HomeMy WebLinkAbout979439STATE OF ARIZONA
COUNTY OF Or
Brenda A. Braswell, being of lawful age and being first duly sworn according to law, on
oath deposes and states:
1. J.D. Braswell and Brenda A. Braswell created the Braswell Living Trust dated November
20, 2006. Said Trust appointed J.D. Braswell and Brenda A. Braswell as the initial trustees of the
Trust.
2. By Quitclaim Deed dated December 12, 2006, J.D. Braswell and Brenda A. Braswell,
Trustees, or their successors in trust, under the Braswell Living Trust, dated November 20, 2006,
became the owners of certain real property located in Lincoln County, Wyoming, to wit:
Said Quitclaim deed was recorded in Book 645, at page 323 of the records of the Lincoln County
Clerk, Kemmerer, Wyoming, on January 3, 2007.
3. J.D. Braswell died on August 25, 2013, at Pima County, Arizona. Attached hereto is a
certified copy of the Death Certificate of J.D. Braswell.
4. Pursuant to Article Three, Section 4. of the Braswell Living Trust dated November 20,
2006, Brenda A. Braswell, became the sole trustee of the Braswell Living Trust dated November 20,
2006, upon the death of J.D. Braswell.
5. This Affidavit is made pursuant to Wyoming Statute §34 -2 -123 for the purpose of
establishing that, following the death of J.D. Braswell, Brenda A. Braswell is lawfully serving as the
sole trustee of the Braswell Living Trust dated November 20, 2006, with the power to convey and
distribute the property of the Trust according to its terms.
1 i
Brenda A. Braswell
The above and foregoing Affidavit CccesOon was subscribed and sworn to before me by
Brenda A. Braswell this Z day of 2014.
My Commission expires: i0- 20 15
ss.
Witness my hand and official seal.
979439 11/21/2014 12:53 PM
LINCOLN COUNTY FEES: $15.00 PAGE 1 OF 2
BOOK: 843 PAGE: 765 AFFIDAVIT
JEANNE WAGNER, LINCOLN COUNTY CLERK
1IIIIIII HIII II I IIIIII IIII II II1III IIII IIIII II ll IIIII 11111 IIII II1III IIII III
AFFIDAVIT OF SUCCESSION OF TRUSTEE
Lot 107 in Star Valley Ranch Plat Eighteen (18) as platted and recorded in the
official records of Lincoln County, Wyoming.
Notary Pu
OFFICIAL SEAL
SUSAN M. KELLNER
NOTARY PUBLIC-ARIZONA
PIMA COUNTY
My Comm. Exp. Aug. 10, 2015
CERTIFICATION OF VITAL RECORD
u';. 'STA E OF ARIZONA
OF HEALTH•SERVICES OFFICE OF- RECORD
CERTIFICATE OF DEATH
_State FIIe�IN�
01✓DECEDPN17SMEOAL NAMEjFIRST, MIDDLE, LAST)
y, q ilt
J BRASWELL.JR
SOCIAL"SECURITY.NUMBER:'<'
;.12 PLACE OF DEATkf HOSPITAL
INPAZIENT 0 E R /OUTPATIENT DEAD, ON ARRIVAL"
25 WAS; :DECEDENTOF HISPANIC 'ORIGIN?
NO NOT •SPANISH. HISPANIC OR LATINO
-fl YES, MEXICAN MEXICAN AMERICAN, CHICANO
YES PUERTO RICAN
-0 YES CUBAN
YES OTHER (SPECIFY)
•DUE TO OR'AS`A''`-
CONSEOUENCE-OF:'.
6.DATEOFBIRTH
07/20/1921
13. P„ CE OF DEATH OTHER THAN HOSPITAL:
0 CARE LOT E OR LONG TERM. RESIDENCE 0 HOSPICE FACILITY
14: •FACILITYNAME(OR-STREETADDRESS IF NOT A FACILITY):
26600 HWY 831
15 CITY TOWN -ZIP CODE,OR LOCATION OF DEATH:
OREATERVILLE 85637
29 FATHERS NC1�E'(FIRST IMID
J.D BRASWELL
31 INFORMANT S NAME
BRENDA ANIJ BRASW
18. MARITAL STATUS -AT TIME OF?
DEATH:
MARRIED
21. CITY AND COUNTY:
GREATERVILLE, PIMA
26; DECEDENT'S RACE(S)
WHITE,
❑'BLACK, AFRICAN AMERICAN
NATIVE HAWAIIAN
❑!'ASIAN INDIAN
CHINESE
FILIPINO
f JAFANl E SE
GUAMANIAN OR'
CHORRO
k OREAN
1 1/IETNAMESE
SAMOAN rs e
❑-4MERICAN_INDIAN900SI NAfI
OTHER PACIFIC ISLANDER
3b'MOTHER'S NAME>(WRST'MIP
COLLEYEnMARY EVANS
qLE LAST NAME PRIOR TO FIRST MARRIAGE
34 NAMEANDADDRESS OE FUNERA
HATFIELD FUNERAL HOME 830 SOUTH,FtGHWAY IS E RA�;V
UNDERAIYEAR id
8. MONT
23 ZIRrCODE
1456
MOM
m iT:� wry-
37 METHOD(S) OF DISPOSITION
CREMATION' i; l ;il;U'
38; NAME AND ,LOcATION;OF 1st DISp„ SITION`
VISTA MOUNTAIN.CREMATOR `SIERRA:
A I i i iJ I I r
t ESPIRATORY ARREST
39 ;NAME AND'LOCATION 2nd DISPOSITION FACILIT
METASTATIC PROSTATE CANCER
DUE .TO,OR:ASA 46:D
CONSEQUENCE OF:
481 OTHER• SIGNIFICANTCONDITIONS CONTRIBUTING TO DEATH BUT NOT RESULTING
SIN THE If DERgING C'A1) ES,OWEN ABOVE
I
DIABETES, CORONARY ARTERY DISEASE
Egi urse Practitioner /Physician's Assistant To the best of my
knowledge death Dgcurred due_to the.cause(s) and manner stated.
o Medical _Examinel law Enforcement Authonty ,'On the basis!of examination
and/or investigationi•in my opinion death•occurred at,th9 date and place; ani
due to :the cause(s)`and manner stated:
Meaexuaropiromt,gatio
,NDMANNERIO ,i
49INJURY 50 INJURY
NO NO
53 WAS AN AUTOPSY PERFOPMED7
55. OF PERSON; OF pEATH:
IM P. MARTINEZ,:M.D.
tV) Io, k,VrlfiVfkitlli
524reg. p ATF{ 14
da Ja ii 9 4 P :rl�rlill'L'oI
Sp.MANNE OFj'pE/
i,4 r yh l r
NATURAL'IOEATFI''`.'I �g20 IJ!f
54 WERE AUTOPSY FINDINGS AVAILABLE,.
�s,:
57 CERTIFIER S ADDRESS R =�j
6236 E'PIMA ST TUCSON, AZ 85712 -3020
8: NAME.OF REGISTRAR:
AUDREY ROGERS'
UNDER.I.DAY'
ADDtTIONAt
27 IF AMERICAN INDIAN'OR AIASKA
SPECIFY.UP704TR1.11E$
PRIMARY,01 ENROLLED CRIBS
OaMA T S'
MAILI G gQP,Fs
SONOITA,'ARIZONA 85
45APPROXIMATE INTERVAL
This'is a true certihcation'ofthe fact on file with the OF OF VITAL RECORDS :1 i KHALEEL I jl1SSAINI
ARIZON DEPARTMENT OF HEALTH SERVICES, PHOENIX, ARIZONA A SISTANTISTATE REGISTRA
Re vi t ed 12/2012"
This copy not valid unless, prepared on a form displaying the State Seal and impressed with the raised seal of the Issuing agerie
ANY ALTERATION OR ERASURE VOIDS THIS DOCUMENT
Arizona
Department of
Health Services