel 5. The estates by the entireties vested solely in Laura Anne Wilson, surviving spouse of decedent, on the 2nd day of October, 2012, the date of death of Algot F. Wilson. Dated this I l§h day of 2013. RECEIVED 6/19/2013 at 9:08 AM RECEIVING 971552 BOOK: 814 PAGE: 34 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY Laura Anne Wilson The State of Wyoming County of Sweetwater ss. Signed and sworn to before me on 2013 by Laura Anne Wilson. J Notary Public 2 My Commission Expires: 11` (A c 2,0‘ CM/via( 60035 Decedent: Name: Gender: Date of Birth: Date and Place of Death: Date of Death: October 02, 2012 City of Death: Opal Location: 77228 U.S. Highway 30 Additional Decedent Information: Place of Birth: Residence: Marital Status: Armed Forces: Name of Father: Name of Mother: Informant: Other Significant Conditions: Manner of Death: Certifier: Type: Name: Address: Date Filed: *J).r \NN Ilk AN q i 659152 CERTIFICATIO ITAL RECORD STATE OF WYOMING Algot F. Wilson Male February 12, 1923. Kemmerer, Wyoming Green River, Wyoming Married Laura Anne Kienke No Axel Martin Wilson Agathe B. Helgesen Laura Anne Wilson DEPARTMENT OF HEALTH CERTIFICATE OF DEATH State File Number: Social Security Number: Age at the Time of Death: County of Death: Disposition: Method of Disposition: Place of Disposition: Funeral Home or Facility: Facility: Cause of Death: The immediate cause is listed on the first line foUowed any underlying causes. (a) Acute Myocardial Infarction Burial Riverview Cemetery, Green River, Wyoming Vase Flaming Gorge Chapel, Green River, Wyoming This is a true certification of the document on file in the offi of Vital Statistics Services,.Cheyenne, Wyoming, DATE ISSUEDFriday, October 12, 2012 This copy is not valid unless prepared on paper with an engraved border. Relationship: Natural Death Time of Death: Coroner Dale S. Majhanovich, Coroner 421 B Street, Rock Springs, Wyoming, 82901 October 08, 2012 EXHIBIT "A" 2012- 003021 89 years Lincoln Interval: 15 :15 (Approxirnate) J ames McBride Deputy State Registrar v t .tvnurlcnnBm,7cNOto4u n %�60" „iPlltZ, !T`