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HomeMy WebLinkAbout975099I, Laura Huffman Heitzman, being of lawful age and duly sworn according to law, upon my oath, depose and state: That under the date of September 16, 2008, for valuable consideration, Leo M. Huffman, by deed of that date, which deed was duly filed of record in the Office of the Lincoln County Clerk, on September 16, 2008, in Book 705, Page 86, conveyed to Leo M. Huffman and Laura Huffman Heitzman, as joint tenants with full rights of survivorship, the following described land, in the County of Lincoln, State of Wyoming, to -wit: Lots Sixteen (16), Seventeen (17) and Eighteen (18) of Block Thirty (30) in the Town of Diamondville, Lincoln County, Wyoming as described on the official plat thereof, together with all buildings, improvements and appurtenances thereon situate or in anywise appertaining thereto That by reason of said conveyance aforesaid, the said Leo M. Huffman and Laura Huffman Heitzman 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 Leo M. Huffman, also known as Leo Millard Huffman, on the 3oth day of December, 2013. That by reason of and upon the death of Leo M. Huffman, also known as Leo Millard Huffman, title in the above described real property vested in Laura Huffman Heitzman. Affiant avers and certifies that Leo M. Huffman, also known as Leo Millard Huffman, is the identical party named with Laura Huffman Heitzman, 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. Dated this 1 day of State of Wyoming ss. County of Lincoln Affidavit of Survivorship C0../"UsitM 20 aura Huffma Heitzman Subscribed and sworn to before me, a notary public in and for said County and State, by Laura Huffman Heitzman, this a( day of ®..111 2014. 0. ov l mituf WITNESS my hand and official seal. ,/zo _..00.00...„ .13: se i t Notary Public 'f ''''''*4 c n ission Expires: IR %r ,�f1 pup �..0 E ov q1�~� l6 1 LL O Relationship: 72 years James McBride Deputy State Registrar 2013 004147; N Other:.Significant Conditions: Manner of Death: Injury Information: Date Of Injury: Injury At Work? Location: Description: Certifier: Type: Name: Address: Date Filed: ,G lrerntiiieT \745313 :4 tip' k, fi:' 1z CERTIFICATIO STATE OF WYOMING DEPARTMENT OF HEALTH Leo Millard Huffman Male October 13, 1941 December 30, 2013 Diamondville 902 Diamondville Ave.: mation: Greenbriar, Arkansas Diamondville, Wyoming Widowed No William Theodore Huffman Ethel Andrews Laura Huffman Heitman This copy is not valid unless prepared on paper with an engraved border. CERTIFICATE OF .DEATH This is a true certification of the document on file in the office of Vital Statistics Services; Cheyenne, Wyoming, DATE`ISSUED: Tuesday, January 21 :2014 Decedent: 'Name: Gender: Date of Birth: Date and Place of Death: Date of Death: City:of'Death: Location: Additional Decedent Infor Placer of Birth: Residence: Marital Status: Armed Forces: Name of Father: Name of Mother: Informant: Disposition: ethod of Disposition: Cremation iace'of Disposition: Funeral Home or Fac ility: Facility: Cause:: of Death: The immediate cause is listed on the first line followed by any underlying causes. (a) Gunshot to the Head UFD Cremation Center, South Jordan, Utah Ball Family Chapel, Evanston, Wyoming Coroner Cliff Boyd, Deputy 274 N St, Box 57, Grover, Wyoming, 83122 January 15, 2014 State File Number: Social Security Number: Age at the Time of Death: County of Death: Suicide Time of Death: Time Of Injury': December 30, 2013 (Actual) No 902 Diamondville Ave, Diamondville; Wyoming Victim shot himself in the head Approximate' 07:00 +_1hr Approximate! 07:00 ±l hr 1