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Home My WebLink About975624WHEN RECORDED, MAIL TO: SCOTT M. McCULLOUGH, ESQ. CALLISTER NEBEKER McCULLOUGH PARKVIEW PLAZA 1 2180 SOUTH 1300 EAST, SUITE 600 SALT LAKE CITY, UTAH 84106 2125303.1 975624 3/17/2014 10:22 AM LINCOLN COUNTY FEES: $27.00 PAGE 1 OF 6 BOOK: 829 PAGE: 219 AFFIDAVIT JEANNE WAGNER, LINCOLN COUNTY CLERK 1111111111 11111 IIIII IIIII IIIII IIIII IIIII illl III I III AFFIDAVIT OF SURVIVORSHIP PARCEL 33192610024900 STATE OF UTAH ss. COUNTY OF SALT LAKE Jane Johnson and T. Scott Johnson, Affiants, being duly sworn, depose and say: 1. That Affiants are of legal age and competent to make this Affidavit. Affiant, Jane Johnson, is a legal resident of Salt Lake County, State of Utah. Affiant, T. Scott Johnson, is a legal resident of Utah County, State of Utah. 2. That Affiants are the surviving joint tenants of Terry W. Johnson, deceased, who died on February 9, 2013, and is the same person as the decedent named in a certified copy of Certificate of Death and which is attached hereto as Exhibit "A" and by reference made a part hereof. 3. That Affiants and Terry W. Johnson, deceased, appear of record as joint tenants of certain real property located in Lincoln County, Wyoming, described in a particular Warranty Deed recorded with the office of the Lincoln County Recorder on August 10, 2012 as receiving number 966073, and more particularly described on Exhibit "B" attached hereto and by reference made a part hereof. 4. That due to the death of Terry W. Johnson, Affiants are now the surviving joint tenants of the real property described in Exhibit "B" attached hereto. From this date forward, ownership of the above real property shall vest in the name of Jane Johnson and T. Scott Johnson, as surviving joint tenants with right of survivorship and not as tenants as common. STATE OF UTAH ss. COUNTY OF SALT LAKE 4\) JANE JOHNSON, the signer of the within inst um t, who duly acknowledged to me that she executed the same. On the 1 day of W M MC, Nor Fu 6cc 1 4 c,::+0 LE pp 1 9 rye, r f h;r i..pf.YP u Oa 1�. P� rynM1 as OrT11r IOr .4355;')21 .4y Cornnnr;« n i xpiro. a M,110,20 6 13 State of UVth rv.. ,0 ael( STATE OF UTAH COUNTY OF LoYe- On the a day of i kt\ )Y 0 q� T. SCOTT JOHNSON, the signer of the within ns ument, who duly acknowledged to me that he executed the same. 2125303.1 Not y� Pub C„ ornmi ^ski, ;`3559` .1 Pi Mot GornrSi<jan tax ®iec�:; State of litth OW, .rtmn® P7M1,7 m May 10.2016 ss. 2 NO A Y PUBLIC NOT Y P BLIC 2014, personally appeared before me, 2014, personally appeared before me, EXHIBIT "B" That certain real property situated in Lincoln County, State of Wyoming and more particularly described as follows: 2125303,1 PARCEL 33192610024900 THAT PART OF THE W1 /2NE1 /4 AND THE NW1 /4 OF SECTION 26, T33N, R119W, LINCOLN COUNTY, WYOMING, BEING ALL OF THAT TRACT OF RECORD IN THE OFFICE OF THE LINCOLN COUNTY CLERK IN BOOK 568 PR, PAGE 665, AND PART OF THAT TRACT OF RECORD IN SAID OFFICE IN BOOK 568 PR, PAGE 680, AS MORE PARTICULARLY DESCRIBED ON THE ATTACHED "DESCRIPTION FOR TERRY W. JOHNSON AND JANE JOHNSON TERRY TRACT WHICH IS INCORPORATED HEREIN BY THIS REFERENCE. HEREBY RELEASING AND WAIVING ALL RIGHTS UNDER AND BY VIRTUE OF THE HOMESTEAD EXEMPTION LAWS OF THE STATE OF WYOMING. DESCRIPTION FOR TERRY W. JOHNSON AND JANE JOHNSON TERRY TRACT TO- WIT: THAT PART OF THE W1 /2NE1 /4 AND THE NW1 /4 OF SECTION 26, T33N R119W, LINCOLN COUNTY, WYOMING, BEING ALL OF THAT TRACT OF RECORD IN THE OFFICE OF THE CLERK OF LINCOLN COUNTY IN BOOK 568 OF PHOTOSTATIC RECORDS ON PAGE 665 AND PART OF THAT TRACT OF RECORD IN SAID OFFICE IN BOOK 568 OF PHOTOSTATIC RECORDS ON PAGE 680, DESCRIBED AS FOLLOWS: BEGINNING AT A SPIKE ON THE EAST LINE OF SAID W1 /2NE1 /4, N00 -29'- 01 "E, 827.78 FEET, FROM THE SOUTHEAST CORNER THEREOF; THENCE N89°-28'-00"W, 2641.24 FEET, TO A POINT; THENCE N00 26' -11 "E, 496.19 FEET, TO A POINT ON AN EXISTING EAST/WEST FENCE LINE; THENCE S89°-28'37"E, 2641.65 FEET, ALONG SAID FENCE LINE AND THE EASTERLY EXTENSION THEREOF, TO A SPIKE ON SAID EAST LINE; THENCE S00 29'01 "W, 496.67 FEET, ALONG SAID EAST LINE, TO THE SPIKE OF BEGINNING; ENCOMPASSING AN AREA OF 30.10 ACRES, MORE OR LESS; THE BASE BEARING FOR THIS SURVEY IS THE WEST LINE OF SECTION 26, T33N R119W, BEING N00°-32'-56"E; IT IS THE INTENT OF THIS DESCRIPTION THAT THE CALLED -FOR MONUMENTS, AND NOT THE EXISTING FENCE LINES, CONTROL THE LOCATION OF THE PROPERTY LINES; SUBJECT TO A RIGHT OF INGRESS, EGRESS AND UTILITIES OVER, UNDER AND ACROSS THE NORTH THIRTY (3) FEET OF THE ABOVE DESCRIBED TERRY TRACT; AND SUBJECT TO AN EASEMENT FOR STATE HIGHWAY 238; EACH "CORNER" FOUND AS DESCRIBED IN THE CORNER RECORD FILED OR TO BE FILED IN THE OFFICE OF THE CLERK OF LINCOLN COUNTY; EACH "POINT" MARKED BY A 5/8" X 24" STEEL REINFORCING ROD WITH A 2" ALUMINUM CAP INSCRIBED, "SURVEYOR SCHERBEL LTD AFTON WY PLS 11810 WITH APPROPRIATE DETAILS; EACH "SPIKE" MARKED BY A 3/8" X 12" STEEL SPIKE REFERENCED BY A 5/8" X 24" STEEL REINFORCING ROD WITH 2" ALUMINIUM CAP INSCRIBED, "SURVEYOR SCHERBEL LTD AFTON WY PLS 11810 WITH APPROPRIATE DETAILS; 2125303.1 2 2125303.1 -3 ALL IN ACCORDANCE WITH THE PLAT PREPARED TO BE FILED IN THE OFFICE OF THE CLERK OF LINCOLN COUNTY TITLED, "PLAT OF BOUNDARY ADJUSTMENT FOR TERRY W. JOHNSON AND JANE JOHNSON, JAMIE LYNN HUDSON AND GARY W. JOHNSON, DOUGLAS W. JOHNSON AND BEVERLY N. JOHNSON REVOCABLE TRUST, DATED 2 JUNE 1994, GARY W. JOHNSON AND SUSAN JOHNSON AND TERRY W. JOHNSON, ET AL. WITHIN THE W1 /2NE1 /4 NW1 /4 SECTION 26 SE1 /4NE1 /4 SECTION 27 T33N R119W LINCOLN COUNTY, WYOMING DATED 20 JULY 2011, AS REVISED. Date of Death: ;City of Death; Age' Place:of`Birth Armed..Services:.;:. Spouse's Name Industry/Business: Residence Mother's Name Facility or Address DISPOSITION INFORM Method of Dispos tion Place of Disposition: bate, of Disposition CERTIFICATION OF VITAL RECORD 17ECEDENT,INF:ORMATION February•9 Sandy INFORMANT.INFORM Name Mailing Address Auburn, ;Wyoming: No Jane Arlene Chalk Education Sandy„ Utah `GenezWalton: 1476 East Point,Circle ATION Jane Arlene Johnson 1476: East Point Circle, Sani Date Registered;::: February 13, 2o: 3' Date I ssued January 31, 2014 ATION Burin( /Removal Aurburn City Cemetery, Auburn, Wyoming February 16, 2013 FU NERAL HOME INFORMATION: ..Funeral Home: As en Funeral Services J Address: 459: Universal Circle, Sandy, Utah 84070 Funeral Director Brian J Robertson MEDICAL CERTI M decal Professional Agnes Szpunar MD, intermountain Budge Clinic; 1 CAUSE OF DEATH Myocardial Inf a rcti o n Due_to (or as a c onsequence of) C oronary Artery Disease Due'to or as a conse uence H erli idemia:. q fl Yp p Tobacco Us e .Non -usex Medical Examiner Contacted: Yes` Autopsy Performed "No Manner of Death: Natural.. C OF D EA'1 State File Number: 2013002043 Terry W Johnson; Time of Death: County of;Deat Date of Birth Sex MaritalStatus Usual Occupation: Education Father's Name: Facility Type: Relationship• y, Utah 84094 19:47 Salt Lake June 28 1942 Married:: School' Teacher Bachelor's Degree Victor Norman Johnson:.; Home 0 Forth 550 =East, Logan Utah 8041 ■•Aiaiiui This is an exact reproduction of the facts registered in the t itah State Office of Vttal Records and Statistics *,..1 Security f of this official document include Intaglio Border, V & R images in top cycloids, and intaglio Micro**. I OF 77 q This doeumer►t d the date, Seal and slgnat�ire of the Utah :State Re and the Coui1 /Dist{ict Healil> Officer. �r ,t 1111��11�� Garyt '"`dwards .0v Alr :::(r.elf 5, 4 anice L. Houston Direcfor /Health Offi 1 State Registrar 0;:6 4 0 4 2 1 6 :6 Reuia CoutyfDistrict Department ..�_I $AIRTMEN