HomeMy WebLinkAbout897077THE STATE OF WYOMiNG
COUNTY OF CARBON
)897077
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RECEIVED
LINOOLN oOUNTY OLERK
OI~ Ft':P, - 5 ~dl I0.' 2 0
AFFIDAVIT OF SURVIVORSHIP
Florence Moore, a/k/a Florence Irene Moore, of lawful age, being first duly
Sworn upon her oath, deposes and says as follows: That she is the surviving wife and
widow of Fred LeRoy Moore, who died at Holladay, Sal
2003. That attached hereto and made a part hereof by ti
is a copy of the official death certificate certified to a~
which such original death certificate is a matter of rec¢
Vital Records of the Departrhent of Health of the State ol
Lake County, Utah, on July 31,
s reference marked Exhibit'"A"
true by the public authority in
~rd, to-wit, the State Director of
Utah at Salt Lake City, Utah.
That the said Fred LeRoy Moore, at the time of his death, and for sometime prior
thereto, was the owner with his wife, Florence Moore, the Affiant, of an estate by the
entireties,, in and to the following described real estate consisting of minerals, situated in
Lincoln County, Wyoming, to-wit:
An undivided 1/10 interest in and to all minerals and mineral and
mining rights of evew kind and character now known to exist or
hereafter discovered in all of said lands including but without li~niting
the generality of the foregoing, oil, gas and other hydrocarbons and
rights thereto, but the right to mine and extract said minerals shall be
linfited to those which can be removed from the ground without
jeopardy to the maintenance or safety of public travel upon the granted
surface estate and without using the surface of the granted lands
described below lands in Lincoln County, Wyoming:
Township 19 North, Range 112 West, 6th P.M.
Section 10: SE¼NW¼
NE%SW¼
by virtue of an April 27, 1967 Decree of Final Settle
Distribution in the Matter of the Estate of Anna M. Tript
Second Judicial District for Sweetwater County.
That Affiant, Florence Moore, and the d,
intermarried many years prior to the year 2003 and conti]
ment of Account and Order of.
deceased, in the District Court,
ceased, Fred LeRoy Moore,
~ued to be man and wife up until
the date of death of the said Fred LeRoy Moore, as aforesaid.
That by virtue of the death of ti~e said Fred LeRoy Moore, and at that time, the
estate by the entireties in and to said real estate terminatedl and ever since said death and
at the present time, Affiant, Florence Moore, surviving wife and widow of Fred LeRoy
Moore, has been and is now the sole and absolute owner in fee simple of record of said
real estate.
That by reason of the foregoing, Affiant is intereSted in the affected real property
and in the title thereto.
STATE OF WYOMING
COUNTY OF C.),f~gc~k5
Subscribed and
Florence Moore.
My Conm~ission expires:
sworn to before
Florence Moore
My Commission Expires
me this ~Oo-r~ day of Janua~, 2004, by
No(ary Public
2
- DEPARTMENT OF HEALTH ~
IFICATE OF DEATH .,^~,,E.~.E. ~,
c',/;:, : I Florence Trtpp
13~ INSIDEC~ I~f.:ZIP~0DE' :~ ~4~;;~S'DE~EDE~.0~ H SPXN CORGN~ ~ I Y,, ~ 2 No t5 ~CE-a~e ~ 16 EDUCAT~(~Iy~ghe~
~:t~: :: ...... Ltllian Marie ~derson
~ ;Alternative Society Lindon, utah::~/;~?~
~~}~¢?:~;:~,??:~082776 I 4813025-0902 Seren~CAre,:: tLC
?; ~: 3~;P~I. ENTEBTHEOS~SE~U~IES ~60~Ty~T~USEDTHED~ DO NOT ENTER T~E MOOE OF DY NG SUCH AS C~D~C
deaB) ~ST ~.:?: r: .::? ,
;dAUsE °F ' ~ PEflFORMFfl~
ihiS office. This certified copy is issued
15,3 'As Amended.
~rQR'OF VITAL RECORDS
*01314399*