HomeMy WebLinkAbout979517STATE OF WYOMING
COUNTY OF LINCOLN
AFFIDAVIT OF SURVIVORSHIP
979517 12/1/2014 2:39 PM
LINCOLN COUNTY FEES: $18.00 PAGE 1 OF 3
BOOK: 844 PAGE: 159 AFFIDAVIT
SS. JEANNE WAGNER, LINCOLN COUNTY CLERK
11111111111111111111111111111II111IIIIIIIIIIIIIIIIIIIIIII11111IIIIIIIIIIIIIIIIII
Kate Resig of Afton, Lincoln County, Wyoming, upon her oath deposes and says:
1. That MARK R. RESIG aka Mark Ralph Resig, the decedent mentioned in the
attached copy of Certificate of Death, is the same person as MARK R. RESIG named as one of the
grantees in that certain Warranty Deed dated the 24th day of August, 2004, executed by Alan L.
Motzkus and Sharan Motzkus, husband and wife, grantors, and recorded August 25, 2004, as
Instrument No. 902298 in Book 565 PR, page 689, of the Official Records of Lincoln County,
Wyoming, covering the following described real property located in Lincoln County, Wyoming, to-
wit:
Lot 4 of Rainbow Meadows, Lincoln County, Wyoming, as described on the official
plat No. 195 -E filed September 4, 2003, as Instrument No. 893114 of the records of
the Lincoln County Clerk.
SUBJECT, however, to all reservations, restrictions, protective covenants,
exceptions, easements and rights -of -way of record, in sight, or in use.
2. That the undersigned affiant is the same identical person as Kate Resig named as
one of the grantees in the above described Warranty Deed, that she and MARK R. RESIG were
husband and wife at the time of the execution and recording of the Warranty Deed described
above, and that as the surviving cotenant and spouse of MARK R. RESIG, named in said
conveyance, the undersigned, Kate Resig, became on September 8, 2014, the date of the death of
the aforementioned decedent, the owner of the lands or the owner of any interest of MARK R.
RESIG, in the lands described in the foregoing, subject to any then existing liens and
encumbrances.
1
Witness my hand and official seal.
GERALD L GOULDING NOTARY PUBLIC
County of
Lincoln
State of
Wyoming
My Commission Expires May 2, 2015
My commission expires: May 2, 2015.
DATED as of the 25th day of November, 2014.
Kate Resig
Subscribed and sworn to by Kate Resig before me this 25th day of November, 2014.
e e,u1.1_4/0.E)
2
NOTARY PUBLIC
Decedent:
Name:
:Gender:
Date of Birth:
Date and Place of Death:'
Date of Death:
r r :City of Death:
Location:
Additional Decedent Infor
Place of Birth:
Other Significant:::-
Conditions:
Manner of Death
Cel tifier:
TyPe:
Name:
Address:.
Date Filed:
matron
Orange California
Afton Wyoming
-(vlarried Mary KatherineAdamaitls.=
Ralph Emi Resig
Orphie Granlund
Mary Katherine Resl
79.0925
This is a true certification of the document on file in the office of Vital
Statistics Services Cheyenne, Wyoming:
DATE "ISSUED. Tuesday, September 16;'2014
This copy,rs not.. valid. unless prepared on paper with an engraved border.;
RTIFIOATE' OF DEATH
State File Number
SoclalSeCurity Number.
Age at the Time_ofDeah:
Resldehca
`Marital;Status:
,Armed Forces :1
>Name of F ather
Name. of Mother:
.Informant:.,
Di position
M ethod -of Dispositiol Cremation
P lace of Disposition I Schwab Mortuary Cremato
Funeral Home or. Facility:
Facility: 'Schwab Mortuary Afton `Wyomin
Cause of Death
The imrrie cause is listed on the first hne followwd by underlying causes
(a) Metastatic Melanoma,. (Stage IV)
Relations
Physician
Donald Kirk, MD
122 Petersen Pkwy Suite 4 thane, Wyoming, 83127
September`15, 2014
amteS /;7
James McBride
Deputy State R egistrar
2014 002869
62 years
lq
is
Vx
r7
+yt ttf V sac, ire stPi%
CERTIFICATION OF VITAL RECORD
y ,:f tla�� O