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887 31
REOEIVED
LtI'.ICOLk! OOUr,.ITY CLERK
BOOK ~LJ_ _PR PAGE
AFFIDAVIT
STATE OF WYOMING
COUNTY OF LINCOLN
I James C. Prather, being first duly sworn on oath, depose and say:
That I am a citizen of the United States of America over the age of 21 years, and a
resident of Rock Springs, Wyoming
q~mt I was well mad personally acquainted with Beverly A. Prather, in that certain
Warranty Deed dated 04/22/96 and recorded 04/24/96 in Book 382 P.R., Page 435
as Filing No. gl 8690 in the office of the Recorder of Lincoln County, Wyoming.
That I 'know of my own knowledge that Beverly A. Prather in the said deed and Beverly
Ann Prater mentioned in the attached Certified Copy of Certificate of Death was one in the same
person.
This Affidavit is intended to terminate the joint tenancy of said Beverly A. Prather, in thc
following described property:
SEE EXHIBIT "A" ATTACHED HERETO
.fi~es C. Prather
CIO .... J# ,
.0~:~I
OM~7431
STATE .OF. OMING
DEPARTMENT' OF.HEAI~TH
STATE OFWYOMING
CERTIFICATE OF DEATH
~EV~R~ ~ ~ ~TRE~ . FE~L~J iL 2A~R 0, 2002
~ 68 ~ ~ ~
~2o-~-~7~ .I .......... I ....... I I' I ~c~s~ ~s, ~9~
202~ CO~TY ~OAD 126'~] /'/? :";~?:.:. :'~;~;~: ~ ~?::::-~.::: :'". ::~?.::":': ?:E~NA J LINCOLN
. -::< '.:; .... :. [:: :.;~RIED .... :.:::::~::.: J~ES P~THER
NEB~S~
NO:::'. .... :? ..........MERC~NT .':'::.L_ :-; ..... :GIFT SHOP
~ ,~ :::::.sTOHN':; ,_ :.. 2: . PAUL~: ¥ ALLEN .::J' : .: LILLIAN CLEMENTSEN
,~iml~l~m~... JAidE~' pRATHER ils'...-!. ..... !i!:i!!:.:..:jl :. sPoUsE .
P. O. BOX 817 : i.(':::::ii!Ji'= ;iii}i: T~,YNE wYOMING:~::' 83127
' BURX~ .:::' · I~R[L'.' 25,2002 :/l:::' ~NEDALE CEHETER~ ..~ .... PXN~DALE
~ ~...~ ~ ~ _ . _'~ : I SCHWAB MORTUARY 45 I 44 EAST FOURTH AVE., AFTON
~ ' :~'-,':: :"'.:l .' J /o./7
q pAUL K: H~'XD:-MD:-':"::~;~:;/'".?: "/~:?:?;i~:0::~:~h6SP~:~X~'~N~~ ..... ~FT6N, ~OM:ING 83110 '
',~
VR:2-89
11/99::15M ~
This is a true and exact reproduction of the document on file in the office of Vital
Re,or sse i .... the, .... Wyom,ng.
DATE ISSUED: JAN 2 "~ 2003 :. ;:'" Lucinda mcCaffrey /
Deputy State Registrar
This copy is not v~id unlcss prepped on paper with ~ cn~ra~cd border displa~pg Ibc date seal and.si~na[urc o~ the Dcpu[y Stale
Exhibit "A"
A parcel of land located in the NE1/4, Section 23, T36N, Rllgw, 6th P.M.,
Lincoln County, Wyoming, and being more particularly described as follows:
Commencing at the Northeast corner of said SectiOn 23; thence S85o52'04"W,
535.25 fee~ to the point of beginning, being the Northeast corner of said
tract in Book 149 P.R., Page 730; thence S05o47,39,,E, 125.50 feet along the
East line of said tract in Book 149 P.R.; thence $87°21'44',W, 347.67 feet
along the North line of said tract in Book 274 P.R.; thence N05: 47'39"W,
125.50 feet along the West line of said tract in Book 149 P.R.; thence
NgT~21'44"E, 347.67 feet along the North line of said tract in Book 149
P.R. to the point of beginning.
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