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HomeMy WebLinkAbout973521liliance Title Escrow PO Box 1367 Kemmerer WY 831 n 1 File No.: 204810 STATE OF WYOMING SS. COUNTY OF LINCOLN I, Mary Susan tariff, being of lawful age and first duly swom according to law, upon my oath, depose and state: 1. That I am of adult age, a resident of Lincoln County, Wyoming, and the Affiant herein. 2. That by virtue of the conveyances which are recorded in the office of the County Clerk for Lincoln County, Wyoming, located at Kemmerer, Wyoming is recorded a Warranty Deed dated the 26 day of February, 1982, in Book 185PR on page 253, conveys unto Charles W. Albrecht, Mary M. Albrecht, Mary Susan Griff and Charlotte Ann Johnson as Joint Tenants, the following described property, to -wit: Exhibit "A" 3. That said Mary Maddalena Albrecht aka Mary M. Albrecht on the 10 day of May, 2011, died and .a copy of the original certificate of death, certified to as true and correct by public authority in which the original of said certificate is a matter of record, is attached hereto as Exhibit `B 4. That by reason of death of said Mary Maddalena Albrecht aka Mary M. Albrecht by reason of 2 -9 -102 W.S. (1980), the decedents interest and title in said conveyance has terminated and title to the real property conveyed thereby has vested absolutely in Charles W. Albrecht, Mary Susan Griff and Charlotte Ann Johnson continuously since the death of the said decedent. FURTHER AFFIANT SAYETH NOT. September 30, 20)3 Mary Susan Griff State of Wyoming) County of Lincoln) The foregoing instrument was subscribed and sworn to me by Mary Susan Griff, this day of S a 2013 Witness my h d officio eal Notary Public My Commission Expires: County of Lincoln AFFIDAVIT TERMINATING ESTATE z/o.z.4 45 r Lori Kalan N tary Public State of Wyoming My Commission Expires 2126/2015 +.s.■ 053 «7 RECEIVED 10/1/2013 at 11:42 AM RECEIVING 973521 BOOK: 821 PAGE: 537 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY CERTIFICATIO TAL RECORD Lloyd Berentzen Director/Health Officer County/District Health Department DECEDENT INFORMATION Date of Death: City of Death: Age: Place of Birth: Armed Services: )Spouse's Name: Industry/Business: Residence: Mother's Name: Facility or Address: INFORMANT INFORMATION Name: Susan Griff Relationship: Daughter Mailing Address: 62 McGovern Avenue, Kemmerer, Wyoming 83101 DISPOSITION INFORMATION Method of Disposition: Removal Place of Disposition: South Lincoln Cemetery, Kemmerer, Wyoming Date of Disposition: May 14, 2011 May 10, 2011 Logan 91 Glenco, Wyoming No Charles W Albrecht Retail Store Diamondville, Wyoming Mary Foremmuto Williamsburg Assisted Living CERTIFICATE OF DEATH State File Number: 2011005716 Mary Maddalena Albrecht' Time of Death: County of Death: Date of Birth: Sex: Marital Status: Usual Occupation: Education: Father's Name: Facility Type:• FUNERAL HOME INFORMATION Funeral Home: Crandall Funeral Home Address: PO Box 6, 105 East Center Street, Kamas, Utah 84036 Funeral Director: William W Ball Date Issued: May 19, 2011 rivr 21:30 Cache January 1, 1920 Female Married Secretary High School or GED John Cattelan Nursing Home /Assisted Living MEDICAL CERTIFICATION Medical Professional Agnes Szpunar MD, Intermountain Budge Clinic, 1350 North 550 East, Logan, Utah 84341 CAUSE OF DEATH Debility Due to (or as a consequence of): Dementia Other significant conditions: Coronary Artery Disease l Tobacco Use: Non -user Medical Examiner Contacted: Yes Autopsy Performed: No Manner of Death: Natural This is an exact reproduction of the document registered in the State Office of Vital Statistics. Security features of this official document include: Intaglio Border, V R images in top cycloids, �u�y ultra violet fibers and hologram image of the Utah State Seal, over the words "State of Utah This 4;;...d document displays the date, seal and signature of the State Registrar and the County /District Health Officer. 0 y am" 4 1 111111011 1 1 1 111 1 1 1III k 1,py4 06.3112792 At 1\ A Janice L. Houston, State. Registrar l it Office of Vital Statistics L 1" l s s s s Ij wr,. ..mss! 0538 204810 EXHIBIT "A" 0539 Lot 10 in Block 9 of Town of Diamondville, Lincoln County, Wyoming as per the recorded plat