HomeMy WebLinkAbout979269RECORDING REQUESTED BY,
WHEN RECORDED MAIL TO and
MAIL TAX STATEMENTS TO:
Michael R. Pope
12545 Quail Meadow Drive
Auburn, California 95603
A.P.N.: 3718-283-01-011.00
STATE OF CALIFORNIA
COUNTY OF CONTRA COSTA
Dated: November 4, 2014
979269 11/12/2014 11:36 AM
LINCOLN COUNTY FEES: $18.00 PAGE 1 OF 3
BOOK: 843 PAGE: 152 AFFIDAVIT
JEANNE WAGNER, LINCOLN COUNTY CLERK
111111111111111111111111111111111111111111111111111111111111111111111111111111
AFFIDAVIT DEATH OF TRUSTEE
Michael R. Pope, of legal age, being first duly sworn, deposes and says:
That Barbara Marie Pope, the decedent mentioned in the attached certified copy of Certificate of
Death, is the same person as Barbara M. Pope, Trustee, named as one of the parties in that certain
deed:
Dated: March 19, 2003
Executed By: Barbara M. Pope
To: Barbara M. Pope, as Trustee of The Pope Family
Exemption Trust UDT dated March 3, 1987
Recorded Instrument Number: 889458
Recording Date: April 24, 2003
of Official Records of Lincoln County, Wyoming, covering the following described real property, more
particularly described as:
Lot Three (3) of the Forest Meadows Subdivision, Lincoln County, Wyoming.
SUBJECT to all easements, exceptions, restrictions, reservations and rights of way of sight
or record, including without limitation those conditions and restrictions set forth in a
Declaration recorded in Book 180 P.R., Page 650, as amended by an Amendment
recorded in Book 274, P.R., Page 121.
Together with all improvements and appurtenances thereon.
THE SUCCESSOR TRUSTEE/ CO- TRUSTEE OF THE TRUST, WITH FULL RIGHT TO SELL OR ENCUMBER THE
PROPERTY DESCRIBED HEREIN, IS MICHAEL R. POPE.
MAIL TAX STATEMENTS TO ADDRESS SET FORTH ABOVE
MICHAEL R. POPE
STATE OF CALIFORNIA
COUNTY OF CONTRA COSTA
Subscribed and sworn to (or affirmed) before me on this November 4, 2014, by Michael R. Pope, who
proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
Signature:
Sara E. Harrison, Comm. No. 1953899, Expires 09/25/2015
Contra Costa County, Stamp Manu. NR01, (925) 906 -1880
JURAT
z
MAIL TAX STATEMENTS TO ADDRESS SET FORTH ABOVE
SARA E. HARRISON
COMM. #1953899
Notary Public California c
Contra Costa County
Comm. .fires -..25 2015
•'S. BIRTJe.STATE)F.OREIGN•COUNTRY
15..EDUCA71O117't42004STLOwYDegne
:1I139e".WaolHASF SAhlq
BACHELOR
1 T :USUAL OCCUPATION -Type of work for most of Ilre: DO,NOT USE•RETIRED
TEACHER
P..L I ASANT.:- :R ILL::::;
20: INFORMANTS NAME, RELATJONSNIP'
CATHY MANN, D:At:1G,HTE
20. NAME OF SURVIVING SPOUSEISROP -FIRST
•:,59. O1SPOSTON'O mMCGle ryy.:.:
09/27/2014:
41. TYPE OF DISPOSITION(S) fr
':44i NAME•OP.FUNERAUEBTAB)ISRMENT `n
L• AY,)f.N O EST •Ct• ;L
(0)
09/12/2014
126. SIGNATURE OE :CORONER/ DEPUTY CORONER
TD:.SOCIAL' SECURLTY NUMBER
116.1GERRFE3RAT IN MY OPINION DEATH OCCURRED AT THE HOUR, GATE .0 suicide STATED FROM TRECAUSES STATED.
Coul
MAN, EATI
.1ER•0F0 WIptiFal 'Accident El 1 m .Ac lolcbe 1 1 0 clO mlg.... u tle d rtn�inetl e
'::':.l I II III II I II II I II I I I I r' I I I I I I II I II o01 V III VI 1 VIII I I I II 1* 11111 11111111 I I II I111V I I I/
.oto 0 02743 2 2
X 18: KIND OFB4511JESS INDI S I' (e,;g;j;
EL'EMENTARY
6 SIG NATURE OP' REG STRAR
W
it W iIF OTHER THAN HOSPITAL, SPECIFY ONE
Nursing Decedent's
HoapKee'AFi Home/LTC Home
;1Vne Interval Between
;;•(Goss, and De40t•};
107. CAUSE OF DEATH ,t,S Entdra chain of events &series :.VAurlea cemplcalg0T tbatdrecly S 9edtleattwoo NOT to t nN N; to such
\1 1 rdl sl piaory arrest, orvenlrl II(TbellatbnWihoUt enoW gth h ippy DONOTABEREv(A,TE
amb ,4T.SQ th .1,A) BLE EDING ET IOLOGY U NKNOWN (4 01 A YE Q(tOSE,p•) GA BLE
In e a;*11.) 0 0)
Se9u11tf I l Ry k a4♦ F F r u
canditl I Y
onT A cause:. y.
UN L'neYIEGtas` 1'
CAUSE (dlseoge;o
I nitiated the evbnta WO
I
resulting In [teeth) LAST
.115. WAS OPERATIONL'PERFORMEOFOR ANKCONOf.T1O1H:
yes.alat type or epe.bBpn'arid m
110. AUTOPSYPERFORMEDT
L7 NO
:11.1VUSEDJNDETERMI
112. OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH BUT NOT RESULTING IN THE UNDERLYING CAUSE LIVEN 1N 107,...
CLOSTRIDIUM.,DIFFICILE NFECTION' SEVERE END STAGE :D:EMENTI
::fi gi FEnv.4:tPRE6Ngt :∎1 .iAsrrEARa
116. LICENSE NUMBER 11T.. DATE mMdd/ccW
A'.26•IO?Q;r;,: 09/26/2.'01
116. A
TYP /1:5NOIN(1:4S
NVIQIRN•S N MAI (•JG q[IFAESS, ZIP CO'+,E 7:v
•,r::.e JAM Ct- 1�ac
4501 1R EK,; LDr ARTIo.CH, CA:J.453
-122;;HgUR;•124 444i4)
;12S, PtJ!.C6JJP INJURY (A; :9 0lt0, wooGeda eo(4 d;j
/125. LOCATION QF INJURY (Street. and ,,umber. or
F !S:RESIOT:I4 QE (S(iget 0rlaFetlon)
AY
L oI.SF99moN LAWNORE;ST ME MQRIAI,::';P,
;PRESS` SV E; :REDDI N:G;'.;;CA''.•96002'
COUNTY OF CONTRA CAST
9s:•kiruealii� fact reproductitin of the document officially registered and placed on 616. �nth2ii$icegY4lietCOLIMACOS`I• O:10N'1'M i?AYzTMENEOFHEALTHSERVICES
UNKNOWN
•CENSUS Tli%1[
'�L¢ L ZMLLiiL4`1�4 >p r a t o`I_ �,o:'i