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I, K. MEGAN ALEXANDER, being of lawful age and being first duly sworn upon my oath, deposes
and states as follows:
1. That my father, Richard R. Severns was the Trustor of the Richard and Gail Severns Trust, dated
June 24, 1997 and any amendments thereto.
2. That on September 8, 2011, my mother Gail Severns died.
3. That on December 18, 2013, my father, Richard R. Severns died.
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a 4. That in the Richard and Gail Severns Trust, dated June 24, 1997 and any amendments thereto, I was
w appointed to act as a Successor Co- Trustee of that Trust in conjunction with my brother, Robert
Severns, jointly or the survivor upon the death of Richard R. Severns, Trustee.
5. That I hereby accept the appointment of my father to act as a Successor Co- Trustee of the Richard
and Gail Severns Trust, dated June 24, 1997 and any amendments thereto.
That in accepting that appointment I receive all powers and accept all limitations and obligations of
a Successor Co- Trustee as set forth in the Richard and Gail Severns Trust, dated June 24, 1997.
Dated this ILI day of December, 2013.
STATE OF WYOMING
ss.
COUNTY OF LINCOLN
I, K. MEGAN ALEXANDER, being first duly sworn, states that I am the affiant noted above, that
I have read the same, know the contents thereof, and that the statements contained therein are true.
This Affidavit of Successor Co- Trustee Upon Death of Richard R. Severns was subscribed and sworn
to before me this 9 th day of December, 2013 by K. Megan Alexander.
DEBRA A. HANSEN NOTARY PU Z;USI;
COUNTY OF STATE OF
LINCOLN \t X sa WYOMING
MY COMMISSION EXPIRES
AFFIDAVIT OF SUCCESSOR CO- TRUSTEE
UPON DEATH OF RICHARD R. SEVERNS, TRUSTEE
372393
4I
ER
9aAit(, Nr.$friAanti
NOTARY PUBLIC
My Commission Expires: „3 i i
RECO 20) 7 35PM
IN BOOK V PAGE 3 S
FEES ,ii v pOUNTY CLERK
SUBLETTE CO Y, PIN A i: LE, WY OMING
izize
STATE OF WYOMING
ss.
COUNTY OF LINCOLN
DEBRA A. HANSEN NOTARY PUBLIC
COUNTY OF
LINCOLN
STATE OF
WYOMING
MY COMMISSION EXPIRES t7 /5
4
AFFIDAVIT OF SUCCESSOR CO- TRUSTEE
UPON DEATH OF RICHARD R. SEVERNS, TRUSTEE
I, ROBERT D. SEVERNS, being of lawful age and being first duly sworn upon my oath, deposes
and states as follows:
1. That my father, Richard R. Severns was the Trustor of the Richard and Gail Severns Trust, dated
June 24, 1997 and any amendments thereto.
2. That on September 8, 2011, my mother Gail Severns died.
3. That on December 18, 2013, my father, Richard R. Severns died.
4. That in the Richard and Gail Severns Trust, dated June 24, 1997 and any amendments thereto, I was
appointed to act as a Successor Co- Trustee of that Trust in conjunction with my sister, K. Megan
Alexander, jointly or the survivor upon the death of Richard R. Severns, Trustee.
5. That I hereby accept the appointment of my father to act as a Successor Co- Trustee of the Richard
and Gail Severns Trust, dated June 24, 1997 and any amendments thereto.
6. That in accepting that appointment I receive all powers and accept all limitations and obligations of
a Successor Co-Trustee as set forth in the Richard and Gail Severns Trust, dated June 24, 1997.
Dated this ,q da of December, 2013.
ROBERT D. SEVERNS
I, ROBERT D. SEVERNS, being first duly sworn, states that I am the affiant noted above, that I have
read the same, know the contents thereof, and that the statements contained therein are true.
ROBERT D. SEVERNS
This Affidavit of Successor Co- Trustee Upon Death of Richard R. Severns was subscribed and sworn
to before me this 9 f41 day of December, 2013 by Robert D. Severns.
/I(T)V
NOTARY PUBLIC
My Commission Expires: c3/-,75//5
titz�tt} i 7)T( \1 i17�t? v1!; 2;:7;0SPI \11
CERTIFICAT R` 1\
AL RECORD ws
S WY I
DEPARTMENT OF :.HEALTH
%WVyfi's f6Fiii /ftT r ilr'Sa1 4 'e g si1 aA' /(AN'( "9 ;;IM
State File Number:
2013- 004030
James McBride
Deputy State Registrar
Decedent:
•:Name:
>Gender:
Date of Birth:
Date and:Place of Death
•'Date of Beath. "December 18';'.2013
'City of Death: Kemmerer
;location: South Lincoln'MedicalCenter PO 39.0''
A 'Additional Information:.
Place of Birth: Encampment, Wyoming
:Residence Kemmerer; Wyoming;;
)'Marital Status Widowed
Armed Forces: No
A Father: Robert William Severns
Name of Mother Velma Lilitan'Olsop ii
Informant:. Megan Alexander,
isposltion:.
e thod 'of Disposition: Cremation'
ace of Disposition: UFD Cremation Center, South Jordan, Utah
Funeral,Home or Facility:
Facility: Crandall Funeral Home Evanston, Wyoming'
CauseofDeath:
The immediate cause is listed: on the first Tine followeetily any underlying causes.
'(a) Cardiorespiratory Arrest
(b) COPD
Other. Significant
:Conditions
Manner'of Death
Certifier•
'Type:
Names
Qddres1:
Date Filed:
289
Richard Ray Severns.,
Male
February 23, 1937
Natural Death
Metastatic Bladder Cancer
Physician
George Krell, M.D.
PO Box 390, Kemmerer,. Wyoming, 83101
January 03, 201 :4.
This is a true certification of the document on file in the office of Vital
Statistics Services Cheyenne Wyoming
DATE Monday, 40nuary06,.2014
f` py.: P paper S
;This po rs not:valid unl g.pre ared op a er with an en 'ru�ed.bordq.
Social Security N Fber
Age at the Time of Death:
County of De
76 years
Lincoln
Interval:
Minutes
Decades
Time.of Death:
02:07 (Actual)
13
--Other Significant
Conditions
Mannerof Death:: Natural Death
STATE' OF 11NYOI
DEPARTMENT OF HEALTH
OF DEATH
Cremation
UFD Cremation Center; South Jordan Utah
BaII Family .Chapel Evanston W
State File Number:
Social Security Number
Age at the Time of Death:
..Certifier:
Type: Coroner
Name: William Ball, Deputy Coroner
Address 800 Uinta .Street,:Eyanston Wyoming, 82930
";Date Filed. October 06, 2011.
Relationship: Husband
s.M7
Deputy State Registrar
2011= 002978
72 years
Uinta
!:Decedent:
ame:
Gender:
:Date of Birth:
Now Zr a s 0
ate and Place of Death:
'Date of Death 'September OS 2011
•City of Death: Evanston
Location: Rocky Mountain Care ,475 YeIIoW Creek Rd
Additional Decedent Information:
Place of Birth: Lander, Wyoming
Ftesidet ce Kemmerer Wyoming
"Marital qtatus Married Richard R St ferns
Armed Forces No
Name of. Father: Carl David Olson
Name of Mother. Azna Marguerite Brothers:
informant: Richard R. Severns
isposiition:
tthod of Disposition:
ixs
pla of Disposition:
i sr
Fun`er' Home or Facility
Facility:
Cause,of
The immediate cause fs li on the first line followed by a n y u nderlying causes.
(a).Cancer of the Lung
*I tg m, r lrl f SiS� .:Y, ea; \1y 1 7s �r r.�, R.RJi: R4^%:(�
-1 '�S`��. an b 2 Es?cc� Yt„ j E �$e'6 ''t�ifFr
CERTIFICATION.OF.VITAL RECORD'
Gail Ann Severns
Female
December 30, 1938
This is a.true of the document on file in the office of Vital
Stahshcs.Sernces Cheyenne Wyoming.
1 ATEISSUED: Wednesday, February 26 2014
This prepared on paper withanengraved border.
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