HomeMy WebLinkAbout971988Alliance Title Escrow
PO Box 1367
Kemmerer WY 83101
File No.: 192997
STATE OF
CO TY OF
I,
SS.
NNW
upon my oath, depose and state:
1. That I am of adult age, a resident of
herein.
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
the day of in Book PR on page
conveys unto
property, to -wit:
3. That said Lp Tau) tAIttraS on the Zb day of e(\
and a copy of the original certificate of death, certified to as true and correct 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 Lore ,Se ar\ kt)r\S by reason of 2 -9 -102 W.S.
(1980), the decedents interest and title in said conveyance has terminated and title to the real
property conveyed thereby has vested absolutely in
continuously since the death of the said decedent.
FURTHER AFFIANT SAYETH NOT.
Date '11 lb 2_013
State of ea)
)ss. t
County of SiNcLS a...—
The foregoing instrument was subscribed and sworn to me by
K ee- L.E.--et &ke this I (t day of
J�� 2013
Wi r ss my hand and ficial seal.
Notary Public
My Commission Expires:
AFFIDAVIT TERMINATING ESTATE
eing of lawful age and first duly sworn according to law,
C i and the Affiant
277Wwwi
3)I 12o1(p
the following described
RECEIVED 7/15/2013 at 1:47 PM
RECEIVING 971988
BOOK: 815 PAGE: 548
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
0548
acts died
CARLYN ALMAZAN
NOTARY PUBLIC CALIFORNIA
COMMISSION 1970225
SHASTA COUNTY
My Comm. Exp. March 18; 2018
RECEIVED
._INeOLN COUNTY CLES;
867007 00 JUL I7 Ail 9 :4[1
,iEANN i GINER
Q U I T C L A I f E M M E R B R, EYd O 6 I N G
KNOW ALL MEN BY THESE PRESENTS, that Lora J. Edwards, in
Consideration of the sum of TEN ($10.00) DOLLARS and other good
and valuable Consideration, the receipt whereof is hereby
acknowledged, convey and quitclaim 'unto Lora J. Edwards and
Kenneth Lee Mahoney, as joint tenants with full rights of
survivorship, whose address is 1399 Wade Lane, Fallon, NV 89406,
all such right, title, interest, property, possession, claim
and demand, as she may have or ought to have, in or to all
the following described premises, to -wit:
Lot No. 15 of the Taylor 5th Subdivision, Lincoln
County, Wyoming as described on the official plat
thereof
Hereby releasing and waiving all rights under and by virtue
of the homestead exemption laws of the State'of Wyoming.
DATED this /?day of 2000.
State of Wyoming
County of Lincoln
a J. gdwards
ss.
Ba0K448 PR PAGE 5 7 8
The foregoing instrument was acknowledged before me, a notary
public in and for said County and State, by Lora J. Edwards,
on this 17T day of �tl 2000.
WITNESS my hand and Official Seal.
A 1 N r, g 1 y
o�
1 P t(
Not ry is
E
j2 1 4a pires CSR (q c e3c1- OF V■1
iii iiiiiiii HO
0549
PE OR
PRINT ISI•
PERMANENT
;::BLACK INK
DECEDENT
IF DEATH
OCCURRED IN
INSTITUTION
SEE'HANDBOOK
REGARDING
COMPLETION OF
RESIDENCE
ITEMS
PARENTS FATNER/PARENT.- NAME (First M :Suffix)
iddle Leal 'Sux)
ISPOSITIO
RADE CALL
CERTIFIER
REGISTRA
cOND)TIONs IF
ANY. WHICH(
GAVE RISE TO
IMMEDIATE is
CAUSE
STATING THE
UNDERLMAS
CAUSE LASST.
F-N
or
(b):
ASHOE COUNTY HEALTH DISTRICT
DUE TO, OR ASIA CONSEQUENCE OF:
(C)
000120302
Samuel Qtly HUDSON!
VITAL STATISTICS RENO, NEVADA
CERTIFICATE:OF DEATH
DECEASED -NAME (FIRST,MIDDLE,LAST,SUFFIX)
Lora -Jean:
EDWARDS
3b. CITY, TOWN „OR'_LOCATIONOF DEATH
Reno
5. RACE White
(Specify)
9a STATE OF BIRTH (If
name country) Texas
13;;SOCIAL SECURITY: NUMBER
15a. RESIDENCE STATE
Nevada
3c. HOSPITAL•OR OTHER INSTITUTION Name(If not either, givestreet
and number).;
Renown :Regional Medical Center
15b. COUNTY
6. Hispanic Origin? Specify
No Non Hispanic
9b CITIZEN OF ;WHAT COUNTRY
United States
10.EDUCATION
12
7a. AGE- Last
birthday (Years)
79
14a' USUAL OCCUPATION (GtVe Kind of Work Done During Most.'
of Working Life, Even If Retired): Homemaker
15c. CITY, TOWN OR LOCATION'
Fallon
2. DATE OFs DEATH:(MO /Day/Year)
May 26, 2013
3e:If Hosp. or Inst. indicate DOA,OP /Emer. Rm.
I n p atie nt(S peclfy),:
inpatient"
.7b. UNDER 1YEAR
MOS I:: DAYS
7c.:'UNDER'1 DAY
HOURS ::'I MINS
11. MARRIED, NEVER MARRIED, WIDOWED, 12. SURVIVING'SPOUSE,(t 4fe, give
DIVORCED (Specify) Widowed maiden name)
14b. KIND OF BUSINESS OR INDUSTRY
;Own:
15d. STREET AND 'NUMBER:
1;399 Wade Lane
3a' COUNTY
Washoe
4. SEX
Female
8' DATE OF BIRTH (MO /Day/Yr)
November, 05, ::1933
Ever in US Armed
Forces? No
15e. INSIDE. CITV
LIMITS (Specify' es
or No) ;:No.:
N
18a °INFORMANT• NANIE (Typ br:Ptlnt)
Kenneth MA HONEY
19a. BURIAL, CREMATION, REMOVAL, OTHER (Specify)
Cremation
208. FUNERAL DIRECTOR :SIGNATURE (Or:Person Actingps
TROY:M SMITH
SIGNATURE AUTHENTICATED
SOch).
20b. FUNERAL
DIREC'TOR:LICENSE
19c LOCATION s:C 1y or Town
Fallon Nevada 8.9.907.
20c. NAME AND ADDRESS OF FACILITY
.Smith Family Funeral Home
'.1 BOX 1545 Fallon:: NV
TRADE CALL NAME AND ADDRESS
21a. To the best of/my knowledge, death occurred at"(he` time; date and place 'and
dile to tlte,:cause(S) stated ..:(Signature Title) SIGN AUTHENTICATED,
:NAUROZ ALI
21p DATE SIGNED (Mo /Day/'/r):." 21c HOUR OF DEATf
May 30 2013
2
21d. NAME OFtA1''T'ENDING PHYSICIAN IF OTHE R THAN CER`rtKIER::
(Type or Print)
23a: NAME AND ADDRESS OF CERTIFIER (PHYSICIAN, A11' PING 1 11t YSICIAE,o_to }L�)=XAMINER, OR CQRO (rype:or Print)
NAUROZ AL lil ,115 M St °R NV 389502
24a. ftGISTR'AR ($ignatuie)'
n m 2 2aebn basis` ofjexatnination aeidlor inves igatioh,:;l0 my opinion death.oecurredat
g ,the time,;,date and place and,due to the,cause s) stated (Signature.$
a
U z:
22b. DATE SIGNED (Mo /Day/Yr)
O„
2d. PRQNOUNCED DEAD: (IVIo /Day/Yr)
24b •IDATE.RECEIVED.'BY REGISTRAR
(Mg19ay{Yq 'June 1;0, 20.13
22c. HOUR OF DEATH
22e.PRONOUNCED DEAD AT
2' 3b. LICENSE:14UMBER.:
fi3285
24c. DEATH DUE TO COMMUNICABLE'•DISEASE'
YES Q NO
196. CEMETERY OR`CREMATORY -NAME
Smith. Famn y Cramato ry
DUE TO, OR AS'A.CDNSE:Q.UENCE OF:
(d)
pART If: OT HER SIGNIFICANT CONDITION ord:Jons contributing to death but not resulting in the underlying causegi eh n Part 1.
Unknown'etlo ogy:
CERTIFIED COPY OF VITAL RECORDS:
Tina it .a trud endtxaet reproduction of the document officially registered and
placed on fi)e in the office'Df the $late Rcgistrir and Vital Records.
06/11 /2013
201;8009318
STATE FILE :NUMB;ER
17. MOTHER/PARENT NAME (First Middle Last Suffix)
Lillie E'C! CHASTINE
18b, MAILING ADDRESS 'r (Street.pc [2 F D OJa„ maTa� n� STaif3 +yar
2:.1001 Falling OakRoad Redding. California 96003
STATE REGISTRAR
DEPUTY REGISTRAR;
SIGNATURE AUTHENTTICATED;
DATE ISSUED: This copy not valid unless' prepared oh engraved border displaying date seal and signature of Registrar i
P emotev)eme 4 4
Interval between onset:and death
Interval between onset;:and death
Interval between onset and death
Interval fiet:ween Oriset death .1
:28a. ACC:, SUICIDE, HOM •UNDET
'0R'PENDING INVEST (Specify)
28e, INJURY AT WORK (Specify
Yes or No)
28b.0ATE,OK INJURY :(Mo /Day/Yr)
28c. HOUR OF:INJURY:
28f. PLACE OF INJURY At home, farm, street, factory, office':
building, etc. (Specify)
26. AUTOPSY
(Specify Ye'sor No.)''
No
285. INJURY OCCURRED
28g. LOCATION
27..NAS CASE'REFERREO
TO CORONER (Specify Yes
or NO) No
VRS- Rev- 20120523a
�14
v: 'I NIPh "I Pk 'ZOO IL: 11111 7� CERTIFICATION OF VITAL RECORD
URIDGES s NDI
SIGNATURE AUTHENTICATED
CAUSE OF 25. IMMEDIATE CAUSE "(ENTER ONLYONE CAUSEPER LINE FOR (a) (b); AND (c)'.),
DEATH PART I (a) Mesenteric Ischemla
DUE TO, OR AS A CONSEQUENCE OF:
e,.