HomeMy WebLinkAbout972674I, Richard R. Severns, being of lawful age and duly sworn according to law, upon my oath,
depose and state:
That under the date November 10, 1997, Richard R. Severns and Gail A. Severns, by deed
of that date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on
December 3, 1997, in Book 4o4PR on Page 786, conveyed to THE RICHARD AND GAIL
SEVERNS TRUST, dated the loth day of November, 1997, Richard R. Severns and Gail A. Severns,
TRUSTEES, the following described property situate in Lincoln County, Wyoming, to -wit:
Lot 12 of Block 2, Lincoln Heights Subdivision to the Town of Kemmerer, Lincoln County,
Wyoming
That by reason of said conveyance aforesaid, THE RICHARD AND GAIL SEVERNS
TRUST, dated the loth day of November, 1997, Richard R. Severns and Gail A. Severns,
TRUSTEES, became the owners of the above described land, and title thereto vested continuously
in said trustees from the date of conveyance described in said deed to the date of death of Gail A.
Severns, also known as Gail Ann Severns, on the 8th day of September, 2011. That by reason of
and upon the death of Gail A. Severns, also known as Gail Ann Severns, and pursuant to said
Trust Agreement, title to the above described real property vested in Richard R. Severns, as sole
trustee.
Affiant avers and certifies that Gail A. Severns, also known as Gail Ann Severns, is the
identical party named as trustee in the aforementioned deed, whose death terminated her
interest, title and estate in said real property; and Affiant attaches hereto and makes a part of this
affidavit, the Official Certificate of Death of said decedent, duly certified by the public authority in
which said death certificate is a matter of record.
State of U.34:4-11‘..)C4.-
)ss.
County of LL L.t.*
Subscribed and sworn to before me, a notary public in and for said County and State, by
Richard R. Severns, this L S'l day of 1.4..i. .QLirr 2013.
Dated this II day of A d505 2013.
WITNESS my hand and official seal.
Affidavit of Trustee
ca Fri;
#un Expires: IQ at).0.4-
RECEIVED 8/15/2013 at 12:10 PM
RECEIVING 972674
BOOK: 818 PAGE: 23
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
00.;3
Richard R. Severns
x 4
CERTIFICATION OF VITAL RECORD
Date and Place of Death:
Date of Death:
City of Death
Location:
Additional Decedent Information:
Place Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Other Significant;
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
Social Security Number:
September 08, 2011
Evanston
Rocky Mountain Care 475 Yellow Creek Rd
Lander, Wyoming
i<cmrnorer, Wyoming,
Married Richard R. Severns
No
Carl David Olson
Azna Marguerite Brothers
Richard R. Severns
Cremation
UFD Cremation Center, South Jordan, Utah
Ball Family Chapel, Evanston, Wyoming
NaturalDeath
Coroner
William Ball, Deputy Coroner
800 Uinta Street, Evanston, Wyoming, 82930
October 06, 2011
This is a true certification of the document on file in the office of Vital
Statistics ,Services;,Cheyenne ;Wyoming.
i
DATE ISSUED: Wednesday,\October 12, 2011
This: copy is not valid:onless prepared on paper with an engraved border.
Facility:
Cause of Death:`
The immediate cause is listed on the first line followed by any underlying causes.
(a) Cancer of the Lung
Husband
13:20 (Actual)
Thomas 0. Forslund
Director and State Registrar
Decedent:
Name:
Gender:
Date of Birth:
Gail Ann,Severns
Female
December 30, 1938
Age at the Time of Death:
2011- 002978
72 years
Uinta