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AFFIDAVIT MADE PURSUANT TO W.S. 34 -11-101
(Facts affecting title to real estate)
STATE OF WYOMING
:ss
COUNTY OF LINCOLN
oath, deposes and states as follows:
Judith Ann Erickson of P.O. Box 654, Afton, WY 83110, being first duly sworn upon her
1. That I am one of the co- tenants of the following described property located in
Lincoln County, State of Wyoming, being more fully described as follows:
That part of the Homestead Entry Survey No. 115 of T34N, R116W, Lincoln County,
Wyoming described as follows:
Beginning at Corner No. 9 of said HES 115, where found a 2" galvanized steel pipe with
brass cap inscribed "HES 115 9 1962"; thence North 71°59' East, the base bearing for this
survey, 588.0 feet along the South line of the said HES 115 to a point; thence North 39 °07'
West, 535.9 feet to a point; thence South 71 °59' West, 400.0 feet parallel to said South line
to a point on the West line of said HES 115; thence South 18 °35' East, 500.Ofeet along the
said West line to the corner of beginning; each point being marked by a 2" galvanized steel
pipe 30" long with brass cap inscribed "PAUL N. SCHERBEL RLS 164 BIG PINEY,
WYOMING 1971" and appropriate details; encompassing an area of 5.670 acres, more or
less.
2. That the property described in paragraph 1 hereof was conveyed to Judith Ann
Erickson, f /k/a Judith Ann Toland, an undivided one -third (1/3) interest, Susan
Walker, an undivided one -third (1/3) interest and Loretta Dory, an undivided one
third (1/3) interest, Grantees, all as tenants in common pursuant to that certain deed
dated January 2, 2012 from the Samuel Albry Young and Ila T. Young Joint Living
Trust, dated October 10, 1990 which deed was recorded on January 13, 2012 in Book
779 Page 280 in the Lincoln County Clerk's Office,
3. That Judith Ann Erickson, Susan Walker and Loretta Dory are the surviving children
of Samuel Albry Young and Ila T. Young.
4. That on April 5, 2006 Ted C. Frome filed an affidavit made pursuant to W.S. 34-
11 -101 which affidavit was recorded on May 12, 2006 in Book 619 Page 648 in the
Lincoln County Clerk's Office.
0301
5. In the affidavit filed by Ted C. Frome it references a Contract for Sale dated October
30, 1970 between Samuel Young, Jr and Ila Young, husband and wife, and William
Paul Callahan, III and Joseph Michaels Callahan and in paragraph 2 of said affidavit
it referenced paragraph 8 of said contract and an alleged right of first refusal that was
purportedly reserved to the buyer of the contract Callahan granting him the right to
meet any bona fide offer pertaining to the property described therein.
6. That the Ted C. Frome affidavit described herein purports to grant to Ted C. Frome
a right of first refusal affecting the above described property. That Ted C. Frome
a /k/a Ted Child Frome died on March 20, 2007 in Harney County, State of Oregon,
and thereupon the certificate of his death was duly filed with the State of Oregon
Center for Health Statistics and made a matter of record in said office, and a certified
copy of said certificate is attached hereto and made a part of this affidavit.
7. That upon the death of Ted C. Frome a/k/a Ted Child Frome, as aforesaid any right
of first refusal that he had pertaining to the above described property was terminated.
8. The facts stated in this affidavit may affect title and the chain of title of lands located
in Lincoln County, Wyoming, appearing by the record to be owned by Judith Ann
Erickson, Susan Walker and Loretta Dory and this affidavit is being filed pursuant
to the provisions of W.S. 34 -11 -101.
DATED this av? 141 day of September, 2013.
A( def-6
udith Ann Erickson
Subscribed and sworn to before me by Judith Ann Erickson this 1 day of September,
2013.
Witness m hand and official seal.
B NEUENSCHWANDER NOTARY PUBLIC
County of
Linno n
State of
Wyoming
My Commtssion:xpires August 31, 2014
A ),Q`(l
Notary Pu lic
0302
fr CERTIFICATIOI\ u TAL RECORD
45784..1
p; 7AG NO
Legal Name First
Ted
Mahe;,
6r
dune 27, 1930
Residence:
.590. E 5th..Avenue
Rd Count
t:inco.In
Marital:, tat ts:at Time of Death
,M
Father's Name
Lionel D Frome
Inr Narne.
Betty Frorn
Place df booth
�thr
Location of Death:;:
Highway 20 East milepost 141
Method.of.Disposition Place of Disposition
Removal Front: State Afton' City Cemetery
Name z nd Complete Address of Funeral Facility..
Date of Disposition 'Funeral Director s;Si
March 21, .2007
caSC referred to Medical Exaimminer?
Yes
CALISE.OF DEATH.
IMtiilt D17 E G�1:USE y
MUA _with Pas Inlurles (Head)
Duo to (oI'as a cansequ snc6 of) y
Internal Hemorrhage
Dole to (or as a consequence of)
Neck Fracture
Dina tii::fet.es a consequence ofy
d
vQther significant conditions ;bntribufiiig to death
L eukemia
Manner of Death If Female
Accident
Date.of in ITtme.of Injury Place of Injury
March 20 .2007 I 1.] 15 Other
Location .cf lnjuty r
t :Pr's y 23 Ca��:rrtuC l isl i r1, Burns, °regal 97720
Describo'how Injury occurred
Roli...,Over.,_MVA with Massiye.Head.Ir j iry_;
Name.and Address of Certifier
John;,Richard. Fo rd
.N4ine4nd Title of Attentling_:I .hysicjan t{ Other than Certifier
Mlddte Last:
Child Frome
Social Security Number
76
Sltthplace:
Afton, Wyoming
/S ,7o /n Ridiard Void
DATE ISSUED:
STATE O' REGON
OREGON HEALTH AUTHORITY
CENTER`FOR HEALTH STATISTICS
CERTIFICATE OF:D ATH.
Spouses Name prior to First Marriage
Carrie Betty:Bagley
Mother's Name Pnor:to First Marriage
Louise :Child
Telephone Number Relationshi o rt Decede `M4a i rn.R.ddra s
Not Available I Spouse P:0'': Box 968, Afton
racil ty Name.;.
City /TbWn or Location of Death:
.14Bums
utopsy findings avaiEabte iQ complete the auae ok
Amendment "Time, Place and Description of Injury" formerly blaflk Corrected by affidavit 20 -Apr 07
rrigf
Augu 013
THIS 'GOPY IS NOT' WIYHOWT INTAGLIO STATE SEALANT BOROS
136- 2007 00798:
STATE FILE NUMBER
Sufifix: Death Date
Ma rch0, 2
count oft Bath
Harney
Was Decedent Ever in
U S, Armed: F.orcea ;,,Yes
LaFollette's Chapel' 22 W Mon roe Burn Oregon 97720 -0488
mature OR ticense Number
David �Dona&f T. Fc
Registrars Signature Date Received Local File Nurnlier
I /S /Steve grasty
Arnendinent
Inside Pity Limits?
Yes
oath
ovation (C ty/Town and State)
A fton,..Wyoming
*2013:0808884
I CERTIFY THAT THIS IS ATRUE, FULLAND CORRECT COPYOF TH OR,IGINAL.GERTIFICATE= ON FILE ORTHE
RECORD FACTS.ON FILE IN THE OREGON CENTER FOR HEALTH STATISTICS':OR A DELEG TED LOCAL OFFICE
JEN J LXVJ:
E A,:WOODWARD, Ph.D.
STATE RE0.ISTRAR
Not .Stated
Dtd tobacco use Contribute to death
No
Injury at Work;?
11ftran mf.try specify
l: Passenger
375SE Norton'tn STE;;E,_McMrnnyrfle,,t7regon 97.128
Date Signed
March 20 2007'
Title of Certifier,
License Number
M Q.:
Z #$0080, J .A. Woodward, :State Registrar
45 -2CC (01/06)
EALTH