HomeMy WebLinkAbout971744AFFIDAVIT OF TRUST
1. That I am a successor trustee of the Wayne Skinner and Carma Skinner W
Revocable Trust dated December 2, 1996.
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2. That on December 26, 1996 in Book 392PR on page 151 and on vet in
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eptember 10, 1997 in Book 401PR on page 429 of the records of the Lincoln c .,i t° w W
County Clerk were recorded Quitclaim Deeds from Wayne Skinner and Carma W Z Y
Skinner to Wayne Skinner and Carma Skinner Revocable Trust dated December 2, M n Q Q x
1996 conveying the following described land:
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Beginning at the northeast corner of the SE1/4NE1/4 of Section 32, TAN c35 4 t Z
R118W of the 6 Lincoln County, Wyoming, thence South 80 rods, N
thence West along the quarter section line 130 rods, more or less to the east co CI 5 W Z
edge of Highway 89, thence northwesterly along said highway to a point of W 0 00
its intersection with a line parallel to said quarter section line and 21 rods 0 Y o
distant therefrom, thence East on aid parallel line to a point 49 rods East ITI W 0
from the North -South Quarter- section line; thence North 58 rods, thence 0 0 O
East 111 rods to the point of beginning. WW
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Excepting therefrom the land described in document recorded in Book 122PR —5
on page 392 of the records of the Lincoln County Clerk.
Excepting therefrom the land described in document recorded in Book 491PR
on page 335 of the records of the Lincoln County Clerk.
3. That Carma Skinner died on February 2, 2011 as shown on the
certified copy of the decedent's death certificate attached to this Affidavit
and, pursuant to the provisions of said Trust, Sandra Sherman and Patricia
Hinkle are the successor Co- Trustees.
State of Arizona
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County of V/vICop
2013, by Patricia Hinkle.
Witness my hand and official seal.
My commission Expires: 0
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atricia Hinkle
I, Patricia Hinkle, do solemnly swear that I have read the foregoing Affidavit
subscribed by me; that I know the contents thereof and verify believe the
statements therein contained are true.
Patricia Hinkle
Subscribed and sworn to (or affirmed) before me this 261-t of June
Notary Public
Date Filed
DECEDENT LEGAL NAME
CARMA SKINNER
FEBRUARY 07, 2011
METHOD HOD OF. DISPOSITION
REMOVAL FROM STATE
STATE OF IDAHO
IDAHO DEPARTMENT OF HEALTH AND WELFARE
BUREAU OF VITAL STATISTICS
CERTIFICATE OF DEATH
FUNERAL SERVICE LICENSEE
JASON P. MECHAM
StateFileNo 2011 01 020
SIX SOCIAL SECURITY NUMBER AGE DATE OF BIRTH
FEMALE 90 YEARS MAY 07, 1920
BIRTHPLACE PLACE OF RESIDENCE
GROVER, WYOMING GROVER, WYOMING
MARITAL STATUS AT TIME OF DEATH NAME OF SURVIVING SPOUSE (If wire, maiden name) WAS DECEDENT EVER IN
WIDOWED U.S. ARMED FORCES?
FATHER NAME N 0
BIRTHPLACE
AMIL LEAVITT WYOMING
MOTHER MAIDEN NAME BIRTHPLACE
LOVINA CHRISTINA JENSEN WYOMING
NAME AND ADDRESS OF FUNERAL FACILITY
NALDER'S FUNERAL HOME, SHELLEY, IDAHO
DATE OF DEATH TIME OF DEATH CITY,TOWN OR LOCATION OF DEATH COUNTY OF DEATH
FEB. 02, 2011 3:40 A.M. RIGBY, IDAHO JEFFERSON
CAUSE OF DEATH (underlying cause last) Approximate Interval Between
a. Onset and Death
FAILURE TO THRIVE
DUE TO (or as a consequence of):
b. AGE
DUE TO (or as a consequence of):
a
DUE TO (or as a consequence of):
d.
OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH but not resulting i n the underlying cause given above WAS AN AUTOPSY
PERFORMED?
NONE STATED NO
MANNER OF DEATH NAME OF CERTIFIER TITLE
NATURAL SCOTT A. TAYLOR, M.D. PHYSICIAN
CORONER SUBSEQUENT CERTIFICATION IF NECESSARY
DATE OF INJURY"
TIME OF INJURY
PLACE OF INJURY
INJURY AT
WORK?
.LOCATION WHERE INJURY OCCURRED
DESCRIPTION OF HOW INJURY OCCURRED
This copy not valid unless prepared on engraved border
displaying state seal and signature of the Registrar.
PSCO (suV) 57/15
This is a true and correct reproduction of the document officially registered and placed
on file with the IDAHO BUREAU OF VITAL RECORDS AND HEALTH STATISTICS.
DATE ISSUED:
FEBRUARY 07, 2011
STATE REGISTRAR
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