HomeMy WebLinkAbout975711dated October 4, 2005, is attached hereto.
975711 3/26/2014 11:11 AM
LINCOLN COUNTY FEES: $48.00 PAGE 1 OF 13
BOOK: 829 PAGE: 503 AFFIDAVIT
JEANNE WAGNER, LINCOLN COUNTY CLERK
1111111 11111111111111111111111 1 1 11111111 111 111111111
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 1 OF 8
iii
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
1111111
COME NOW RONALD L. McKIM, ROBERT M. McKIM, JAMES H. McKIM,
JERRY McKIM, MARTHA ANN CLINES, and MELANIE WILKES, after being sworn and
under oath, hereby stating pursuant to Wyoming Statutes 2 -1 -201, which authorizes Affidavits
of Distribution, as follows:
1. That Howard V. McKim, a resident of Thayne, Wyoming died on December 7,
2013. An official copy of the Certificate of Death issued by the State of Wyoming is attached
hereto.
2. That Howard V. McKim owned a Vanderbilt Champion Mobile Home, VIN No.
47957605841, Wyoming Title No. 12 0230426. A copy of the Certificate of Title for that mobile
home is attached hereto.
5. That Howard V. McKim died testate. A copy of his Last Will and Testament,
6. That the Last Will and Testament of Howard V. McKim provides that the
beneficiaries of his estate, after the death of his wife, Martha McKim on February 27, 2006, are
Ronald L. McKim, Robert M. McKim, James H. McKim, Jerry McKim, Martha Ann Clines, and
Melanie Wilkes, per stripes.
hereby state:
7. That, in accordance with the requirements of Wyoming Statutes 2- 1- 201(a), we
a. That the value of the entire estate of Howard V. McKim, wherever
located, less liens and encumbrances, does not exceed Two Hundred Thousand Dollars
($200,000.00).
b. That Thirty (30) days have elapsed since the death of Howard V. McKim
c. That no application for appointment of a Personal Representative is
pending or has been granted in any jurisdiction in Wyoming.
d. That pursuant to the above referenced Last Will and Testament, we, as the
beneficiaries thereof, are entitled to title to the above referenced trailer. There are no
other persons or entities having a right to that asset under probate proceedings.
8. That we hereby request that title to the above referenced trailer be titled in the
names of "Ronald L. McKim, Robert M. McKim, James H. McKim, Jerry McKim, Martha Ann
Clines, and Melanie Wilkes with the address of record being: "P.O. Box 4345, Bedford,
Wyoming 83112
[Separate Signature pages follow.]
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 2 OF 8
DATED this 124 day of March, 2014.
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
ON THIS, the 126. day of March, 2014, RONALD L. McKIM, affiant herein,
appeared before me, and being duly sworn under oath, affirmed that the facts stated in this
Affidavit of Distribution are, to the best of his knowledge, information, and belief, true and
complete.
WITNESS my hand and official seal.
M KEVIN VO YLES NOTARY PUBLIC
County of =;jn State of
Lincoln Wyoming
My Commission Expires: July 16, 2015
My Commission expires: 0 /b /5
e....�Jl Y
R ALD L. McKIM
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 3 OF 8
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
ON THIS, the 204 day of March, 2014, ROBERT M. McKIM, affiant herein,
appeared before me, and being duly sworn under oath, affirmed that the facts stated in this
Affidavit of Distribution are, to the best of his knowledge, information, and belief, true and
complete.
1
DATED this 9 0 day of March, 2014.
WITNESS my hand and official seal.
l KEVIN VOYLES NOTARY PUBLIC
County of ;p State of
Lincoln Wyoming
My Commission Expires: July 16, 2015
My Commission expires: 0 lb it
ROBERT M. McKIM
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 4 OF 8
DATED this 2O day of March, 2014.
STATE OF W yu si u*
SS.
COUNTY OF LINCoLIJ
ON THIS, the Z1 day of March, 2014, JAMES H. McKIM, affiant herein, appeared
before me, and being duly sworn under oath, affirmed that the facts stated in this Affidavit of
Distribution are, to the best of his knowledge, information, and belief, true and complete.
WITNESS my hand and official seal.
M KEVIN VOYLES NOTARY PUBLIC
County of e State of
Lincoln :1` Wyoming
My Cornmission Expires: July 16, 2015
My Commission expires: d U is
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 5 OF 8
DATED this g day of March, 2014.
STATE OF W yoP 1 i Nc
SS.
COUNTY OF L /N'C 0 Lnl
ON THIS, the 2 1 day of March, 2014, JERRY McKIM, affiant herein, appeared
before me, and being duly sworn under oath, affirmed that the facts stated in this Affidavit of
Distribution are, to the best of his knowledge, information, and belief, true and complete.
WITNESS my hand and official seal.
M KEVIN VOYLES NOTARY PUBLIC
County of
Lincoln
State of
Wyoming
My Commission Expires: July 16, 2015
t'?:'fC'fi'`.r �a7CxCOO:Y'T4Ft1'E:ff�6`V'.� S" v'Cn4:r'4A'ar'+t -J
My Commission expires: 07 1 1(
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 6 OF 8
DATED this 2 0 'day of March, 2014.
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
ON THIS, the 21 s day of March, 2014, MARTHA ANN CLINES, affiant herein,
appeared before me, and being duly sworn under oath, affirmed that the facts stated in this
Affidavit of Distribution are, to the best of her knowledge, information, and belief, true and
complete.
WITNESS my hand and official seal.
M KEVIN VOYLES NOTARY PUBLIC
County of 'jK State of
Lincoln Wyoming
My Commission Expires: July 16, 2015
My Commission expires: 01' d G 1!
AR HA ANN CLINES
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 7 OF 8
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
DATED this f: ,C)`ay of March, 2014.
WITNESS my hand and official seal.
M KEVIN VOYLES NOTARY PUBLIC
County of State of
Lincoln Wyoming
My Commission Expires: July 16, 2015
My Commission expires: 01-
ON THIS, the 2 day of March, 2014, MELANIE WILKES, affiant herein,
appeared before me, and being duly sworn under oath, affirmed that the facts stated in this
Affidavit of Distribution are, to the best of her knowledge, information, and belief, true and
complete.
AFFIDAVIT OF DISTRIBUTION
PURSUANT TO WYOMING STATUTES 2 -1 -201
FOR
THE ESTATE OF HOWARD V. McKIM
PAGE 8 OF 8
CERTIFICATION OF VITAL RECORD
STATE OF WYOMING
745605;
This is a true certification of the document on file in the office of Vital
Statistics Services, :Cheyenne, Wyoming.
DATE ISSUED: Wednesday, January 22, 2014
J This copy is not valid unless prepared on paper with an engraved border.
DEPARTMENT OF HEALTH
:James McBride
Deputy State Registrar
Page 1/2
Decedent:
Name: Howard Vance McKim
Gender: Male
Date of Birth: February 09, 1912
Date and` Place of Death:
Date of Death: December 07, 2013
City of Death: Afton
Location: Star Valley Medical Center 110 Hospital Lane
Additional Decedent Information:
Place of Birth:, Auburn, Iowa
Residence: Thayne, Wyoming
Marital Status: Widowed
Armed Forces: Yes
Name of Father: Orville Howard McKim.
Name of Mother: Nina Mae Streeter
Informant: Ron Lorenzo McKim
Disposition:
Method of Disposition:
Place of Disposition:
Funeral Home or Facility:
Facility: Schwab Mortuary, Afton, Wyoming
Cause of Death:
The immediate cause is listed on the ft line followed by any underlying causes.
(a) Pneumonia
(b) T12 compression fracture
(c) Congestive heart failure
(d) accidental fall
Other Significant
Conditions:
Manner of Death: Natural Death
Certifier:
Type:
Name:
Address:
Date Filed:
qff tAta',Ei
CERTIFICATE OF DEATH
Burial
Thayne Cemetery, Thayne, Wyoming
State File Number:
Social Security Number:
Age at the Time of Death:
County of Death:
Physician
Christian M. Morgan, M.D.
110 Hospital Lane, PO Box 579, Afton, Wyoming, 8311
December 11, 2013
Time of Death:
2013- 003764
101 years
Lincoln
Interval
days
weeks
years
weeks
22:07 (Actual)
Tn7Ti 7a 7,'YlS@M..�'t
PAST
CERTIFICATION AL RECORD
Name: Howard Vance McKim Date of Death: December 07, 2013
County of Death: Lincoln City of Death: Afton
Amendment 1
Signature Christian M. Morgan, MD, Date 1/22/2014
Attending Physician.
Affidavit of Correction completed by Christian M. Morgan, MD, Attending Physician.
Description Original New
Cause of Death D
Cause of Death D Onset Interval
745606
AxiacricanBalik_Note Co a
STATE OF WYOMING
Page 2/2
AFFIDAVIT TO AMEND DEATH CERTIFICATE
DEPARTMENT OF HEALTH
This is a true certification of the document on file in the office of Vital
Statistics Services, Ohoyenne, Wyoming.,
4. DATE/ISSUED: Wednesday, January 22, 2014
This copy is not valid unless prepared on paper with an engraved border.
State File Number: 2013-003764
accidental fall
weeks
e4
:James McBride
amaes5 Irna
Deputy State Registrar
aaaa ANT, „TAAL
LAST WILL AND TESTAMENT
OF
HOWARD V. McKIM
I, HOWARD V. McKIM, of Thayne, County of Lincoln, State of Wyoming, being of
sound and disposing mind and memory and being in reasonably good health, but mindful of the
uncertainties of life, hereby make, publish and declare this to be my Last Will and Testament,
hereby revoking all previous wills and codicils heretofore made by me.
FIRST: I direct that all my just debts and obligations, including my funeral expenses,
the expenses of my last illness, and the expenses of the administration of my estate, be paid by
my Personal Representative hereinafter named as soon as is reasonably possible.
SECOND: I hereby confirm my intention that the beneficiary interest in all property,
real or personal, tangible or intangible (including joint checking or savings accounts in any bank
or savings and loan association or credit union, and in any money market funds, or mutual funds
or accounts, or stocks or bonds, or United States Government securities), registered or held, at
the time of my death, jointly in my name and any other person, but excluding any tenancy in
common, shall pass by right of survivorship or operation of law and outside of the terms of this
Last Will and Testament to such other person, if he or she survives me. To the extent that my
intention may be defeated by any rule of law, I give, devise, and bequeath all such joint property
to such person or persons who shall survive me.
THIRD: I give any and all of my tangible personal property (including but not limited
to, jewelry, clothing, household furniture, furnishings and fixtures, chinaware, silver,
photographs, works of art, books, boats, automobiles, all artifacts relating to my hobbies, and all
other articles of household or personal use) that I list on a written, signed, and dated
memorandum that may be left by me, in accordance the distributions specified therein. Should I
leave multiple written memorandums which conflict as to the disposition of any item of my
tangible personal property, then that memorandum which is dated last shall control as to any
items which may be in conflict.
FOURTH: I hereby give, devise, and bequeath all of the remainder of my estate,
including all property of which I may die seized or possessed or to which I may be entitled to at
the time of my death, of whatsoever kind and nature, be it real, personal or mixed, where ever it
may be situate, as follows: to my wife, MARTHA V. McKIM. In the event that my wife
predeceases me, I hereby give, devise and bequeath unto my children, JAMES, JERRY,
MARTHA, MELANIE, ROBERT, and RONALD, all of said property in equal shares, per
stirpes and not per capita.
LAST WILL AND TESTAMENT
OF
HOWARD V. McKIM
PAGE 1 OF 3
LAST WILL AND TESTAMENT
OF
HOWARD V. McKIM
PAGE 2 OF 3
FIFTH: I hereby nominate, constitute, and appoint my sons, RO': ;ERT McKIM and
RONALD L. McKIM, or either of them separately, as Personal Representative(s) of this my
Last Will and Testament and I direct that the said Personal Representative(s) shall not be
required to give any bond or other surety in connection with qualifying or acting in this capacity.
SIXTH: I hereby give my Personal Representative(s) appointed herein, in addition to
and not in limitation of their statutory and common law powers, the following powers:
a. To settle and compound any claims either in favor of or against my estate, to
execute all proper and necessary conveyances, and to give full receipts and discharges.
b. In general, to do and to perform all acts and things whatsoever the Personal
Representative could do and perform if he were the absolute owner thereof. No Personal
Representative shall be liable for the acts, omissions, or defaults of any agent appointed
with due care, no Personal Representative shall be liable for the failure to contest the
accounts of any preceding Personal Representative, and no Personal Representative shall
be liable for the failure to redress a breach of trust.
c. To sell, convey, exchange, transfer, assign, mortgage, pledge, invest, or
reinvest the whole or any portion of my real or personal estate.
IN WITNESS WHEREOF, I, HOWARD V. McKIM have hereunto set my hand to
this my Last Will and Testament, typewritten on three (3) pages, including the attestation clause
and signature of witnesses, this LIM day of October, 2005.
crs V, yyJR.I\
HOWARD V. McKIM
I, HOWARD V. McKIM, the Testator, sign my name to this instrument this day
of October, 2005, and being first duly sworn, do hereby declare to the undersigned authority that
I sign and execute this instrument as my Last Will and Testament, and that I sign it willingly,
that I execute it as my free and voluntary act for the purposes therein expressed, and that I am an
adult person, of sound mind, and under no constraint or undue influence.
4 O 2i1k)--
HOWARD V. McKIM
We, in\1`( \v'e(\ and 0 1.4 MI5,
the witnesses, sign our names to this instrument, being first duly sworn, and do hereby declare to
the undersigned authority that the Testator signed and executed this instrument as his Last Will
and Testament, that he signed it willingly; and that he executed it as his free and voluntary act
for the purposes therein expressed; and that each of us, in the presence and hearing of the
Testator, hereby sign this as witnesses to the Testator's signature, and that, to the best of our
knowledge, the Testator is an adult person, of sound mind, and under no constraint or undue
influence.
WITNESS
WITNESS
STATE OF WYOMING
SS.
COUNTY OF LINCOLN
WITNESS my hand and official seal.
M. KEVIN VOYLES NOTARY PUBLIC
County of k State of
Lincoln Wyoming
My Commission! :.pires Juiy 16, 2007
My Commission expires: 0 6/0 '7
RESI
LAST WILL AND TESTAMENT
OF
HOWARD V. McKIM
PAGE 3 OF 3
RESIDING ATJ
K e
ING AT
SUBSCRIBED, SWORN TO, AND ACKNOWLEDGED before me by HOWARD V.
McKIM, tin Te tator, and _subscribed and sworn to before me by
l hri .5 irep and inek. ei AS witnesses, this of th day
of October, 2005.
9