HomeMy WebLinkAbout889611 1
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
24
25
26
27
28
STATE OF GEORGIA
Co
SS~
BOOK51~C1) PRPAGE. 386
AFFIDAVIT OF SUCCESSOR TRUSTEE
REOE/VED
L/NCOL~J COUI'~T'r' CLERK
03
DEA~A G. SEGU~, being first duly sworn, deposes and says:
1. Affiant is over the age of 21 },ears and competent to be a witness as to the matters
hereinafter stated.
SPRADLING created the "SPRADLING FAMILY TRUST" dated
2. VERNON L.
October 7, 1996, wherein VERNON L. SPRADLING was designated as the original Trustee of said
trust.
3. The said VERNON L. SPRADLING died on February 15, 2003. A certified copy of
the Death Certificate is attached hereto as Exhibit "A" and incorporated herein by reference.
4. DEANNA G. SEGUIN and PHILIP BLAINE SPRADLING are named in said trust
instrument as the Successor Trustees.
5. The said PHILIP BLAINE SPRADLING died on January 9, 2003. A certified copy
of the Death Certificate is attached hereto as Exhibit "B" and incorporated herein by reference.
6. Pursuant to the provisions of the trust agreement, DEANNA G. SEGUIN now
becomes the sole Successor Trustee of the "SPtLADLING FAMILY TRUST", dated OCtober 7,
1996.
7. DEANNA G. SEGUIN hereby files this Affidavit and accepts the office of the sole
Su6cessor Trustee of the "SPRADLING FAMILY TRUST" dated October 7, 1996.
PEARSON, PATTON,
SHEA, FOLEY & KURTZ, P,C.
6900 WestcliffDrive, Suite 800
Las Vegas, Nevada 89145
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
1 8.
2
3
4
5
387
The real property conveyed to the "SPRADLING FAMILY TRUST" dated October
7, 1996, is situated in the County of Lincoln, State of Wyoming, bom~ded and described as follows:
LOT SIXTY-SEVEN (67) in Star Valley Ranch Plat Sixteen (16) as
platted and recorded in the Official Records of Lincoln County,
Wyoming.
SUBSCRIBED AND SWORN to before
met,~ /~' day of/~arch, 2003.
OTARY PUBLIC in and for COUNTY
of ~'e'{-q , STATE of GEORGIA
Gary W. Rheingrover
Notary Public, Coweta County, Georgia
My Comrn}s...ion Expiras March 2, 2004
When Recorded Mail to:
Nathaniel G. Hammford, Esq.
Pearson, Patton, Shea,
Foley & Kurtz, P.C.
Bank of America West
6900 Westcliff Drive, Suite 800
Las Vegas, NV 89145
(702) 228-7717
PEARSON, PATTON,
SHEA, FOLEY & KURTZ, PC.
6900 WestcliffDrive, Suite 800
Las Vegas, Nevada 891'15
2
001397
/OC..~ Ffl. E NUM~aER
DECEASED--N.4M£ Fi~
sT^~ or .Ev..D^ -- m'^.mE~ Or .U,.,.~..ESOU.C~S
mm,o. OF.~^.T. -- S~C~O. OF V,T^~. s'r^m',cs
388
STATE FIL~NUMBER
,. Vernon Lester SPRADLING z February· 15, 2003 Is,, Clark
Cfi'Y, TOWN OR LO~ATION OF: DEA'~( ] I"IOSPITAL OR OTHER INSTITUTI~f'; t'----~e (/I not mth,~r, give atreel an~ nu,~l~eZ) I II H~e¢. e¢ I~eL ~lclkT.~e OOA. OP.~mef, ] SEX
~ . fl~ I~ (S~)
. Las Ve~as ~. Mountain View Hospital ~. Inpatient ~. Male
~ ~ o~, P~ R~. ~' " I ~V (V~) MOS : ~YS ~ ~'MNS J ~ (~, D~V. W)
STA~ ~ 81RTH
j um~N ~ ~T COON- J ~'m r~.,~ S~ ~,
(~ ~ u~.~. ~ ~) I TRY ~ ~ ~- ' ' ' ~---' I ~EO,~EO' NEVER~EO~IED, ~ ~VmW~
~ Arkansas I~. USA ~1o. 17+ J(~ Widowed ~,z '
~ SECURJ~ NUMBER ~ ~ ~PAT~ (~ ~ ~ W~ ~ ~ ~ ~ ~ K~ OF BU$~ESS OR IN~S/Ry
..s,o~-smr~'" 530-70-3692 {~- Civil Service Specialist j,~.l US Air Force
..~
C~N~
C~.
~O~,
L~AT~
~... __Deanna Seguin [,~.45 Grange Crt.~ Sharpsburg, Georgia 30277
I
L~TION
I
T~
Cremation ['~. Memory Gardens Cre~torv ~,~ Las v,a~ w
~~) ,~ /Iluc~E,.,.U~° i~E~O~F~C~ BU.,
J UCENBE NUIdS.ER
~'Shargn~ander~ M.D.~ 1555 E. FlaminEo ~319~ Las Ve~as. NV 89119[~.
~ANY
WI"I~H GAVE
RISE TO
m~Eou,'rE
CAUSE /
WrA'II~ 'llqE /
DUE TO, OR
I ~' ~o J~. ~o
o~%~&~.~"~.,
~URY AT ~ I
~-~,} -~ m ~} j ~. ~. (~) ' ' C~ ~ T~N STATE
' ~' }~' ., . ~1'".
sm~ .msm~. No2 312 5 4
"CERTIFIED TO BE A TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE wITH THE REGISTRAR OF
VITAL STATISTICS, STATE OF NEVADA." This copy was issued by the Clark County Health District from State
certified doculnents as authorized by the State Board of Health pursuant to NRS 440.175.
NOT VALID
RAISED SEAL
COUNTY "' .HEALTH
!;~i~:i: i:' '.,L:fi
WITHOUT THE
OF THE CLARK
DISTRICT
CLARK COUNTY HEALTH DISTRICT
625 Shadow Lane P.O. Box 3902
Las Vegas, Nevada 89127
702-383-1223
Tax ID#~& 151573
DONALD S. KWALICK, MD, M.P.H.
Registrar of Vital Statistics
By~)
Date Issued: HAR 0 4 200~l
~ DEPARTMENT OF HUMAN RESOURCES
I~{Jl (..) 88~L1 VITAL STATISTICS
[~OCAL FiLE NUMBER
TYPE / DECEASED--NAME First Middle Last
DIVISION OF HEALTH -- SECTION OF VITAL STATISTICS
CERTIFICATE OF DEATH ~---
STATE FILE NUMBER
IOATE OF DEATH (Month, Day, Year)
2. January9, 2003
COUNTY OF DEATH
OR PRINT
IN
PERMANENT
BLACK INK
IF DEATH
OCCURRED IN
INSTITUTION
SEE HANDBOOK
REGARDING
COMP~EDON OF
RESIDENCE ITEMS
3ONDITIONS
IF ANY
YHICH GAVE
RISE TO
IMMEDIATE ,/
CAUSE
;TATING THE
~. Phillip SPRADLING
Blaine Nye
RACE--(e.g., White, Black, American
s. Whitelndi .... tc.) (Specify) 6.specily Mexican, Cuban, Puerto Ricoh, elc. 7a.Birthda~;~!;~ears)v-- 7b.MOS ' DAYS 7c.HOURS · MINS eptember 6.1943
STATE OF B~RTH CITIZEN OF WHAT COUN- Decedent's Education. Specify highest MARRIED, NEVER MARRIED, I SURVIVING SPOUSE.Of wife, give maiden name)
WIDOWED, ~VORCED _
(If DoLI~I.S.A., n@me count~) TRY I grade complete~ ~
9~. mevaaa 9bUSA {10 --. (Spec,~) Mlvorceo
I
U~UAL OCCUPATION (Give Kind'of Work Done During Mosl of 11. 12.
SOCIAL SECURI~ NUMBER ~ KiND OF BUSINESS OR INDUSTRY
Workin~fe .Ev~ i~ Retired)
~3. 530-28-3~0 J~.a. M~US[ ~.~. Envimnmen~l ~ote~ion Agen~
FATHER~NA~E First MJddie Last MOTHE~MAIDEN NAME
I
F First ~iddle Last
~. Vernon L Spr~ling ~7. ~rot~ T~llion
INFORMANT NAME ~ype or Prin~ MAILING AOO~S~ (Street or R.F.D. No., Ci~ or Town, Slate, Zip)
~a~. Demna Sequin · ~a~, 45 G~ge ~. Sh~sbu~, ~ 3~
BURIAL, CREMATION, REMOVAL, OTHER (Specie) CEM~ERY OR CREMATORY--NAME LOCATION Oi~ or Town Slale
~. ~EMATION ~. N~ ~un~,~emato~. ~. P~mmp. Nevada
FUNER~IRECTOR SIGNATURE I FUNERAL DIRECTOR INA~EANDADDRESSOF FACILI~
Z 21a. To the ~esl ol ~y knowl~ge, dem~curred at the lime, date and pmce and
~ due to the cause(s) s~aled. ~
22a. On the basis ol examinm~n an~o~ invesliga~i~in my opinion death o~urred
~ ~ (Signal ..... d Title) ~ ~. at the time, date a~ p~ a~ ~,e ,o the ~fys)and ....... ,ated..
e~ DATE SIGNED (Mo., Day, Yr.] HOUR OF DEATH ~O DATE 81GNED (Mo,, Day, Yr~ ~ - HO~ O~ D~TH '
Be~re
23~
~[ 2~b. 21c.
~ NAME OF A~ENDING PHYSICIAN IF OTHER THAN CERTIFIEB (Tyoe or Pdnd ~ ~
PRONOUNCED DEAD (Mo.~Day,~r.) PRONOUNCED D~J~ud
~ ~o Janua~ 9.2~ 2~. ,T Z~
21d. 22d. ON .
NAME AND ADDRESS OF CERTIFIER {PHYSICIAN, A~ENDING PHYSICIAN, MEDICAL E~MINER OR CORONER). (Type or Print.) I LICENSE NUMBER
REGIST.R~X,.~._._~._ ~ ~ I DATE RECEIVED BY REGISTRAR (M°" Day' Yr') ID'TH DUETO cOMMuNICABLE DIs'S[
25. IMMEDIATE CAUS~ (ENTE~ONL Y ONE CAUSE PER LINE FO~ fa), (b), ~D (c)J · Inte~al be~een onsel and death
PART (.) Gunshot to Head
I (b)
DUE TO. OR AS A CONSEQUENCE OF:
Interval between onset and dealh
,:
( DUE TO. OR AS A CONSEQUENCE OF; · Interval between onset and death
(c)
PART OTHER SIGNIFICANT CONDITIONS-Conditions conlributing to dealh but not resulting in the underlying cause given in Part 1. AUTOPSY (Speci[y WAS CASE REFERRED TO
Yes Yes or No) CORONER (,~' ~io,~/o)
ACC., SUICIDE, HEM., UNDO., DATE OF INJURY (~., Day, Yr.) ~ HOUR OF INJURY ~ DESCRIBE HOW INJURY OCCURR~
(sn~)TM ' ~.0 1-09-03 ] 2323 [ Gunsh~ ToHead
28a. 28c. M 28d.
INJURY AT WORK P~CE OF INJURY Al home, larm, street, fado~, office LOCATION STRE~ OR.R F.~ No.. CI~ O~ ~N STATE
(Speci~ ~, No) Ho~ildthg. ~t~. (s~/¢) 8221 S. Old Sp~lshT~ml P~rump, mv
28e. 28f. 28g. '
.EG,sT,,,, N0.2 2 7 6 4 0
This is to cedify that the above is a true and correct c ' ....
of the certificate on file in this office.
JAN 2 8 2003