HomeMy WebLinkAbout978743STATE OF CALIFORNIA
COUNTY OF SAN BERNARDINO
ss,
978743 10/9/2014 11:30 AM
LINCOLN COUNTY FEES: $24.00 PAGE 1 OF 5
BOOK: 841 PAGE: 52 AFFIDAVIT
JEANNE WAGNER LINCOLN COUNTY CLERK
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II II
AFFIDAVIT OF SURVIVORSHIP
I, ELLEN TIMMRECK, being first duly sworn, on oath depose and state that I
make this Affidavit pursuant to W.S. 2 -9 -102, on behalf of myself, as a distributee, as
hereinafter set forth, that I make the following statements in connection therewith:
1. I am the Affiant herein and am of adult age.
2. On May 25, 2004, ARCHIE CARL TIMMRECK passed away in Sandy,
Salt Lake County, State of Utah, as is evidenced by the Certificate of Death attached
hereto as Exhibit "A" and incorporated herein by this reference.
3. Decedent left Thomas Carl Timmreck as his surviving child.
4. At the time of Archie Carl Timmreck's death, he and his son, Thomas Carl
Timmreck, jointly owned certain real property located at 260 East Main Street, Cokeville,
County of Lincoln, State of Wyoming, as evidenced by a Warranty Deed recorded on
August 9, 1976 in Book 129PR Page 439, as No. 482328, and more particularly described
as follows:
The lots numbered sixteen, seventeen, eighteen, nineteen and twenty of the
block numbered one in the Town of Cokeville, as the same appears of
record on the maps and plats on file and of record in the office of the
County Clerk and Ex- officio Register of Deeds in and for said County of
Lincoln in the State of Wyoming.
5. At the time of Archie Carl Timmreck's death, said property passed to his
son, Thomas Carl Timmreck.
6. On November 5, 2013, Thomas Carl Timmreck passed away in Pomona,
Los Angeles County, California, as is evidenced by the Certificate of Death attached
hereto as "Exhibit B" and incorporated herein by this reference.
7. Decedent left Ellen Timmreck as surviving spouse. By reason of the death
of said Thomas Carl Timmreck, and by reason of W.S. 2 -9 -102, his interest and title in
Affidavit of Survivorship (Timmreck)
1 of 2
said Warranty Deed has terminated and title to the real property conveyed thereby has
vested in Ellen Timmreck.
8. That an executed copy of this Affidavit is being presented to the transfer
agent for the above listed assets in compliance with W.S. 2 -9 -102.
DATED this 30 day of Sii(, -xdad 2014.
STATE OF CALIFORNIA
COUNTY OF SAN BERNARDINO
SUBSCRIBED AND SWORN to before me, a Notarial Officer, by$I A tffEE
DAW 1 &AR this day of 2014.
My Commission Expires: J cO I g
gee_ 0. j esteki
oJ tr
ss.
ELLEN TIMMRECK
r
i ll NOTA Y PUBLIC
Odcetev3 14
Affidavit of Survivorship (Timmreck)
2 of 2
APA01 /2008
ALL PURPOSE ACKNOWLEDGMENT
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State of California
County of
On
k 3O ..e)/ L4 before me,
DATE
personally appeared c I P f uS hJntht_ who proved to me on the
basis of satisfactory evidence to be the person
S. D. MARQUEZ
COMM. N 2063373 t
YF M?r NO PUBLIC•CALIFORNIA
SAN BERNARDINO COUNTY .i
or Mr Comm. Exr. APR. 28, 201Y
TITLE(S)
SIGNER (PRINCIPAL) IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
CAPACITY CLAIMED BY SIGNER (PRINCIPAL)
KI INDIVIDUAL
CORPORATE OFFICER
PARTNER(S)
ATTORNEY -IN -FACT
TRUSTEE(S)
GUARDIAN /CONSERVATOR
OTHER:
SS.
whose name( 0aat subscribed to the within instrument
and acknowledged to me thatXfe /(i 'tliy executed the
same in Iffs thei authorized capacity(i and that
by Ws /their signature(s) on the instrument the
person(), or the entity upon behalf of which the
person(4 acted, executed the instrument.
1
1 certify under PENALTY OF PERU ':Y under the
laws of the State of California that the foregoing
paragraph is trace and correct
WITNESS my hand and official seal.
PLACE NOTARY SEAL IN ABOVE SPACE
OPTIONAL INFORMATION
The information below is optional. However, it may prove valuable and could prevent fraudulent attachment
of this form to an unauthorized document.
DESCRIPTION OF ATTACHED DOCUMENT
sa dio c 7 r t 1•�
TITLE OR TY
RIGHT
THUMBPRINT
OF
SIGNER
MBE
OF DOCUMENT
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