HomeMy WebLinkAbout971583File No.: 188086
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
I, wy j
upon my oath, depos
herein.
Lam^
and state:
1. That I am of adult age, a resident of Cwt and the Affiant
2. That by virtue of the conveyances which are recorded in the office of the County Clerk for
Lincoln County, Wyoming, located at Kemmerer, Wyoming is recorded a Warranty Deed dated
/A in Book %BLS` PR on page ?S`
th9L day of
conveys unto
property, to -wit:
e follong described
CLS l`�/2GIi2 6 1e r� j/✓eJ
3. That said 6 YZC 4 t on the ,7'? day of died
and a copy of the original certificate of death, certified to as true andcorrect by public authority
in which the original of said certificate is a matter of record, is attached hereto as Exhibit "A
4. That by reason of death of said Kr, fi) fa.4. t by reason of 2 -9 -102
W.S. the decedents interest and title in said conveyance has terminated
and title to the real roperty conveyed thereby has vested absolutely in
continuously since the death of the said decedent.
FURTHER AFFIAg1T SAYETH NOT.
June 18, 2013
State of Wyoming)
)ss.
County of Lincoln)
The foregoing instrument was subscribed and sworn to me b
�lG/"
Witness my 1 cj4iid official pe
Notary Public
My Commission Expires: %7
AFFIDAVIT TERMINATING ESTATE
this /f day of
.A..... F....
Lori Kalan Notary Public
County of
Lincoln
State of
Wyoming
My Commission Expires 2/2612015
4 d..PN S�rs�od
being of lawful age and first duly sworn according to law,
O07`-
RECEIVED 6/20/2013 at 3:44 PM
RECEIVING 971583
BOOK: 814 PAGE: 73
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Decedent:
Name:
Gender:
Date of Birth:
Certifier:
Type:
Name:
Address:
Date Filed:
EXHIBIT "A"
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:
Other Significant
Conditions:
Manner of Death:
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Facility: Vase Funeral Chapel, Rock Springs, Wyoming
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Acute Myocardial Infarction
(b) Coronary Sclerotic Heart Disease
State File Number:
Richard Deorr Taylor
Male Social.; Security Number:
February 26, 1938 Age at the Time of Death:
May 27, 2012
Rock Springs
Mem Hospital of Sweetwater County PO Box 1359
Cokeville, Wyoming
Cokeville, Wyoming
Married Bona Hyde
No
William Richard Taylor
Ella Lenor Anderson
Bona Taylor
Burial
Cokeville Cemetery, Cokeville, Wyoming
Diabetes
Natural Death
Coroner
Dale S. Majhanovich, Coroner
421 B Street, Rock Springs, .Wyoming, 82901
May 29, 2012
This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming.
This,copy is not valid unless prepared on paper with an engraved border.
ITAL RECORD
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
County of Death:
2012- 001510
74 years
Sweetwater
Interval:
16:50 (Actual)
v James McBride
Deputy State Registrar
p xulcNtac
188086
EXHIBIT "B"
Lot 1, 2 and 3 in Block 2, Heuett Addition to the Town of Cokeville, Wyoming, a portion of
Tract 82