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STATE OF WYOMING
County of Lincoln
PIN: 3718-204-01-001
PIN: 3718- 204 -01 -007
AFFIDAVIT OF SURVIVORSHIP
PURSUANT TO W.S. 2 -9 -102
ss.
I, Tina R. Seay, being first duly sworn, do hereby state as follows:
1) I am an adult, competent to testify, and make the following affirmations based
upon my own best investigation, information and beliefs;
2) I am an interested person and make this Affidavit pursuant to W.S. 2 -9 -102;
3) This affidavit relates to the following described parcels of real property situate in
the County of Lincoln, and State of Wyoming, more particularly described as
follows, and hereinafter referred to as "Lot 58" and "Portion of Lot 58
a. Lot 58: Lot No. 58 of the Rees Subdivision, Lincoln County, Wyoming;
exception therefrom all that land, more or less, beginning from the Northeast
Corner Stone Section 20/21 first course West 126.4 feet; thence second course
South 285 feet to Northwest corner line of Lot No. 57, thence Ease 126.4 feet to
Northeast corner of Lot No. 57, thence North to 1/4 corner stone Section 20/21.
Including and together with all improvements and appurtenances thereon
and thereunto belonging, but subject to taxes, reservations, covenants,
conditions, restrictions, rights -of -way and easements of sight and record, if
any.
b. Portion of Lot 58: A parcel of land being a portion of Lot 58, Rees Subdivision,
of record in the Office of the Clerk of Lincoln County, Wyoming as Plat No. 171,
and located in the NE1 /4SE1 /4 of Section 20, T37N, R118W, 6th P.M., Lincoln
County, Wyoming; said parcel being more particularly described as follows:
BEGINNING at the northeast corner of said NE1 /4SE1 /4 of
Section 20, coincident with the northeast corner of said Lot 58;
thence along the east boundary of said Lot 58, S00 °00'00 "W,
238.75 feet to the southeast corner of said Lot 58;
thence along the south boundary of said Lot 58, N89 °56'56 "W,
126.40 feet;
thence N00 °00'01 "E, 239.04 feet to the intersection with the north
boundary of said Lot 58;
thence along said north boundary, S89 °48'56 "E, 126.40 feet to the
Corner of Beginning;
ENCOMPASSING an area of 0.69 acres, more or less;
said parcel being SUBJECT TO any easements, rights -of -way,
covenants, conditions, restrictions, agreements, reservations and /or
encumbrances of sight and /or record;
the BASIS OF BEARING being S00 °00'00 "W along said east
boundary of Lot 58.
4) Lot 58 was conveyed to Gregory E. Seay and Tina R. Seay, husband and wife as
tenants by the entireties, Grantees, from Thomas H. Migel and Judith L. Migel,
AFFIDAVIT OF SURVIVORSHIP
Page 1 of 2
via that certain Warranty Deed recorded in the Office of the Lincoln County
Clerk, Lincoln County, Wyoming, as document number 867210, in Book 449 of
Page 260 on or about July 27, 2000;
5) Portion of Lot 58 was conveyed to Gregory E. Seay and Tina R. Seay, husband
and wife as tenants by the entireties, Grantees, from North Alpine Improvement
and Service District No. 1, a political subdivision of the State of Wyoming, via
that certain Warranty Deed recorded in the Office of the Lincoln County Clerk,
Lincoln County, Wyoming, as document number 895539, in Book 542 of Page
544 on or about November 26, 2003;
6) That Gregory E. Seay died on December 22, 2013, and the place of last residence
of Gregory E. Seay was the County of Lincoln, State of Wyoming. See Attached
Death Certificate;
7) Decedent, Gregory E. Seay, was the same party who was named in and whose
death terminated his previous estate in the property under the aforementioned
Warranty Deeds, and following the death of Gregory E. Seay, Tina R. Seay is the
sole interest holder in Lot 58 and Portion of Lot 58.
FURTHER AFFIANT SAYETH NAUGHT.
Dated this 24 day of February, 2014.
STATE OF WYOMING
County of Lincoln
ss.
The foregoing Affidavit of Survivorship Pursuant to W.S. 2 -9 -102, was subscribed, sworn to
and acknowledged before me by Tina R. Seay, Affiant, on this 24 day of February, 2014.
Witness my hand and official seal.
S.P.AI)A \4SON..IR NOIAIRY I'tJRLIC
STAIR OF
WYO \1INCi
('O1 IN'rY O1'
L ]CI'ON
M Y ('OMMISSION I:\i'IItI:S Angusl 225, 2516
Tina R. Seay
P.O. Box 3462
Alpine, WY 83128
AFFIDAVIT OF SURVIVORSHIP
Page 2 of 2
Notary Public for the State of Wyoming
My Commission Expires: d
.1.10
Decedent:
Name:
Gender:
Date of Birth:
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
,Disposition:
Mehod of Disposition:
Place of Disposition:
Other Significant
Conditions:
Manner of Death:
Certifier:
Type:
Name:
Address:
Date Filed:
v 771
n• s nE5'ir 9
CERTIFICATIO TAL RECORD
Gregory Edward Seay
Male
May 15, 1963 7
Date and Place of Death:
Date of Death: December 22, 2013
City of Death: Alpine
Location: 487 Pine St.
Additional Decedent Information:
STATE OF WYOMING
D OF HEALTH
CERTIFICATE OF DEATH
Charlottesville, Virginia
Alpine, Wyoming
Married Tina Rene Vess
No
Curtis Seay
Diana Seay
Tina Rene Seay
Cremation
Valley Mortuary Crematory, Jackson, Wyoming
Funeral Home or Facility
Facility: Valley Mortuary, Jackson, Wyoming
Cause of Death:
•The immediate cause is listed on the first line followed by any underlying causes.
(a) Adenocarcinoma lung
Natural Death
Physician
Dennis Butcher, M.D.
555 East Broadway, Suite 201, Jackson, Wyoming, 83.001
December 31, 2013
741.65
This is a true certification the document on file in the office of Vital
Statistics Services, Cheyenne, Wyoming,
DATE SSUED:
Friday, January 03, 2014
I
This copy is not valid unless prepared on paper with an engraved border.
State File Number:
Soda! Security Number:
Age at the Time of Death:
County of Death:
Relationship:
Time of Death:
2013-003981
50 years
Lincoln
Wife
8 months
12:00 (Approximate)
aritAS ath•
James McBride
Deputy State Registrar