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~t f 0~3.~ a E C E IVE D
IN THE DISTRICT COURT OF THE THIRD JUDICIAL DISI1RI,~L ~i~-0 I t~'~TY~ OLERK
IN ~D FOR THE COUNTY OF LI ~ATE OF
~ THE MATTER OF DETESTATION OF HEIRSHIP OF )
ROBERT F. VIC~Y, Deceased. ) Probate No.
)
)
AFFIDA~T FOR DISTRIBUTION OF ESTATE
STATE OF ~OM~G )
) SS.
CO~TY OF L~COLN )
We, Robe~ D. Vic~ey, Ralph G. Vic~ey and ~ita M. Vic~ey being first duly sworn, on
oath depose and state as follows
1. That we ~e over the age of~enW-one (21) years.
2. That Robe~ F. Vic~ey is our hther.
3. That our father, Robe~ F. Vic~ey died on the 20th day of April, 2003 in Ke~erer,
Wyoming.
4. That our hther, Robe~ F. Vic~ey did not have a Will upon hs death ~d accordingly died
intestate.
· ha,. ~ooe~, F. Vicl~ey was not ma=ied at thc time of his death.
6. That the only heirs ofRobe~ F. Vic~ey are Robea D. Vic~ey, Ralph G. Vic~ey and ~ita
M. Vic~ey.
7. That the value of the entire estate ofRobe~ F. Vic~ey, wherever located, does not exceed
one hundred fifty thousand dollars ($150,000.00).
8. That they (30) days have elapsed since the date of the death ofRobe~ F. Vic~ey.
9. That no application for appointment of a personal representative is pending or has been
granted in any jurisdiction regarding Robea F. Vic~ey.
10. That we are entitled to the payment or delive~ of the personal prope~ owned by Robe~ F.
Vic~ey and no other person has a right to succeed to our father's interest in the prope~
under probate proceedings.
11. That the prope~y ~own to be owned by Robeg F. Vic~ey is as follows:
a. Account ~1497 in the Advantage Plus Federal Credit U~on
b. Contents of Safety Deposit Box ~61 at the First National Ba~
Probate\VickreykAffidavit 6fDisthbution
12.
That if any other personal property is located that is not identified above, we are entitled to
that property in equal shares or percentages.
Dated this i7- day of ~"O/)P__ ,2003.
'-
STATE OF COLORADO
) SS.
COUNTY OF
)
}, Robert D. Viekrey being first duly sworn, states that I am one of the affiants noted above,
that I have read the same, know the contents thereof, and that the statements contained therein are
true.
RO2k D. 'e CKR Y '
~~,'bed and swom before me this
ftC"':' ..... _ ::""?...
1~- day of .~-'yC~a ~.
NOTARY P~LIC
,2003.
STATE OF COLORAD° )
) SS.
COUNTY OF _/~/',oe )
I, Ralph G. Vickrey being first duly sworn, states that I am one of the affiants noted above,
that I have read the same, know the contents thereof,,aOd that the statements contained therein are
true.
l and sworn before me this I~ ,2003.
M~e'ok~ii'sion Expires: q-I
day of .~om O__
NOTARY PUBLIC
Prob ate\VickreykAffi davit of Distribution
2
-~'~qlTA M. VICKRI~Y
STATE OF CALIFORNIA )
) ss.
COUNTY 0 ,.gz~ ,' d~_- )
I, Anita M. Vickrey being first duly sworn, states that I am one of the affiants noted above,
that I have read the same, know the contents thereof, and that the statements contained therein are
tree.
~lXFITA VICKREY
Subscribed and sworn before me this ~ "~ day of ,~j~.~,-~L ,2003.
My Commission Expire .'~zJD
NOTAR~IC
Probate\V ckreykAfIidavit of Distribution
FOR .x
INEIrIIuCIION$
1006
STATE'"?~ ~,.WY" .... OMING
.. :,o
ii~:., iiil ~:;~ ...... ;!::' DEPARTM~N~ OF.HEAETH
STATE OF WYOMING
:CERTIFICATE OF'DEATH
ROBERT F~KL~N :: ? ~::VIC~EY · [~: Male'': April 20, 2003
March 17, 1909
442 - 10 - 7289
South LZncolh Medicaz?ce';';'';,
No
K~mmerer
FMC Coke Plant
)er ColIar Row
This m a true ano exact rearoduction of the document on file n the office of
Records S~ices, Gneyenne, Wyoming.. ......: .
DATE ISSUED: APR Z 9
Depu~ State
~th ~:~ng~aved'~O~der ~,:'----~V" te i~il ~d:~ignat~e ~th¢ Deputy State Registrar
..... ..: ::.:. ::::