HomeMy WebLinkAbout973199STATE OF WYOMING
SS.
COUNTY OF LINCOLN
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF DIANE B. JONES
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF DIANE B. JONES
PAGE 1 OF 2
0148
RECEIVED 9/11/2013 at 11:47 AM
RECEIVING 973199
BOOK: 820 PAGE: 148
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
COMES NOW ROBERT K. JONES, after being sworn and under oath, hereby stating
pursuant to Wyoming Statutes 2 -1 -201, which authorizes Affidavits of Distribution, as follows:
1. That Diane B. Jones, a resident of Star Valley Ranch, Wyoming, died on June 25,
2013. An official copy of the Certificate of Death issued by the State of Idaho for Diane B.
Jones is attached hereto.
2. That Diane B. Jones died testate. A copy of hers Last Will and Testament, dated
March 31, 1993, is attached hereto.
3. That the Last Will and Testament of Diane B. Jones complies with the
requirements of Wyoming Statutes 2 -6 -114 and is therefore, a self proving will.
4. That the Last Will and Testament of Diane B. Jones provides that all of her
interests in property shall be distributed to Robert K. Jones as the surviving Trustee of The R
D Jones Family Trust dated March 31, 1993.
5. That, in accordance with the requirement of Wyoming Statutes 2- 1- 201(a), I
hereby state:
a. That the value of the entire estate of Diane B. Jones, wherever located,
less liens and encumbrances, does not exceed Two Hundred Thousand Dollars
($200,000.00). 0 4 9
b. That Thirty (30) days have elapsed since the death of Diane B. Jones.
c. That no application for appointment of a Personal Representative is
pending or has been granted in any jurisdiction.
d. That pursuant to the Last Will and Testament of Diane B. Jones, I, Robert
K. Jones, surviving Trustee, am the sole beneficiary of her Estate. There are no other
persons or entities having a right to the assets of his Estate under probate proceedings.
6. That I hereby request that the following assets be transferred to and be titled in the
name of "Robert K. Jones, Trustee with the address of record being: "P.O. Box 5247, Etna,
Wyoming 83118 2007 Toyota Utility, VIN No. JTMBD33VX76025369.
DATED this 28th day of August, 2013.
ON THIS, the 28th day of August, 2013, ROBERT K. JONES, affiant herein, appeared
before me, and being duly sworn under oath, affirmed that the facts stated in this Affidavit of
Distribution are, to the best of his knowledge, information, and belief, true and complete.
WITNESS my hand and official seal.
M KEVIN VOYLES NOTARY PUBLIC
County of A j;?Y State of
Lincoln Wyoming
My Commission Expires: July 16, 2015
My Commission expires: 07
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF DIANE B. JONES
PAGE 2 OF 2
CERTIFICATIO I TAL RECORD
State of. Idaho
C OF D EATH.
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b Lool Re NO.
1,DECEDEHT'S LEGALNAME (Intludo AKA's ll any). (FI 1 M EAe; Lail, Suds)
5 DIANE B. JONES
FEMALE
4. AGE Lae/ 6411.1 44 U NDER 1 R 14 UNDER 8. D ATE OF 81670 (MO/0. t
O Days YEA H rs I M lei Y 8 eIRTHPLACE (Glly'add shoe, Terelory F Aign Couolry)
Months 70. (v y ri! I i 06107(1943 OGDEN, UTAH
N T RESIDENCE STATE OR FOREIGN 7p COUNTY 7' N
1 049 7 CITY OR TOWN
7d 8 1.
C LINCOLN. STAR:VALH
T6 NUMBER LEV RAMC
7 APTNO. 71ZIP CODE
84 7gINSIDE CITY
g 'COTTONWO00 LANE .UMIrST
8312Y N
N 8, MARITAL STATUS AT TIME O DEATH Vas
LL 1 'B,$IIRVMNQ SPOUSES NAME'(1l vole, plus maiden name)
;.:72..,.14 m reed p M rr e but separalerl 0 Wdow d 0 Divorced 0 New are d 0 Unknown 1 ROBERT K.' JONES
Z+18 EVER.IN U S 111x, FATHER'S NAME (F 1 Middl :t1. L 596x) n
11b, BIRTHPLACE (SlalO. Ten51 r or Foreign Counlry)
2. ORD @sT GE E. BARRY UTAH
t 01,46 123. MOTHER'S MAIDEN NAME (Flial M ddl Lail 5 0 1 8 *1
I2b BIRTNPIJICE (51 I Te �Il ory q K Igd�ounlryj
E ®NO RUTH DAWSON' UTAH'
0 17e INFORMANT'S NAME if yin or
y pool) 1J.. REL*TONSNIP'TO DEC N7c, MAILING 40ORESS {SI eel and N b.r� Lily. 51 1 Zlo Cgde{ ROB K. JONES r
Z HU SBA N D P
O 80X(5247 ETNA;MY.83118'
14 METHOD OF DISPOSITION 16 PLACE OF DISPOSITION (Name and address of oemelery, 18, NAME ANb COMPLETE OF F UNERAL'FA DIUTY
Bbdal ®C Ion IOy..oln pl u)
p Obnaibri;- 0.E Ipmbmen( B CREMATQRY. BUCK- MILLER -HANN FUNERAL HOME ova('
6 n.from Idaho 132 S,i AVE•, x$ EAST 17TH STREET
0 olh :(9pAdly) BLACKCOOT IPAHQ 8 IDAHO F ALLS IDAHO 81404
17 SIGNATURE OF FUNERAL SERVICE LICENSEE OR PERSON ACT)(N'fl ASSUCH 11b LICENSE NUMBEA,(011 tenbee) TB W ASCORO NER CONTACIEO
k "ELECTRONICALLY FILED: KEVIN:K .BODILY i :M0751
..PLACE OF DEATH (191
19a. IF DEATH OCCURRED IN A NOSPITAL:t 19b. IF DEATH OCCUR SOMEWHERE OTHER THAN A NOS-PITAG
10 InPall'enl x pER/Oulpal M 3000* 1 4 0HOSo facility 50N g home/Low lerm cam facility 600 oedenl h 70 Olhe (Sally)
20,FACILI11Y NAM H"
6( IID{ fatal IY 9 (!e.slr d nlrn 21. CRY, TOWN O R LOCATION OF DEATH, AND 21P CmE I'2s COUNTY OF
DEATH
EASTERN (0460 Ra3IONAL MEQICALGENTER IDAHO FALLS.10.8 ,SONNI:VILLE
27. OAT,Eq* 094TH (4 o/D 47' ((S i, n(4) 24. TM E'OF DEATH 125, 04TE.PRONOUNC® DEAOIMO/Deyy.,) (SD 1) month) 26, T (ME PR deauec
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June'25, 2013 20;23 June` 25, 2013 20 2 3 aa
27: CAUSE OF DEA1N�
PART I. Enter the Fhaln devote disease elegies, or complications_11ml dlredly 'aided the death DONOT 1 t 1 1 Is ud 6:'08.0 App 1 19 (10
Ael, resplr 1 ry erred or Idalar fibrillation Without showing the etiology DO NOT ABBREVIATE Enter only one 08 60 on a 1 na:. Ogse Io Dsel
IMMEOIATECAUSE'(FIna1 ATHE�i0LER0TICHEARTDISEASE
dl B d:tondlon :._8. a. S.0 7----
e. flmo §+death). ouE ro (er a. a eona on: 1 MONTH
a 5 c nu'liyn l0Rndpi a'i b ISCHEMIC:BOWEL 2. WEEKS
y d y I alb, 1 me 6e DUE To (or a equen 07:
p 'Haled ort pope E to too. UNOERLY{NGD4U5E ACUTE RENAL FAILURE 3 WEEKS
LAST (disease c r
a DUE TO (or as sequence on
TYPE OR
PRIM IN
PERMANENT
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DISPOSITION
PLACE OF
DEA TH
DATE OF
DE 1711
CAUSE OF
DEATH
ITEMS 32 "39
TO BE USED
FOR ETERNAL
CAUSES ONLY
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'OUETD OTHER
THE COR06ER
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STATE OF IDAHO
:IDAHO DEPARTMENT OF HEALTHD WELFARE
BUREAU OF VITAL RECORD' .AND :HEALTH STATISTICS'
1 This is a true registered and correct of the document officially re istered and placed
S y Ip on file with the IDAHO BUREAU OF VITAL'RECORDS AND HEALTH STATISTICS.
,2..5E% "!:3:'SOCIAL SECURITY NUMBER;
DART II Enl OIhBT.Ip11IflCaM coedlllons Con(nb 1nq (0 death bet not resulting In the underlying reuse given m Pae l 290. WA AN AUPSV 289. Tp WERE AUTPSY, FINDINGS
PERF S ORMED? AVAILABLE O TO COMPLETE
38 DID TOBACCO USE P O 1 thin D I Yeaf N l Ore 4 ]0; IF FEMALE (Ag d tD 84) THE CAUSE OF DEATHI
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CONTRIEUTETD DEATHS 10 p Snot a] 907
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of I 1 y ar belpr."dflelh ;]t MANNER DG
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el4 Nal rat Ho0.Ode
t31 No UnknowA 0 0 Adddenl 0 d,091nvealioaltori
0 0 Could AC('4o•delennlge
32. DATE OF INJURY Mo/Day/vr
THE OF INJURY I ne PI ene�ne INJURY
(20111 nursing home. restaurant, forest. etc.)
JS:.INJURY:AT WORK
i
]6 LOCATION�OF INJURY: 0 Yes -0
Zip Code
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Numbs' or L allon.
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3INJURY
Y. DESCRIBE U 9 T0 TRANSPORTATI O N INJURY 5TATETRE TYPES VENICLE(Sj bile, k p, olpmyble ATV bs:ycle, IC
''SPECIFY WHCH VEHICLEOECEDENT OCCUPIED; dapd¢abk
TRANSPORTATION 1 Ma, WAS DECEDENT. -1 b. in pnv erl0peralor 0 Pass per 7eb. WHAT SAFELY DEVICESIS DECEDENT;USFJEMP
INJURY 1
0 Seat belt D Child safety Met 0 •elms{' 0 A 43 S Non., 0 U kddW
3 8a CERTIFIER (Ch dr:dnly nested on olpd p By h rl le
39b LICENSE NUMBER
PHYSICIAN O ASSSTANT 0 ADVANCED: PRACTICE PR0E551ONAL NURSE
ro Ih b est I my 4 p4oledp lealh ocalr d !the ISM Pal d.dace,:and d lo Me oar_ c uod yrnanner aaleQ, 4-08368
7 DoRGNER
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d man staled:.
0(5 tun. and nee IC yr 9 PA TRICK D:GORMAN M D
AM 80 Ty9 or
394. NAME, *OGRESS, AND DP CODE OF CERTIFIER (Type or pHN)
D. GORMAN, 2001 S. WOODRUFF AVE. STE 12A IDAHO FALLS, ID 83404
0a REGisr_RAft's SIGNATURE' l y
'JAMES 13'. AYDELO PFE
STATE REGISTRAR
DATE ISSUED:
This copy valid unle'Iprepare n engraved border
•displaying :.state,seal'an• signature the Registrar.
(C OOBCV)61g2.
0 .,..:..,.Hitt ,,,,,1 ..,.a,a tv:iv: as 1.111,, ,,,a,,,.a ,r n,., 1111.-.-.
LAST WILL and TESTAMENT
OF
DIANE B. JONES
I, Diane B. Jones, a resident of Davis County, Utah, declare that this is my Will.
FIRST: I hereby revoke all Wills and Codicils that I have previously made.
0. 51
SECOND: I am married to Robert K. Jones and all references in my Will to my
"Husband" are to him. I have no deceased children leaving issue now living. I have three
(3) children now living, whose names are: Kenneth D. Jones; Kathleen Jones; and Kym M.
Jones.
THIRD: A. As used in this will:
1.) the terms "my child "my children" and "my issue" as used in this Will shall
include any other children hereafter born to or adopted by me.
2.) the term "issue" shall refer to lineal descendants of all degrees, "child" and
"children" shall refer only to descendants of the first degree, and the terms "child
"children" and "issue" shall include adopted persons. In construing the term "by right of
representation all children of an ancestor shall divide only that portion that their
ancestor would have taken, had that ancestor survived distribution.
3.) the masculine, feminine, or neuter gender and the singular or plural number
shall each be deemed to include the others whenever the context so indicates;
4.) the term "survive" shall mean that the beneficiary shall survive the death of
the Testator by sixty (60) days.
B. I have not entered into either a contract to make Wills or a contract not to revoke
Wills.
FOURTH: A. If I have left a list disposing of personal property, then it is my wish that
the terms of that list be given effect by my Executor.
B. I give the residue of my estate (excluding property over which I may have a power
of appointment) to the Trustee(s) then in office under that Trust designated as The
R &D Jones Family Trust, established earlier this day, of which my Husband and I are the
Will of Diane B. Jones Page 1 of 3
0152
Settlors and the Trustees, to be administered as provided in that Trust Agreement, including
any amendments made to it before or after my death (if the trust agreement allows such
amendments), to be held as a separate trust.
C. If for any reason the disposition in subparagraph B. above is inoperative or invalid,
or if the Trust referred to in that subparagraph has failed or has been revoked, then I give
the residue of my estate, excluding property over which I have a power of appointment, to
the Trustee(s) named in the present provisions of that trust agreement to act after my death,
to be administered in trust as provided in the present provisions of that trust agreement
which, for such purpose, I incorporate by reference into this Will.
D. I have in mind all persons who are the natural objects of my bounty. Except as
expressly provided in this Will, and because of a Trust created elsewhere, I have omitted
to otherwise provide in this Will for my Husband and all of my issue, and any other person
claiming to be an heir of mine
FIFTH: A. I nominate my Husband as Executor of this Will. If he shall for any
reason fail to qualify or cease to act as Executor, I nominate as successor Executor the
following, (except to the extent "Co- Executors" are named) each to serve alone and in the
order named: Kenneth D. Jones; Kathleen Jones.
B. The term "my Executor" as used in this Will shall include any personal
representative of my estate. I further request that no bond be required for any person
named as Executor herein. If Co- Executors are named, then any one can act alone, and if
one fails to qualify or ceases to act, the other is nominated as sole Executor.
C. I authorize my Executor to sell, with or without notice, at either public or private
sale, and to lease any property belonging to my estate, subject only to such confirmation of
Court as may be required by law. My Executor shall have the authorization to continue to
hold, manage and operate any property (including any business) belonging to my estate.
D. If any of the above named persons shall cease to act or fail to qualify as Executor,
I hereby confer upon any person specifically named in subparagraph A. above to act as
Executor, the power to designate a person or persons to act. as Executor of this Will; upon
failure of said appointment, I hereby confer upon my attorney, Walter C. Bornemeier, the
power to designate a person or persons to act as Executor of this Will. Said appointed
persons are to act without bond.
Will of Diane B. Jones Page 2 of 3
I subscribe my name to this Will
State Of Utah
County Of Davis
Will of Diane B. Jones
I, Diane B. Jones, the testator, sign my name to this instrument the day and year last above
written, and being first duly sworn, do hereby declare to the undersigned authority that I
sign and execute this instrument as my last Will and that I sign it willingly, that I execute
it as my free and voluntary act for the purposes expressed in it, and that I am 18 years of
age or older, of sound mind and under no constraint or undue influence.
Diane B ones
We, the undersigned, witnesses, sign our names to this instrument, being first duly sworn,
and do hereby declare to the undersigned authority that Diane B. Jones signs and executes
this instrument as the testator's Will and that she signs it willingly, and that each of us, in
the presence and hearing of the testator and of each other, hereby signs this Will as witness
to the testator's signing, and that to the best of our knowledge she is 18 years of age or
older, of sound mind, and under no constraint or undue influence.
itnesS Witness
Subscribed, sworn to, and acknowledge before me by Diane B. Jones, the testator, and by
the witnesses named herein, the day and year last above written.
152
.ss
1993.
Page 3 of 3
0153
MV-301 (03/06)
YOMING
OFFICE OF COUNTY CLERK
LINCOLN COUNTY
KEMMEEER,, WY
TITLE NUMBER
14-UZi /787
FEE
$9.00
DATE ISSUED
11/14/2006
i O 54
Vs•
CE
111
TIFICATE OF TITLE
VEHICLE IDENflICATION NO.
WOIORY P1E116E:INF
qualmwo
$20,520
OWNER
YEAR
STATO!
JONES, ROBERT &/OR DIANE
84 COTTONWOOD LANE
ETNA, WY 83118-
JTMBD33VX76025369
SELLER
PRIOR TITLE NO.
MSO
MENLO YE DODGE
?BrAINTWUTi.„ 'UT
FOR COUNTY CLER
VEHICLE BRAND
ben ReleaAd
BODY STYLE
UTLP
ODOMETER
15
eonty Clerk
NEW
XX
PURCH. DATE
USED
10/13/200.6
ACT TAL MILEAGE
ItITENANT&WIT11. RIGHT OF IN WITNESS WHEREOF, I have hereunto caused this Certifi-
I AND NOT TENANT Jj
cate to be signed and the official seal of thNisoof,rrce t
,o b
e
COMM placed thereon.
tqi
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F.; F
4., 4
Deputy
(SEAL)
///i
trbAtie4 Assistant Clerk
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LU
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co
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.Aelk
.Q.Z;t1011.A,
First Lien Releas4d
County gerk
Deputy
(Date)
(SEAL)
Second Lien Relapsed
A
Celinty Clerk
Deputy
(Date)
(SEAL)
(Date)
(SEAL)
LOOK FOR EAGLE WATERMARK IN SHEET NOT VALID IF ALTERED OR CHANGED
3858783
THIS DOCUMENT IS VOID IF ALTERED THIS DOCUMENT MUST BE SIGNED BY ALL SELLERS AND BUYERS
ASSIGNMENT OF OWNERSHIP
THIS IS TO BE FILLED IN BY THE SELLER AND DELIVERED TO THE PURCHASER AT THE TIME THE VEHICLE IS DELIVERED. PURCHASER MUST MAKE APPLICATION
OR�uu A NE VI� CERTIFICA E OF T�I WI OUNTY CLERK.
1 1' 'II14 I� N N Q I i�lp dWIIPIi' yn
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tai (Must be printed)
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GHASER(S) AD SS
5 1 'AM' N i t
M Kf VIV v oYLES
rrty of
Lincoln
f 44" it
N 7TARStiF f u BG I
ate Nl 'of
Wyoming
t.., x,ires:..Jul 16 .,20
OUNTY C ERK OR NO
MY COMM -.SION EXPIRES:
SIGNATURE OF
U CHASER(S) SIGNATURE
t
id s 0 .a*" t H �hlta
Subscrib and abefcr�
Notary or Pe:. o Authorized
My commission expires
Name and Address of Secured Party
SIGNATURE OF PURCHASER(S)
Title No. Issued to Applican
PUBLIC
67 /6
am() AO,rl '.(o iF5g dE T OF 0 1 r"+a•' i/
1 11 3011,0
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IN 111
URCHASEfI(S) f�.g ,fir i o_
I me t .t X02 day of S CI I liS�'
OWNERS AGREE THAT
TITLE. WILL SHOW
JOINT OWNERSHIP
WITH SURVIVORS HIP1j tu,
YES
STREET
�'TYVA wyom ay.: 83 if 8
CITY ati';4'j t ,„„;STATE ;'l'l'I
wu II n w u n n
O OM TER SC�SIRE
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of
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ENT
ZIP
FEDERALiAND STATE REGULATIONS REQUIRE you to stae,
result in fines and /or imprisonment.
/20 BC74,T k NGS
of my knowledge, it reflects the statement checked below:
r N171
vehicle. Failure to complete or providing a false statement may
hereby state that the odometer now reads Itl il S 6 '(p 4O b (No tenths) miles and to,the best
NIIII �i Ili il,.rli tX 1 .4 I!!
DSr li �titi�l Il l l ll !I IP l �en t4r!ll i I h J
the actual mileage of the vehicle, or Tithe amount of mileage in excess 01 mechanical limits', ,or Nlli 'IP theotlometer!readl gI SiNOT tt a ck ti vahmileagt
11ry WAR It 1 OD ETERI'OI SCR EP N CY
N* d ll u nIIgN N pd (ul ��II( 4tuiui
INJE do hereby certify and warrant that IM/E am /are the true and lawful owners) of the vehicle described he rein "and fuAher warrant t a t tL �e diens 9 a d en n c"1} br nces <p ed h e eo ere
Rena and encumbrances against the vehicle herein described and hereby transfer and, donvev all rinhts: title anri ct intera that 1/WE hl i:r( the veliigi .ice: e,:, d r,, th the mobile Arne have been paid.
indiv(dual(s): and if the vehicle herein described fs'a Mnbile home, do hereby certify tha't all taxes due for the preceding 'and current yeall
;i II it tl h N ui
ALL OWNERS WHOSE NAMErc APPEARS 0
SNI'N'ATUIFjE iOF'INN?��li tl
SELLER(S) ul ip nli
i; �4
51G' OF !u..11)°!
SELLER(S)
PRI NAME OF �y
S b eavi tflfa s
DATE OF
SALE -6' 1 se 0 2
-r tc roffES
THIS
Amount of Lien /V/ I7 Date of.,Lien lw IB,!r„ mem
THE FACE MUST'. SIGN IN THE PRESENCE OFIA,NOTARY. PUBLIC
Ac
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1 uI ie!' llP
IrvYR 'Thc dfi' "l OIANG
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40,X 01 r tl J I S lul °rx 1F mm trt. ®'ReYL 6 JDNEr
�LLER() Il R f A yy Y 1 �P S, AM ivT�I
'�;Nrl xmrhlllM TF ��II
APPEARED BEFORE ME IN THE STATE OF /V VC /n Al FS
II 'Il II I
DAY OF t tC t2 rNlp 'Wip' lijn
Y 'I(5E Ai�17r(4.n;nl'
County of
Lincoln
My Commission Expw
PURCHASER'S APPLICATION
N
tttaf I information on this application for CERTIFICATE CF TITLE is true and correct and that l am lawfully applying for Wyoming
d�tjyr'me /us and is subject to the liens shown and none other.
l Ill,ir
wes 7 RiSr