HomeMy WebLinkAbout888414STATE OF WYOMING
COUNTY OF LINCOLN
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RECEIVED
LINCOLN OOUNTY CLERK
AFFIDAVIT OF SURVIVORSHIP
I, VALDEE HEAP, being first duly sworn, states as follows:
1. That on October 14, 1993, CAROL LaMONA HEAP passed away, a copy of the
Death Certificate'is atta6hed.
2. That because of the foregoing, VALDEE HEAP has full rights of survivorship
and title to the subject property described in the Quit Claim Deed attached hereto as Exhibit A
DATED this 'Z G day of February, 2003.
VALDEE '~IE-AP
The. foregoing Affidavit was acknowledged before me by Valdee Heap this '2~ day of
February, 2003.
Witness my hand and official seal.
N A~RY PU~Li~C
My Commission Expires:
:: ':' FOR
::! INSTRUCTION'S
SE[:
~ANOBOOK
DEPARTMENT OF: HEALTH
783
........ :~ :STATE:OF WYOMING L~ :~ C{ r.] ~ .~ ~
::~::::DE PARTMENT OF HEALTH
L~C~9~--~SE. CERTIFICATE OF DEATH
Carol La~0n~ :? :;:::: HEAp ?:~: :;~:..~::: F~le': October 14,
I
~:? 7'?/:1 ' '~:':'1'::' ;~' ':F September 6,
520:::- 38 607.5 I ;~::~ : :: ;~::; ::1 :::::: ./
Washa~kie Memorial %Ios
California:
1993
1936
7 ~:'CIT¥: TOWN,' OR k~)CAlK)N QE DEATH
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Heap
Office
Worland,. Nyoming
VR 2~89
2/91 15M
NAME *NO AD~RESS:~::CERTIFIER (pH¥~iC1AN
RichA:rd::M' ~hsh::;::' -::::Worland, Wyoming 82401
This ~s a '[rue aha exact reproduction of the aocument on file in [he office of Vital
Records S ..... Chey~EwE~om~)g
O 20.03;:;
DATE ISSUED: LDclnda McCaffrey
Deputy State Reg~s[rar
:Th~s.copy ~ not v~Jd uni¢ss