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AFFIDAVIT OF SURVIVORSHIP
THE STATE OF WYOMING )
CO~TY OE LZ~CO~ )
DORIS J. DEGRAW, being first duly sworn upon her oath, deposes
and states as follows: ~
1. On the 7th day of November, 2001, my h~sband, WILLIA24
RICHARD DEGRAW, also known as WILLIAM R. DeGRAW, passed away,, as is
evidenced by the official certificate of death attached hereto and
incorporated herein by this reference.
2. At the time of his death, my hU'sband jointly owned certain
real property with me, said property being located in the County of
Lincoln, State of Wyoming, and more particularly described as
follows:
Lots 12, 13 and 14, Block 7, of the Town of LaBarge,
Lincoln County, Wyoming.
3. Said"real.propertyinterest was originally conveyed to
William R. DeGraw and Doris J. DeGraw, husband and wife, by a
Warranty Deed dated November 5, 1955 and recorded in the Office of
the Lincoln County Clerk and Ex-Officio Register of Deeds on
November 5, 1955 in Book 12PR at Page 538; and a Quitclaim Deed
dated November 5, 1955 and recorded in the Office of the Lincoln
County Clerk and Ex-Officzo Register of Deeds on November 5, 1955
in Book 12PR at Page 539; and a Warranty Deed dated December 13,
2000 and recorded in the Office of the Lincoln County Clerk and Ex-
Officio Register of Deeds On December 20, 2000 in Book 457PR at
Pa~e 197.
4. By reason of my husband's death, I became entitled to sole
ownership of the ab_ove-described real property.
SUB~BED,~~~ SWORN to and acknowledged before me this ~~,
day o~~~ , 2001, by DORIS J. DEG~W.
[85. HA~E.~S my hand and official seal/~
{~, ~
~,LE
~b TIME OF DEATH (24 h~ c/ock
':~~""/~ :' '"' ' '. ~ ~H ~a ~m ~ R NUMBER
October I3~-192 ,:~:~: ~,~ ~F~ ....
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' · .. Salt L~L~¢~~~a~e'-~ , Doris Jean Bau hman
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'~' ~;": 4 ~GacneP Crematory Salt Lake City Utah
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C~FIER ~ 2. M~DIO~,
~ MANNEROFB~ ,?,~?Y[~; ~)~D~J~ID~ ~tZj'laSb TI~OF~fly 3~ NJURYAT~? ~ p 0 N~RY-AIh · fa~ si facto
,, ,'.
I l~. ~ul~ ., T I 4. ,.'H°~'~l~ ~)~ ,: , ,'~ z~ ~: ~ .:,.'~ ~ ~ '~ ~ ~' ""~? ~ , ' ' ' ~ ~ ~s~ , '
, .... .'"",:,
Rev, 1~6 .: ~ ,. ~,, .v; ;',;;~' ~ ,,~.';~"~ ~,~;':~ :'
that this
I~ to certify office. T~is certified copy is issued ~ ' ,,
-:~underaut~ority of sectionl
' DaCe:Issued: ~NOVEHBE
County
~ SALT LAKE
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