HomeMy WebLinkAbout971986The State of Wyoming
ss.
County of Lincoln
AFFIDAVIT
KELLY J. PAGE, of lawful age, being first duly sworn upon her oath according to
law, deposes and says:
1. That SANDRA L. RUDDY died testate at Kemmerer, Lincoln County,
Wyoming, on February 13, 2005.
2. That DONALD D. RUDDY and SANDRA L. RUDDY were married to each
other on April 6, 1957, at Oxnard, California.
3. That on the 1 day of August, 2003, DONALD D. RUDDY and SANDRA L.
RUDDY, husband and wife, purchased the following described real property from DAVID
R. NEILSON and SHANNA NEILSON, husband and wife, Grantors of Lincoln County,
Wyoming.
Lot 1 of Block 6 of the Lincoln Heights Subdivision to the Town of
Kemmerer, Lincoln County, Wyoming, as described on the official plat
thereof, together with all improvements thereon, and easements, appurtenances
and incidents belonging or appertaining thereto, or used in connection
therewith; subject, however, to all mining, mineral and other exceptions,
reservations, covenants, conditions and rights of way of record.
4. That DAVID R. NEILSON and SHANNA NEILSON, husband and wife, duly
and regularly executed and delivered a Warranty Deed dated August 1, 2013, in favor of
DONALD D. RUDDY and SANDRA L. RUDDY, husband and wife, Grantees, which
Warranty Deed was filed for record in the office of the County Clerk within and for Lincoln
County, Wyoming, on the 7th day of August, 2003, in Book 529, Page 830.
5. That at the time of said purchase, and the execution and delivery of the above
described Warranty Deed, the conveyance of the real property hereinabove described was
made to DONALD D. RUDDY and SANDRA L. RUDDY, husband and wife, as tenants by
the entireties, and they owned and held the title to said real property as tenants by the
entireties continuously from said August 1, 2003, until the death of SANDRA L. RUDDY on
February 13, 2009.
1
RECEIVED 7/15/2013 at 12:51 PM
RECEIVING 971986
BOOK: 815 PAGE: 543
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
0543
6. That DONALD D. RUDDY survived SANDRA L. RUDDY, and by virtue
thereof, said estate by the entireties vested in him upon the death of said SANDRA L.
RUDDY, and that he then became the owner in fee simple of all the real property held as
such tenants by the entireties hereinbefore particularly described.
7. That this affidavit is made in accordance with the provisions of Section 2 -9-
102, Wyoming Statutes, 1977, and that the Certificate of Death hereunto annexed, and by this
reference made a part of this affidavit, is a copy of the official death certificate of the
decedent, SANDRA L. RUDDY, certified to by the public authority in which such original
death certificate is made of record.
DATED this 11) day of 2013.
The State of Wyoming
County of/trial/7
spt 1L4-
My Commission Expires:
:ss.
f� e W)
el tea.
g
A SUBSCRIBED AND SWORN to before me this /0»2) day of
d► wp,t4 2013, by KELLY J. PAGE.
2
CitA.,aelJ
NOTARY PUBLIC
0544
5.
03
mcc w 0
w
18 rc
0 C1
a<
E a
W
C.) Z:..,
0 LL'.
m
1
1. DECEDENTS LEGAL NAME(inchge AKASd any) (First, Middle, lasl) 2. SEX
,SANDRA LOUISE RUDDY Fealnale
3. DATE OF DEATH 04o/Day/YrI(Spell
February 13, .2005
4. SOCIALSECURITYNUMBER:
4111.1111111111111111110
S. AGE -Lest Birthday
63
63
50.UNDERt.YEAR
5c. UN0 AI0AT
6DATE OF BIRTH (MoiDay/Yr)
October 22, 1941
M onths
Data
Houro
Minutes
7a. P1ACE'OF DEATH')Check'only one)
IF DEATH OCCURRED IN AHOSPITAL'.
Cl Inpatient O ER 1 O Ipelienl 0006
IF DEATH OCCURRED SOMEWHERE OTHER THAN AHOSPITAL �sr
0 8000,00 Froggy 0 Nursing Harem
aLong Tenn Cars Facility' }g Decedent's Home 0Other (Sp, 4 y)
7b. FACILITY NAME III Parr Institution give street and number)
Residence 1023 3rd West Avenue
70. CITY TOWN, 0R LOCATION OF DEATH'
Remmerer
74. COUNTY OF DEATH
Lincoln
8. BIRTHPLACE (City and stale or !welkin cn)ry)'
Glendale, C al i fo r nia
--1-120.
9. MARITAL STATUS AT TIME OF QEA01
))Malrwd OM rued bteaepe led 0 wee
0D5 0 M;mo.i n kn
10. SURVIVING SPOUSE (II Why give'rlalne prior lo Wel heintage)
Donald Dugan R u dd y.
T2p •Cfry, µWN OR LOCA7pN
t r i 1
Ke
E VER IN U.S. M
RE2)0CE -5TATE
ARMED FORCES? I Wyoming
Ll Yes [rlFro
1211 ..gUHYY t
Lincoln
i
120. STREETAND NUMBER
1023 3rd West Avenue
1¢B. ZIP CCOE
831
t¢I, INSIDE CITY LIMITS?
2O YES ❑NO: .
13. FATHER'S NAME (First Meddle, Legg
Edward Carl Juhnke
14. MOTHER'S NAME TOR TO FIRST MARRIAGE (First, MItlOb, Last)
Dorothea, Luang, Davis
157. INFORMANTS NAME
Donald 1.uddy
1511 RELATIONSHIP TO DECEDENT
Husband
15c MAILING ADDRESS'(Slrawlaa4N7obe City,$, t 24.3449)
1023 3rd West Kemmerer, Wyoming $3101
16. METHOD OF DISPOSITION',
0 Burial 0 Donation 0 Removal from Wyoming
(7)Cremalinn ;:OEntombment OOther
17a PLACE OF DISPOSITION (Name of
cemaley a eremaloryl? a"
UFD Cremation Center
"17b... LOCATION CITY QR TOWN A51) STATE
_S.outh Jordan, Utah
1Be FUNERAL ERVICE UCEN
y g
MA. L10ENSENO.
464
16,NAME OF FACILITY, 1911. ADDI)ESSOF FACILITY'
Crandall Funeral,H.ome.'915 Pine Ave..Kemm
5.
m
•0
W
W m
CI 17
E F.
F,) 111
W c)
m
tO
20. ACTUAL OR PRESUMED TIME OF DEAT
0300
211 DATE PRONOUNCED DEAD (MoDay/Yr);
February 13, 2005
22.. TIME RRONQU(10ED DEAD"
0300..:
23eWAS CORONER CONTACTED?
OYES L'.NO
CAUSE OF DEATH
24. PART I Enter 11 chain I events diseases. elegies or aompleations -Mal dkaay tamed N. 00.0, DO Noy enter t mr 1 'events own as cardiac
arrest. respiratory arrest. or vontnedlar fibrillation without ing the etiology. DO NOT ABBR TE. EMer only onbuuse on 1106 Add orMIt lines
I ry /y'' u r rI
IMMEDIATE CAUSE (Foal tl es0 r 7 J av�"'r
Approximate inserval
Onset I Ih
d�
eontllUOnro§u111ngN death). DUET 0000seg60009 of)
S W I Iy list centltli s, d any; y.�. s
leading l NDE listed e_ /���j�f]/f
M UNDE tedonW "art V�� K (/e,}7
Enter r
(disease or H1Ury that initiated the DUE l'O (w as a consequence 08
events resulting death) LAST,
DUE TO (or as a 00naagdan00 o0
PART IL :Enter other sig truant co7ddlonc conlnbuhng 100(ealh but not i1aullmg in the underlying ver me,Yan M Pad I'
25, WAS AN AUTOPSY
PERFORMED?
OYES $I NO
26. WERE AUTOPSY FINDINGS AVAILABLE TO COMPLETE THE CAUSE OF DEATH?
.11 YE 5 (3'NO
27 DID TOBACCO USE CONTRIBUTE TO DEATH?
Q YES ONO 0 7100ARL0 0 UNKNOWN
26.17 FEMALE AGED
,r•. AL 1OS:
U' NO1 pregnadl :,thin past year 0 NO pregn nl. but pregnant 43 days la 1 y ar Wore death
0 Pregnant at time of death 0 Unknown d pregnant within the peal year
0 Nol pregnant. but pregnant within 42 days of death
.m MANNER OF OEAThI
Natural 0 hom'cide
0 Accident 0 Pending investigation
0 Suiodo 0 Could not be determined
30. DATE OF IN.71)RY (Mb/Day/Yr),
OYES'
31. TIMEOF INJURY
32 PLACELbF INJURY Decedem's home coi31msa0n s le, bras, e(01�:
33. INJURY AT WORK?
090
34. LOCATION OF INJURY (Street and number. C,y or Tow Stale)
35 IF TRANSPORTATION ACCIDENT, SPECIFY:
0 Driver Operator 0 Pedestrian
O Olper (seedy)
35'DESCRIBE HOW INJURY OCCURRED; ANb IF TRANSPORTATION INJURY, THE TYPE(S) OF VENICLE(S(:INVOLVED (Aidomob le, plgkup, moomyce,:ATVrbicyc,e; 61e3
378. CERTIFIER (Check only one)
0 PHYSICIAN To.(ho best of my knowledge. death mad al the lime, •ate an6Plaee, anti d7e 10 the ...MI end,giOnnor slated..,
0 CORONER.- On:lhe bash o, esemin nd/or n igs, n, in my Mon, d lammed at eat lime del 'end place, andeue Io61a cau00)) and Ipannat6taled.
Signatere 01 Cedil101
37b. DATE CERTIFIED (Mo/Day/Yr)
February 14' 2005.
37c. NAME, TITLE AND ADDRESS OF CERTIFIER (Type or print)
Dr. 'Gary Noe, 197.-North Main, :Lyman4-Wyoming 82937
30e. REGISTRAR'S SI RE,. sGAL'IG
350' GATE RECEIVED REGISTRAR (MO/OaY/
February y 17, 2005
AtUalin
er
1 1
LOCAL FILE NUMBER 10
264110
I11�7Ji -t �l. 5 lfilAl��tt t r
CERTIFICATUI VITAL RECORD
STATE OF WYOMING
DEPARTMENT OF HEALTH
to
STATE OF WYOMING?
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
This is a true and exact reproduction of the document on file in the office of Vital
Records Services, Cheyenne, Wyoming.
2OQ5- flrO4.5 0.545
Lucinda McCaffrey
Deputy State Registrar
'IE t DATE ISSUED:
JJ ro 8 Deputy B
N (Qr: Th copy is not valid unless prepared on paper with an engraved border displaying the date, seal and signature of the De ut State Re istrar,
VMS
2'
nA
Z a+e�� rma�+IF`
1L
L�M•� l -1
178 Na^ AZa,
0
1