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Home My WebLink About866286STATE OF WYOMING ss. COUNTY OF LINCOLN Name Jeannine C. Roberts BOOK Relationship Wife RECEIVED I\.' 866286 00 JUN -8 8:57 AFFIDAVIT FOR COLLECTION AND DISTRIBUTION CIE A1Jiq DECEDENT'S PERSONAL PROPERTY PURSUANT TO W.S W.SqUidielifil. WYOMING PR PAGE .r 3 •i 1, Jeannine C. Roberts, being first duly sworn, on oath deposes and states that I am making this affidavit pursuant to W.S. 2 -1 -201, on behalf of myself as sole distributee, as hereinafter set forth, and that I make the following statements in connection therewith: 1. That Bryce Clark Roberts became deceased November 30, 1999, in Idaho Falls, Bonneville County, State of Idaho; that said decedent died intestate; that I am the surviving spouse of the decedent; that I am the sole and only party entitled to the estate of the decedent as his surviving spouse, in accordance with the statutes of descent and distribution of the State of Wyoming. 2. That the value of the entire estate of said decedent, wherever located, does not exceed $70,000.00. 3. That more than thirty (30) days have elapsed since the date of death of the decedent. 4. That no applications for the appointment of a personal representative of said decedent is pending or has been granted in any jurisdiction. 5. That the following named distributee is the sole and only party entitled to the estate of the decedent; that there are no other distributees of the decedent having a right to succeed to any of the property of the decedent under probate proceedings; and that therefore, the following named claiming distributee is entitled to payment or delivery of all of decedent's property: 7 spegou •0 eu!uue z :saaidxe uo!ss!wwoo ALAI Mle me- wind hem ONIGVIOO 1 0'1V830 `000Z 'AeW }o step s!y} speqo eu!uueer Aq aw aao}aq o} worms pue paquosgns 'OOOZ `ieIN }o step 4191. s!y} 40 se 4311103X3 •papuewe se `(o) i.oZ 'S'N! 1 111m eoue!idwoo u! '6u!woA 'A}unoa u!oouil 4o JJal3 Aluno3 alai-111m paooaa 40 pal!} 6ulaq s! }!nep!4.e s!y} 4o leu!6!ao ay} }eyl •anoge o} pauela.i elo!yan ay} iO4 9111140 a }eol, 190 ay} }o Adoo e y }!M 6uole }uepeoep ay} Jo4 a}eo!}!pao y}eep ay} }o Adoo pa!}!peo e s! 90U9.194ei s!11} Aq u!aaay pa}eiodaoou! pue o }ai q peyoe} }e ley!. "L •spego 0 au!uueer `peu6!siepun all jto aweu ay} u! penss! aq pimps ai 1!1 }o 9}eo!}!pa3 Mau V 17Z66L I• 'oN el 1!1 }o a}eowpe0 A}uno3 uloou!1 pue LLVZ1.I. :NIA y }!M Tonal uo1 -Z }alomego L961. :6u!M011o� ay} seM }uepeoep p!es Aq peuMo s}esse eqj 6uowe }ey1 .9 Make Body Type Name of Owner Roberts, Bryce STATE OF WYOMING OFFICE OF COUNTY CLERK LINCOLN, COUNTY KEMMERER. WYOMING tertifirate 14 Tale frar Alai= Pellicle DESCRIPTION OF VEHICLE C @Y.I=4 €1: Year _19.61 V.I.N. CE5372:__112 _427 2 Ton Vehicle Truck icle Tk Type Model som Used Previous Title No. A 1563433 State. Idaho (Signature of Owner) Address City Etna Date Purchased -5 -76 Address City Twin Falls No. 12 VEHICLE SUBJECT TO THE FOLLOWING LIENS AND NO OTHERS SPACES BELOW FOR COUNTY CLERK USE ONLY 79924 $2.00 Date 5 Issued Factory Cost 2869 State WY Purchased From Pacific Container Supply Co. L Inc. St Idaho FIRST LIEN Nature of Lien Amount Date of Filing Lien Holder Address Clerk's Signature By Deputy Above lien discharged from County Clerk's Records. Date of Discharge Clerk's Signature By Deputy SECOND LIEN Nature of Lien Amount Date of Filing Lien Holder Address Clerk's Signature____ By Deputy Above lien discharged from County Clerk's Records. Date of Discharge Clerk's Signature_._____ By Deputy THIRD LIEN Nature of Lien Amount Date of Filing Lien Holder Address_ Clerk's Signature By Deputy Above lien discharged from County Clerk's Records. Date of Discharge Clerk's Signature..___._.. By Deputy CERTIFICATE I, ALAN E. ZIEGLER County Clerk LINCOLN County, Wyoming, do certify that the above applicant has stated under oath that —he is the owner of the above described motor vehicle and that such motor vehicle is subject to the liens listed above and no others. I hereby certify that reasonable diligence has been exercised in ascertaining that the facts stated in the application for a Certificate of Title are true, and that this instrument was field for record on the 5 day of May 1976.__, and duly recorded in Book 76 Page_ 79 _9 24 of the records of this office. IN WITNESS WHEREOF, I have hereunto caused this Certificate to be signed and the official seal of this office to be placed thereon. (SEAL) 12- 79924 Deputy County Clerk (Do not alter or lose this Certificate as it must be presented at the County Treasurer's office when procuring motor vehicle licenses and must be used In making a sale or transfer. When title is transferred, application for new certificates must be made to a County Clerk within ten days after the assignment on the reverse side hereof is executed.) TM( MILL\ COMPANY. SHERIOAN 142188 735 dDhiiiiIi' .;11, I FF 1• 1 4iik14 0 NOWSUSit: 01.0 '£9 1 1 1 111 a3Y fief-atiie 03NDIS .3DA2 XMVjLiLOfl 331.CIAt Ala I EV UT MO IA« 1+5. 0 1 00 le!.0)!9viiii0,04nnuetus epapewoo so.o orlgek, AlOddel S•013003CI 811£9" --68 Ritti 1.11”:,`11 44t9Q1 ouvagamandomeirmeetar' 1 14 Pi 1 1 11 IlP