HomeMy WebLinkAbout976471AFFIDAVIT FOR COLLECTION AND DISTRIBUTION OF
DECEDENT'S PERSONAL PROPERTY
PURSUANT TO W.S. 2 -1 -201
Gary D. Nellen and Anita Nellen, being first duly sworn according to law, upon their
oaths depose and say:
1. That Glenn L. Nellen, died intestate at Rock Springs, County of Sweetwater,
State of Wyoming, on January 13,2 014.
2. That at the time of his death, Glenn L. Nellen, was domiciled in the State of
Wyoming, County of Sweetwater.
3. That at the time of his death, said Glenn L. Nellen left surviving him the
following named persons who would have, under probate proceedings, the right to succeed to
the property of said Glenn L. Nellen.
Name, Address and
Relationship Age
Gary D. Nellen, brother
308 Locust Street
Rock Springs WY 82901
Anita Nellen, sister
213 Locust Street
Rock Springs, WY 82901
(b)
(c)
Legal
Legal
Share of Estate
1 /2
1 /2
4. That at the time of his death, Glenn L. Nellen was the owner of the following
described personal property:
(a) One (1) 2008 Dodge, UTLP, VIN 1D8HB48N18F131873, Registered
Under Wyoming Certificate of Title No. 04- 0720464;
One (1) 1998 Dodge, PU, VIN 1B7KF2368WJ219682, Registered under
Wyoming Certificate of Title, No. 12- 0187458; and
One (1) 1997, Travel Trailer, VIN 1NW32KR02SD049179, Registered under
Wyoming Certificate of Title No. 12- 0227446
5. That the value of the entire estate, wherever located, less liens and
encumbrances, does not exceed Two Hundred Thousand and No /100 Dollars ($200,000.00).
6. That thirty (30) days have elapsed since the death of the decedent.
7. That no application for appointment of a Personal Representative is pending or
has been granted in any jurisdiction.
8. That the above -named distributes are entitled to payment or delivery of the
property of said decedent; and there are no other distributees of the decedent having a right to
succeed to the property under probate proceedings.
9. That affiant(s) as the surviving heir(s) -at -law of the decedent herein, state(s)
that the above -named heir(s) are entitled to have the above described personal property by
virtue of and have executed and filed this affidavit pursuant to the provisions of Section 2 -1-
201, Wyoming Statutes, 1977; and that the Certificate of Death, hereunto annexed and by this
976471 5/2/2014 3:19 PM
LINCOLN COUNTY FEES: $18.00 PAGE 1 OF 3
BOOK: 831 PAGE: 511 AFFIDAVIT
JEANNE WAGNEP_LL COLN COUNTY CLERK
111111111111111111111111IIIIIII11111IIIII11111IIIIIIII IIIIIII II II 1111III
reference made a part hereof, is a certified copy of the Certificate of Death of said decedent,
Glenn L. Nellen.
10. FURTHER, by their signatures hereon, each of the affiants hereby request that
the title to the 2008 Dodge Durango be issued to Gary D. Nellen, that the title to the 1998
Pickup be issued to Anita Nellen and that the title to the 1997 Travel Trailer be issued to both
Gary D. Nellen and Anita Nellen.
DATED this 1/) day of
`ellen, brother
Anita Nellen, sister
THE STATE OF WYOMING
COUNTY OF SWEETWATER
The foregoing Affidavit for Collection and Distribution of Decedent's Personal
Property Pursuant to W.S. 2 -1 -201 was acknowledged before me by Gary D. Nellen on this
/D day of `7- 77-a- 2014.
d official seal.
PAMELA A. ANDERSON NOTARY PUBLIC
COUNTY OF ti STATE OF
SWEETWATER O WYOMING
DIY COMMISSION EXPIRES AUGUST 12, 2015
My Commission Expires: o .s' c>
THE STATE OF WYOMING
SS.
COUNTY OF SWEETWATER
The foregoing Affidavit for Collection and Distribution of Decedent's Personal
Property Pursuant to W.S. 2 -1 -201 was acknowledged before me by Anita Nellen on this
/a day of `71 2014.
PAMELA A. ANDERSON
COUNTY OF
SNIEETWATER
NOTARY PUBLIC
STATE OF
JYOMING
13Y COI'l. IPSSI9j1 WOES AUGUST 12, 2015
SS.
d and official seal.
My Commission Expires: z
Notary Public
Notary Public
2014.
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.VIN) CERTIFWATION. OF: VITAL RECO 4
and.Place Of Death:
Date of Death:' JanuarY13, 2014
City of Death; Rock Springs
Location 213 LocustSteeeti
Additional Decedent Information:
0,ther.Significa.nt.
Manner of Death': Natural Death
Type
Name:
ddresS:
Filed:
p,lace of Birth:
Resideflce
Marital Status:
Armed Forces:
Name of Father:
Name of Mother:
Informant:
7 1
Decedent:
Gender:
Date of Birth:
Glenn LeeNellen,
Male :::i,..
June 28, 1924
RockSprings, Wyoming
'Rock Springs;Wyoming:::
Divorced*"
No
William Henry'Nellen
Vidiet
Gary Nellen
Burial
!Disposition:
ethod of Disposition:
j
Face of Disposition: Rest Haven Memorial Gardens, Rock Springs, Wyoming
2
Funeral Home Faci
FaCility: Vaie Funeral Chap RoCk %rings; Wyoming
The immediate cause is Iisted on the first line follow016y any underlying ceuse
(a) Acute Congestive Heart Failure
b) Atherosclerotic Heart Disease
Coroner
Dale S. Majhanovich, Coroner
421 B Street,: Rock Springs, W.Yorning,*82901
January 18 2014.
STATE OF
FtlEAL H.
...0 E RT.! F IcAT E...P
•,•7
yThis copy,is notyalid unless:prepared on paper wi,th.an engraved.border:
This is a trtie certification of the document on file in the office of Vital
Statistics Services. Wyoming:
4 DATE1SSUED: Thursday, janUary23., 201.4
State File-Numb.er:
Social SeCutitY Number
Age at the Time of Death:
County'of Dealh:
A.
I
Tirriesif
1
2014-000065
89 years
SVileetwater
04:001ApprOximatef
omes .44.
James McBride
Deputy State Registrar
VT5TTI •MN167..
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