HomeMy WebLinkAbout972098State of Wyoming
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County of Lincoln
2013 by Fred Rainey.
Witness my hand and official seal.
My commission Expires:
AFFIDAVIT OF TRUST
1. That I am a successor trustee of the Verna Leora Rainey Living Trust
dated November 17, 1997.
2. That on July 13, 1999 in Book 432PR on page 802 of the records of the
Lincoln County Clerk was recorded a Warranty Deed from Kathleen L. McFarlane to
Verna Leora Rainey, Trustee of the Verna Leora Rainey Living Trust dated
November 17, 1997 conveying the following described land:
Part of Lot 4 of Block 9 to the Town of Afton, Lincoln County, Wyoming
being more particularly described as follows:
Commencing at a point 4 rods East from the southwest corner of said
Lot 4 and running thence North 20 rods, thence East 5 rods, thence
South 8 rods, thence West 1 rod; thence South 12 rods; thence West 4
rods to the point of beginning.
3. That Verna Leora Rainey died on February 25, 2013 as shown on
the certified copy of the decedent's death certificate attached to this Affidavit
and, pursuant to the provisions of said Trust, Fred Rainey is the successor
Trustee.
RECEIVED 7/19/2013 at 11:08 AM
RECEIVING 972098
BOOK: 816 PAGE: 78
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
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Fred Rainey
I, Fred Rainey, 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.
Fred Rainey
Subscribed and sworn to or affirmed) before me this
'clay of July,
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Notary Public
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Decedent:
Name:
Gender:
Date of Birth:
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
Date and Place of Death:
Date of Death:
City of Death:
Location:
Additional Decedent
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
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STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
Verna Leora Rainey
Female Social Security Number:
May 13, 1921 Age at the Time of Death:
February 25, 2013
Afton
Star Valley Medical Center 110 Hospital Lane
Information:
Freedom, Idaho
Afton, Wyoming
Widowed
No
Frederick C. Luthi
Mary Magdalene Zotlinger
Clyde Rainey
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Facility: Schwab Mortuary, Aftort, Wyoming
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Failure to thrive
Burial
Freedom Cemetery, Freedom, Wyoming
Fractured Hip
Natural Death
This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming.
DATE ISSUEDFriday, May'10, 2013
This copy is not valid unless prepared on paper with an engraved border.
County of Death:
Relationship:
Time of Death:
Physician
Michael Pieper, D.O.
110 Hospital Lane, PO Box 579, Afton, Wyoming, 83110
April 23, 2013
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2013- 001212
91 years
Lincoln
Interval:
days
06:40 (Actual)
James McBride
Deputy State Registrar
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CERTIFICATION OF VITAL RECORD
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