HomeMy WebLinkAbout979518STATE OF WYOMING
COUNTY OF LINCOLN
AFFIDAVIT OF SURVIVORSHIP
SS.
979518 12/1/2014 2:40 PM
LINCOLN COUNTY FEES: $18.00 PAGE 1 OF 3
BOOK: 844 PAGE: 162 AFFIDAVIT
JEANNE WAGNER, LINCOLN COUNTY CLERK
111 111 1111 1111 IIII II II
Kate Resig of Afton, Lincoln County, Wyoming, upon her oath deposes and says:
1. That MARK RESIG aka Mark Ralph Resig, the decedent mentioned in the attached
copy of Certificate of Death, is the same person as MARK RESIG named as one of the grantees in
that certain Warranty Deed dated the 10th day of May, 2001, executed by Jean Golden, a single
person, grantor, and recorded May 11, 2001, as Instrument No. 873228 in Book 464 PR, page 244,
of the Official Records of Lincoln County, Wyoming, covering the following described real property
located in Lincoln County, Wyoming, to -wit:
Lot 1 of the Fox Hollow Subdivision, Lincoln County, Wyoming, as described on the
official plat thereof.
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 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 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 RESIG, in
the lands described in the foregoing, subject to any then existing liens and encumbrances.
DATED as of the 25th day of November, 2014.
1
Kate Resig
Subscribed and sworn to by Kate Resig before me this 25th day of November, 2014.
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.
2
NOTARY PUBLIC
7
CERTIFICATE :QF
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1
Decedent: State File Number:
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Ivi Ralrii\F*0
Name
i Geoder:
Date of Birth: Augus127, 172-.:i,„
Male,
So6ial NUMber:
s
Age et the of Death: ,:,i...,,....., 7 years 1
bate and Place of Death
bate of i)eath:
i.,
S ber 08 2014 eptem
bOunty Of i)
Lincoln
pity of Death Afton
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Addi tional Decedent Informaijan. (7 ifotrili
P■ft9r r i. ...;'-itherinA
a Wyoming dafriaitis
-of rivP.i'''''',7 '.1::::::, ..iif•-•
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Married Mary13:.i.,•..„:::•?•-•:„:`:
Name of Mother:
Name of Father
Armed Forces:-
Marital Status:
InfOrmant:. Graniu9_ Relationship p
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No 4
Ralph Ei'lljikR161.'::'1..'.!:.k.'.. 1: :1- L
Orphie ri
iit e l t p h o od oi l o D i f o i D s n is p P .5 o it s: 9 ii n io i.. r:: 1 :, :i_ sCMcrae:.:11:111riaaKtbi;mbh:::::[...ti::L13.•iil':::.6.'s,..r.ige0:;;'.i'\'.:,;...,.....,'.7'y-'9-:i:i..,...,,i;16t.:.:::.;'...\IY.-•,:. 1,..r.'..o7, i .,..i i
1,1 1 ..Funeral
Facility:
or Fac Schwab .:::::::'.2.::::-;"::::/' ','i:::,:,• causes
The immediat cause is listed on the first Jibe f91161/640ypliyoncleilying
(a) Metastatic Melanoma, (Stage IV)
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CERTIFICATION
:PtherSighificant:.
Conditions:
Manner of Death: Natural Death
Certuer
Physician
Donald Kirk, MD
122 Petersen Ptwy Sute 4 thaYne, Wyoming
\Septembee i5, 2014
Address
Date Filed:
700930
DkP AIITIVIENT.OP:1EA14TH•1
This is a true certification of the document on file in the office of Vital
Statistics ServicesCheyenne, Wyoming;-
I DATEIS8Ueb: Tuesday, Septeriber 16;-2014
nqvalicimiless prepared 9 .0 paper with 9engravedborder..":
AL RECORD
AuterlennBaxth.Note Cotap
/014-002869
1.• avas •1 9.
James Mean e
Deputy State. Registrar 9
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