HomeMy WebLinkAbout893306-. 7,.I¥;-:.
';;;:;il;;:,:;;;'
' OOK534 PRPAGE 7J 7 8
STATE OF WYOMING
RECEIVED
AFFIDAVIT OF SURVIVORSHIPINCOLI, I COUNTY CLERK
COUNTY OF LINCOLN.
893306
)SS.
)
THELMA DANA, being first duly sworn upon her oath, deposes and states as
follows:
1. On or'about the 21st day of June, 2000, my husband, Van Hokanson Dana,
died as is evidenced by the official certificate of death attached hereto and incorporated
herein by this reference.
2. At the time of his death he jointly owned an interest in certain real property
with me, said real property being located in the County of Lincoln, State of Wyoming,
and more particularly described as follows:
The Soutlawest QUarter of the Southeast Quarter
(SW1ASE!/,) of Section Eighteen (18) in Township Thirty-four
(34) North of Range 118 West of the 6% Principal Meridian
continuing 40 acres of land hence forth more or less.
3. Said real property interest was originally conveyed to Van H. Dana and .
Thelma Dana, husband and wife, as tenants by the entireties, with right of survivorship,
by a Warranty Deed dated December 30, 1949, and recorded November 26, 1951, in
the Office of the Lincoln County Clerk and Ex-Officio Register of Deeds in Book 28 of
P.R., Page 140.
4. By reason of my husband's death, I am entitled to sole ownership of the
interest in and to the above-mentioned real property.
DATED this ~5'/~day of May, 2003.
THELMA DANA
Page I of 2
379
STATE OF WYOMING )
) SS.
COUNTY OF LINCOLN )
The f, oregoing instrument was acknowledged before me by THELMA
DANA this _r0O-/"/-day of May, 2003.
WITNESS my hand and official seal.
NOTARY PUBLIC
My com[nission expires:
Page 2 of 2
IT:OF
POI
IMMEDIATE CAUSE
disease Or condition
~gUlting In death)
.~:~,:~;.:~;::-,~.:~ : :.:
]~[]'1~0 ~': Pe~Oing Investigalion
_L; -: ~_":_-'_:~ ~Thi~:i~ a tr;J~ a
' '-?:~_'i -?-6~ 'file ~viih th~
~::; ;~-:;~ :: DATE I:
Ji~l~ing slab