HomeMy WebLinkAbout976249Please send tax notices to:
Petty Benshoof
7004 Monarch Court
Knoxville, TN37918
STATE OF WYOMING
COUNTY OF LINCOLN
NOTICE OF FILING AFFIDAVIT OF SUCCESSOR TRUSTEE
FOR THE GRISSOMFAMILYLIVING TRUST
COMES NOW, Jack D. Edwards who hereby provides notice of the attached Affidavit of
Successor Trustee for the Grissom Family Living Trust signed by Perry Benshoof, Successor
Trustee. The Grissom Family Living Trust is the record owner of the following described real
property located in Lincoln County, Wyoming, to wit:
A portion of the SE1 /4SE1/4 of Section 23, T35N, R119W, 6th P.M., Lincoln County,
Wyoming and being more particularly described as follows:
A copy of the Certificate of Death of Shari M. Grissom is also attached hereto and
incorporated by this reference.
Dated: April 10, 2014.
The foregoing instrument was acknowledged before me by Jack D. Edwards this 10th day of
April 2014. Witness my hand and official seal. My co, ss;: expires: II 121 1 201
SEAL
BEGINNING at a point in the South line of said SE1 /4SE1/4, said point being
442.75 feet West from the Southeast corner of said Section 23; thence NO 10'26 "E
295.17 feet; thence West 295.15 feet; thence SO °10'26 "W 295.17 feet; thence East
295.15 feet to the Point of Beginning.
Subject to reservations and restrictions contained in the United States Patent and to
easements and rights of way of record or in use. Together with all improvements and
appurtenances thereon.
ATARI PONCE NOTARY PUBLIC
COUNTY OF
LINCOLN
SS.
STATE OF
WYOMING
MY COMMISSION EXPIRES 11/21/ '16
976249 4/22/2014 9:51 AM
LINCOLN COUNTY FEES: $18.00 PAGE 1 OF 3
BOOK: 830 PAGE: 815 NOTICE
JEANNE WAGNER LINCOLN COUNTY CLERK
111 I III 1111 IIIII II 1I 1 III I11 IIIII II 11111 II IIII II I III IIII I
otary Public
STATE OF WYOMING
SS
COUNTY OF LINCOLN
Perry Benshoof, upon his oath, deposes and says as follows:
1. On April 22, 2013, Shari Grissom executed the Grissom Family Living Trust
dated April 22, 2013.
2. Shari Grissom appointed herself as the initial Trustee of the Grissom Family
Living Trust.
3. Shari Grissom provided that upon her disability or death, Perry Benshoof would
become the successor Trustee of the Grissom Family Living Trust.
4. That Shari Grissom passed away on January 26, 2014.
5. As a result of Shari Grissom's death, Perry Benshoof is now the sole, currently
acting Trustee of the Grissom Family Living Trust.
6. By this document, Perry Benshoof hereby accepts his appointment as trustee of
the Grissom Family Living Trust and agrees to effectuate-the provisions of the Trust to the best
of his ability.
Dated: January 30, 2014.
JACK D. EDWARDS NOTARY PUBLIC
S EthlJ1 Ji Y OF STATE OF
LINCOLN WYOMING
MY COMMISSION EXPRESS
AFFIDAVIT OF SUCCESSOR TRUSTEE
FOR THE GRISSOM FAMILY LIVING TRUST
The foregoing instrument was acknowledged before me by Perry Benshoof this 30th day
of Janu y 2014. Witness my hand and official seal. My commission expires:
n1H
aa
This Is a true certification of the document on file in the office of Vital
Statistics, Services, Cheyenne, Wyoming:
DATE ISSUED: Thursday, April 17, 2014
STATE OF WYOMING
This,copg notrvalid.ynless prepared on'paper wjth an engraved border.
DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
Relationship:
Father
James McBride
Deputy State Registrar
Decedent:
Name:
Gender:
Date of Birth:
Date and. Place of Death:
Date cl?f Death: January 26, 2014
City of Death: Etna
Location: 961 Clark Ln.
Decedent Information;
Place of Birth:
Residence:
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
Disposition:
Method of Disposition:
yP,. I'ace of Disposition:
Funeral Home or Facility:
Facility.:
Cause of Death:
The immediate cause is listed on the first line followed by any underlying causes.
(a) Complications from Breast Cancer
(b) Metastatic Breast Cancer
Other. Significant,
Conditions:
Manner of Death: Natural Death
C ertifier:
Type:
Name:
Address:
Date 'Filed:
l il
1 CERTIFICATION OF VITAL RECORD
Shari Marlene; Grissom
Female
February 05, 1959
Torrington, Wyoming
Etna, Wyoming
Widowed
No
Darrell Wilson Benshoof
Norma Jean Stephens
Darrell Wilson Benshoof
Burial
Etna Cemetery, Etna, Wyoming
Schwab Mortuary, Afton, Wyoming
State File Number:
Social Security Number:
Age at the Time of Death:
County of Death:
Time of Death:
Physician
Michael Pieper, D.O.
110 Hospital Lane, PO Box 579, Afton, Wyoming; 83110
February 20, 2014
2014- 000444
54 years
Lincoln
11:00 (Actual)