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BOOK 51~pR PAGE 60 5
AFFIDAVIT OF INCUMBENCY
RECEIVED
LIN00LN 00d,~TY CLERK
STATE OF WYOMING
COUNTY OF LINCOLN
:SS
Affiant, Quinn R. Heiner, having been first duly sworn, deposes and states as
follows:
1. .By trust agreement dated May 16, 1997 (the "Trust Agreement"), Quinn
R. Heiner and Carolyn S. Heiner, as grantors, and Quinn R. Heiner and Carolyn S.
Heiner, as trustees, created and placed in effect The Quinn R. Heiner and Carolyn S.
Heiner Family Revocable Trust (the. "Trust").
2. I am the same Quinn' R. Heiner that is designated as a co-trustee of the
Trust pursuant to the terms of the Trust Agreement.
3. By Special Warranty Deed April 12, 2002 and recorded May 1, 2002 as
Entry No. 880672, Book No. 488, Page Nos. 612-613, in the office of the Lincoln
County Clerk,~ State of Wyoming, F.A.T. Investments Limited Partnership, as grantor,
conveyed an undivided one-half interest to Quinn R. Heiner and Carolyn S. Heiner, as
trustees of The Quinn R. Heiner and Carolyn S. Heiner Family Revocable Trust dated
May 16, 1997, as grantee, in and to the following described real estate, Situate in
Lincoln County, State of Wyoming (the "Easement"):
Any and all of grantor' s interest in and to that certain CommOn Easement
Agreement dated August 23, 1978, and recorded in the office of the Lincoln
County Clerk on November 17, 1978, in Book 150 PR, Page 694.
4. Carolyn S. Heiner died on the /! day of ~)~' , 200P._, as
evidenced by her Certificate of Death that is attached hereto as Exhibit A and
incorporated herein by this reference.
6O6
5. Upon the death of Carolyn S. Heiner and as of the date of this Affidavit of
Incumbency, I am the incumbent trustee of the Trust with full power and authority to
transfer interests in real property constituting the corpus of the Trust. A copy of the
relevant provisions of the Trust Agreement reflecting this fact is attached hereto as
Exhibit B and incorporated herein by this reference.
DATED this ~J day of ~/~ (~C/~ ,2003.
Quinn R. Heiner
On the ~) J day of /~ 0~/'~(~/q' , 2003, before me, the undersigned, a notary
public, personally appeared Quinn R. Heiner, proved to me on the basis of satisfactory
evidence to be the person whose name is subscribed to the within instrument and
acknowledged to me that he executed the same.
My Commission Expires:
Notary Public
Residing at:-~~P~
~07
EXHIBIT A
Certificate of Death of Carolyn S. Heiner
[See document attached hereto]
STATE OF WYOMING
CAROLYN
608
DEPARTMENT OF HEALTH
STATE OF WYOMING
DEPARTMENT OF HEALTH
LOc~ ~ .u,.,~. CERTIFICATE OF DEATH
SUZETTE . HEINER IFEMALE NOVEMBER 11, 2002
591-O3-8887 OCTOBER 14, 1963
STAR VALLEY MEDICAL CENTER :]; ':~:~ ':~: AFToN I LINCO~
FLORIDA ~IED QUINN ROBERT HEINER
NO HOUSEWIFE : HOME.KING
~OMING [ ~ T OF T °uNTY RoAD 120 ~779
LINCOLN
:' ' WHITE
~ Y. O is~=~ 12
/
CHAROLLETE '
CLYDE WILBURNE RICH JR. ~NETTE NUNREY
SPOUSE
~ QUINN ROBERT HEINER
P. O. BOX 226 T~Y~E ~O~ING 83127
BEDFORD,
~ l SOV. ~s, 20o2
AVE. AFTOR
~ M
X K PAUL HEAD MD. llo.H~sP:ITAL LANE AFTON, '~OMING 83110
X % ~ ..... ~ ~,~.~, I
1~9 ~su ~ [ I~ ~ I
191S19
This is a true and exact reproduction of the document on file in the office of'Vital
Records Services, Cheyenne, Wyoming·
0£C I~ ~cu2
DATE ISSUED:
· , is not v&lid unless prepared on paper with an engraved bordcr d~spla 'i
tucinda McCaffrey /
Deputy State Registrar
seal and signa(ure of(he Deputy
609
QUINN R. HEINER AND CAROLYN S. HEINER
FAMILY REVOCABLE TRUST
TRUST AGREEMENT
THIS AGREEMENT is made this 16th day of May, 1997, between Quinn R. Heiner
and Carolyn S. Heiner aka Suzie Heiner, husband and wife, of Thayne, Lincoln County,
Wyoming, as Grantors and as Trustee. Grantors and Trustee, desiring to create a
revocable living trust on the terms and conditions hereinafter set forth, state, confirm and
agree as follows:
CONVEYANCE IN TRUST
1.01' All trusts established hereunder shall be collectively known and referred to
as the Quinn R. Heiner and Carolyn S. Heiner Family Revocable Trust.
1.02: The Grantors hereby transfer, convey and assign to the Trustee the
property described on the Schedule A attached hereto and made a part hereof.
1.03: Grantors, or any other person, may transfer, by will or otherwise, any other
property to the Trustee, to be administered as provided in this instrument, and may subject
the proceeds of any insurance policies to the terms of this instrument by designating the
Trustee as beneficiary thereof.
II
REVOCATION
2.01' During the joint lifetimes of the Grantors, the Grantors jointly may alter,
amend or revoke this agreement, in whole or in part, at any time or from time to time by an
instrument in writing (other than a will) signed and delivered to the Trustee.
2.02: From and after the death of the first Grantor to die, the Survivor's Trust shall
be amendable and revocable by the surviving Grantor, and the Decedent's Trust shall be
unamendable and irrevocable.
GiO
EXHIBIT B
Relevant Provisions ,of the, Trust Agreement
/'See document attached hereto/
11.07: No surety or other security shall be required on any bond furnished by any
Trustee in any jurisdiction for any purpose. Trustee shall serve without bond if allowed by
law.
11.08: Any power granted to the Trustee in this' instrument shall be void to the
extent that it may cause the loss of all or part of the Federal estate tax marital deduction.
11.09: No individual Trustee shall participate in the exercise of any discretion
COncerning payments of income or principal or the making of loans to himself or to any
person whom he has a legal obligation to support, if such payments are to be made from
the decedent's Trust or from separate property contributed by any person other than such
Individual Trustee.
11.10: Any Individual Trustee, by notice in writing to his Co-Trustee, may for any
period or periods delegate all of his powers and dUties to his Co-Trustee. Any person may
rely on the written certification of a Co-Trustee that the Co-Trustee has the power to act
without the concurrence of any other Trustee.
11.11: In the event that there is more than one Trustee acting under this
instrument, a majority of the TrUstees may take any action authorized by this instrument.
This Trust Agreement Was signed by the Grantors, and accepted by the Trustee, as
of the 16th day of May, 1997.
~Heiner
Grantor, Quinn R. Helner
Trust~el Carolyn S. Heiner
Granto¢, CarOlyn S'. Heiner
14