HomeMy WebLinkAbout974280Affidavit of Survivorshiu
RECEIVED 11/22/2013 at 1:26 PM
RECEIVING 974280
BOOK: 824 PAGE: 487
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
I, Bonnie J. Skinner, also known as Bonnie Skinner, being of lawful age and duly sworn
according to law, upon my oath, depose and state:
That under the date of March 1, 1992, for valuable consideration, Dennis Hacklin, a single person,
by deed of that date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on March
9, 1992, in Book 3o7PR, Page 537, conveyed to Marcus L. Skinner and Bonnie J. Skinner, husband and wife
as tenants by the entireties, the following described land, in the County of Lincoln, State of Wyoming, to -wit:
The Lots Number 10 to 32 inclusive of the Block Numbered 13 of the First Addition to the Town of LaBarge
(formerly Tulsa) and
Lots 11, 12, 13, 14, 15 and 16, Block 10 of the First Addition to the Town of LaBarge, formerly Tulsa, Lincoln
County, Wyoming
That under the date of November 3, 1995, for valuable consideration, Dennis Hacklin, a single
person, by deed of that date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on
November 3, 1995, in Book 375PR, Page 635, conveyed to Marcus L. Skinner and Bonnie Skinner, husband
and wife, the following described land, in the County of Lincoln, State of Wyoming, to -wit:
Lots Number 4 through 10, of Block 10 of the First Addition to the Town of LaBarge (formerly Tulsa) Lincoln
County, Wyoming
That by reason of said conveyances aforesaid, the said Marcus L. Skinner and Bonnie J. Skinner,
also known as Bonnie Skinner, became the owners of said real property, and the title thereto vested in them
continuously from the date of said conveyances, to the date of death of Marcus L. Skinner, also known as
Marcus Laverial Skinner, on the 25th day of September, 2013. That by reason of and upon the death Marcus
L. Skinner, also known as Marcus Laverial Skinner, title in the above described real property vested in
Bonnie J. Skinner, also known as Bonnie Skinner.
Affiant avers and. certifies Marcus L. Skinner, also known as Marcus Laverial Skinner, is the
identical party named with Bonnie J. Skinner, also known as Bonnie Skinner, in the aforementioned deeds,
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.
Dated this r20 day of 2013.
WITNESS my hand and official seal.
My Commission Expires:
Bonnie J. Skinner
Also known as Bonnie Skinner
Subscribed and sworn to before me, a notary pu lic in and fq aid Count and State, by Bonnie J.
Skinner, also known as Bonnie Skinner, this day of
2013.
11! L
Nota Public
NOTARY PIALry
OF
STAT t'; OF
WYOMING
SION EXPIRES SEPT. IS. 2016
CINDY D.
;f COUNTY0
LINCOLN
Y COMM
TAL RECORD
STATE OF WYOMING
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
State File Number:
Social Security;' Number:
23:43 (Actual).
tb
q This is a true certification of the document on file in the office of Vital stn a J'
Statistics Services, Cheyenne, Wyoming.. Q`S M.'
DATE ISSUED:
Tuesday, October 22 J ames McBride
This copy is not valid unless prepared on paper with an engraved border.
Deputy State Registrar
Decedent:
Name:
Gender:
Date of Birth:
Date and Place of Death:
Date of Death:
City of Death:
Location:
Additional Decedent Information:
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Fality:
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
tiKrâ–º
CERTIFICATIO
Marcus Laverial Skinner
Male
December 09, 1940
September 25, 2013
La Barge
1020 W. Skinner Dr
Fletcher, Oklahoma
La Barge, Wyoming
Married Bonnie Jean Hemphill'
No
Allen Alvie Skinner
Maudie Agnes Baker
Bonnie Jean Skinner
Cremation
UFD Cremation Center, South Jordan, Utah
History of Heart Disease.
Bali'Family Chapel, Evanston, Wyoming
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Sudden Cardiopulmonary Arrest
Coroner
Cliff Boyd, Deputy
274 N St, Box 57, Grover, Wyoming, 83.122,
October 15, 2013.
4r
Age at the Time of Death:
County of Death:
Relationship:
2013- 003127
72 years
Lincoln
Wife
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