HomeMy WebLinkAbout973294Affidavit of Survivorship
I, Tamara C. Sheldon, being of lawful age and duly sworn according to law, upon my oath,
depose and state:
That under the date of October 26, 2006, for valuable consideration, Tamara Sheldon,
formerly known as Tamara Carringer, by deed of that date, which deed was duly filed of record in
the Office of the Lincoln County Clerk, on October 27, 2006, in Book 638, Page 348, conveyed to
William L. Sheldon and Tamara C. Sheldon, husband and wife, as tenants by the entireties, the
following described land, in the County of Lincoln, State of Wyoming, to -wit:
Lot 5 of Block 21 of the First Addition to the Town of Kemmerer, County of Lincoln, State of
Wyoming
Together with an easement in Lot 6, Block 21 of the First Addition to the Town of Kemmerer, for
access and use to a garage used in common by the owners of said Lots 5 and 6 of Block 21, First
Addition to the Town of Kemmerer, and subject to the easement of the owner of Lot 6 in Block 21
to access and use of said garage situated on Lots 5 and 6 of Block 21. Said easements shall
terminate upon the destruction or removal of said garage from Lots 5 and 6 of Block 21, First
Addition to the Town of Kemmerer
That by reason of said conveyance aforesaid, the said William L. Sheldon and Tamara C.
Sheldon, became the owners of said real property, and the title thereto vested in them
continuously from the date of said conveyance, to the date of death of William L. Sheldon, on the
7th day of May, 2012. That by reason of and upon the death of William L. Sheldon, title in the
above described real property vested in Tamara C. Sheldon.
Affiant avers and certifies that William L. Sheldon is the identical party named with
Tamara C. Sheldon in the aforementioned deed, whose death terminated his interest, title and
estate in said real property; and Affiant attaches hereto, and makes a part of this affidavit, a copy
of the Official Certificate of Death of said decedent, duly certified by the public authority in which
said death certificate is a matter of record.
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Dated this /4 day of
State of 1 !t d 11J(Q
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County of U
WITNESS my hand and official seal.
2013.
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RECEIVED 9/17/2013 at 10:30 AM
RECEIVING 973294
BOOK: 820 PAGE: 391
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Tamara C. Sheldon
Subscribed and sworn to before me, a notary public in and for said County and State, by
Tamara C. Sheldon, this I6 day of c� 2013.
1
0391
CERTIFICATION OF VITAL RECORD
STATE OF WYOMING
rj
This is a true certification of the document on file in the offkte of Vital
Statistics Services, Cheyenne, Wyoming.
DATE ISSUED:Tuesday, May 22, 2012
Thiscopy is no valid: unless prepared on paper with an engraved border.
Social .Security Nu mber:
Age at the Time of Death:
60 years
Lincoln
Wife
Interva
Months
years
years
Approximate 06:15 ±1 hr
M4
James McBride
Deputy State Registrar
JL
Decedent:
Name:
Gender:
Date of Birth:
Date and Puce of Death:
Date of Death: May 07, 2012
City of Death: Kemmerer
Location: 418 Carbon Street
Additional Decedent Information:
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Narne of Father:
Name of Mother:
Informant:
Other Significant
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
William Leroy Sheldon::.
Male
August 19, 1951
Council Bluffs. Iowa
Kemmerer, Wyoming
Married 'Tamara Carringer
No
Elmer Dempsey Sheldon
Berta Gene Goslin
Tamara Sheldon
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Facility:
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) COPD
(b) Cardio M.yopathy.,
(c) Atrial Fibrilation
Cremation
Garner Crematory, Salt Lake City, UT.
Bali Family Chapel, Evanston, Wyoming
Natural Death
Coroner
Cliff Boyd, Deputy
274 N St, Box 57, Grover, Wyoming, 83122
May 21, 2012
State File Number:
2012- 001412