HomeMy WebLinkAbout975030IN THE DISTRICT COURT OF THE THIRD JUDICIAL DISTRICT
IN AND FOR THE COUNTY OF LINCOLN, STATE OF WYOMING
IN THE MATTER OF DETERMINATION OF HEIRSHIP OF
RICHARD R. SEVERNS,
Deceased.
STATE OF WYOMING
ss.
COUNTY OF LINCOLN
Trust Sevems \Affidavit of Distribution
AFFIDAVIT FOR DISTRIBUTION OF ESTATE
PR-
We, K. Megan Alexander and Robert D. Sevems, being first duly sworn, on oath depose and
state as follows:
1. That we are over the age of twenty -one (21) years.
2. That Richard R. Severns is our father.
3. That our father, Richard R. Severns was a widower when he died on the 18 day of
December, 2013 in the City of Kemmerer, County of Lincoln, State of Wyoming as is shown
by the certified copy of the certificate of death that is identified as Exhibit 1 and attached
hereto and made part of this instrument by this reference.
4. That Richard R. Severns' spouse, our mother, Gail Sevems, pre deceased him, having died
on September 8, 2011.
5. That our father, Richard R. Sevems had a Will upon his death and that Will devised or
granted the remainder of his estate to the Richard and Gail Sevems Trust, dated June 24,
1997 and any amendments thereto.
6. That we are the successor co- trustees of the Richard and Gail Sevems Trust, dated June 24,
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1997 and any amendments thereto.
7. That the personal property owned by Richard R. Severns is as follows:
a. 2012 Buick; VIN 5GAKVCED1CJ285783
b. 1995 Kawasaki; VIN JKALF8C13SB547604
c. 2008 Polaris Ranger; Serial 4XARH68A882375416
d. 1995 Voyager Trailer; VIN 4JVS01318SA002101
e. 2000 Polaris Sportsman; Serial 4XACHSOA2YA333406
8. That the value of the entire estate of Richard R. Severns wherever located, does not exceed
two hundred thousand dollars ($200,000.00).
9. That thirty (30) days have elapsed since the date of the death of Richard R. Severns.
10. We, as successor co- trustees of the Richard and Gail Severns Trust, dated June 24, 1997 and
any amendments thereto, are entitled to the payment or delivery of the property of Richard
R. Severns and there are no other distributees of the Decedent having a right to succeed to
the property under probate proceedings.
11. That no application for appointment of a personal representative is pending or has been
granted in any jurisdiction regarding Richard R. Severns.
12. If any other asset or personal property is located that is not identified above, the Richard and
Gail Severns Trust is entitled to that property.
Dated this day of January, 2014.
Trust \Sevems \Affidavit of Distribution
K. MEGAN AL
Page 2 of 4
XANDER
STATE OF WYOMING
COUNTY OF LINCOLN
I, K. Megan Alexander, being first duly sworn, states that I am one of the affiants noted
above in the Affidavit for Distribution of Estate, that I have read the same, know the contents
thereof, and that the statements contained therein are true.
This Affidavit for Distribution of Estate was signed and sworn to before me this „N day
of January, 2014, by K. Megan Alexander.
DEBRA A. HANSEN
COUNTY OF
LINCOLN
MY COMMISSION EXPIRES
Trust \Sevens \Affidavit of Distribution
NOTARY PUBLIC
STATE OF
WYOMING
ss.
1A>lat
K. MEGAN ALEXANDER
NOTARY PUBLIC
My Commission Expires:
Page 3 of 4
[The remainder of this page is intentionally blank.]
COUNTY OF
Dated this O day of January, 2014.
STATE OF NEW MEXICO
ss.
ROBERT D. SEVERNS
I, Robert D. Severns, being first duly sworn, states that I am one of the affiants noted above
in the Affidavit for Distribution of Estate, that I have read the same, know the contents thereof, and
that the statements contained therein are true.
Trust \Sevems\Affidavit of Distribution
ROBERT D. SEVERNS
This Affidavit for Distribution of Estate was signed and sworn to before me this k day
of January, 2014, by Robert D. Severns.
it A
NOTARY PUBLIC
My Commission Expires:
Page 4 of 4
j`•�L�N�
This is a true certification of the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming.
G DATE ISSUED: Monday, January 06, 2014
rte This oopyis not valid unlesprepared OR paper with aneng a4d.border.
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
.....s,„.„4„..
J ames McBride
Deputy State Registrar
Decedent:
Name:
Gender:
Date of Birth:
Place of Birth:
Residence:
Marital Status:
Armed Forces:
''!Name of Father:
Name of Mother:
Informant:
Disposition:
Method' of Disposition: Cremation
Place of Disposition:
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address
Date Filed:
CERTIFICATIO TAL RECORD
Richard Ray Severns.
Male
February 23, 1937
Date and Place of Death:
Date of Death: December 18, 2013
City of Death: Kemmerer
Location: South Lincoln Medical. Center PO Box 390
Additional Decedent Information:
Encampment, Wyoming
Kemmerer, Wyoming;
Widowed
No
Robert William Severns
Velma Lillian Olson
Megan Alexander
UFD Cremation Center, South Jordan, Utah
Metastatic Bladder Cancer
Natural Death
Physician
George Krell, M.D.
PO Box 390, Kemmerer, Wyoming, 83101
January 03,2014..
State File Number:
Social Security Number::r
Age at the Time of Death: 76 years
County of Death:
Relationship:
Funeral Home or Facility:.
Facility: Crandall Funeral Home, Evanston, Wyo
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Cardiorespiratory Arrest
(b) COPD
Time of Death:
Lincoln
111
2013- 004030
Interval:
Minutes
Decades
02:07. (Actual)