HomeMy WebLinkAbout886323 RECEIVED
LINP, OLN ¢,OUNTY CLERK
88632_3
AFFIDAVIT OF COLLECTION AND DISTRIBUTION
DECEDENT' S PERSONAL PROPE~
The undersigned, being first duly sworn, on oath deposes and
states that I am making this affidavit pursuant to Section 2-1-201,
W.S.A. (2001), as amended, as Successor Trustee of the Jimmie Ann
Wideman Trust dated January 26, 1998, and that I make the following
statements in connection therewith:
That Jimmie Ann Wideman died on or about November 6,
2002, in Lincoln County, Wyoming, andwas a resident of
Lincoln County, State of Wyoming, at the time of her
death; that said decedent died testate; that I am the
sole and only party entitled to the property-of the
decedent pursuant to her Last Will and Testament dated
October 7, 1999, a true copy of which is attached hereto.
That the value of the entire estate
administration wherever located, less
encumbrances, does not exceed $150,000.00.
subject to
liens and
o
That more than thirty (30) days have elapsed since the
date of death of the decedent.
That no application or petition for the appointment of a
personal representative of said decedent is pending or
has been granted in any jurisdiction.
5. That the only personal property owned solely by said
decedent not otherwise disposed of is the following:
Proceeds payable pursuant to a Peoples Benefit
Life Insurance Company (4333 Edgewood Road NE,
P.O. Box 3183, Cedar RaPids, IA 52406-3183)
policy to the "Residuary Estate for Jimmie Ann
Wideman" - Annuity Number 520TI40562
The undersigned requests that the above-mentioned annuity
proceeds be distributed to Kathleen Carollo, as Successor
Trustee of the Jimmie Ann Wideman Trust dated January 26,
1998, P.O. Box 59!, Kemmerer, WY 83101.
DATED this {'%4~- day of ~£b_b~.~L
, 2002.
ia{[ieee-- Carollo, Successor
Trustee of the Jimmie Ann
Wideman Trust dated January 26,
1998·
THE STATE OF WYOMING
COUNTY OF LINCOLN
) ss
)
The above and foregoing instrument was acknowledged before me
this I'q day of .~c~..T , 2002, by Kathleen Carollo,
Successor TrUstee of the Jimmie Ann.Wideman Trust dated January 26,
1998.
WITNESS my hand and .official seal·
Notary Public
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