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899641
JEANNF
COMES NOW, NATALIE NICOLE RILEY, being of lawful age and
being first duly sworn upon her oath according zo law, deposes
and states as follows:
1. This Affidavit was made and executed pursuant to the
provisions of the Wyoming Probate Code, W.S. ~2-1-201 and, W.S.
62-1-202, providing for the collection and distribution of
personal propergy by affidavit.
2. That MICHAEL EUGENE RILEY was the father of the
Affiant.
3. That MICHAEL EUGENE RILEY died on February 15, 2004 in
LaBarge, Lincoln County, ~yoming, as evidenced by the certified
copy of the death certificate attached hereto, and more than
thirty (30) days have elapsed since his death.
4. That ['ETTZ ANN RILEY is the mother of the A£ffiant.
5. That MICHAEL EUGENE R~LEY and PETTI ANN RZLEY were
divorced in Casper, Natrona County, Wyoming on October 26, 1988,
and MICHAEL EUGENE RILEY did nog remarry.
6. The value of the entire estate of MICHAEL EUGENE RILEY,
less liens and encumbrances, does non exceed One Hundred and
Fifty Thousand Dollars ($150,000.00) .
7. No application for appointment of personal
representative is pending or has been granted in any jurisdiction.
AFFIDAVIT FOR DISTRIBUTION
ESTATE OF MICHAEL EUGENE RILEY
Page 1 of 2
· ,, 806
8. The undersigned is the sole claiming distributee and is
ent±tled to payment,or delivery of the property as distr±butee.
9. There .are no other distributees of the decedent,
MICHAEL EUGENE RILEY, having a right to succeed to the property
under probate proceedings.
DATED this-/~ day of May 2004.
NAtALie -NI'COLE RILEY
ACKNOW~,F. DGMENT
STATE OF SOUTH CAROLINA )
)SS.
COUNTY OF HORRY )
The foregoing Affidavit For Distribution and Summary
Procedure was subscribed and sworn to before me by NATALIE NICOLE
RILEY this day of May 2004.
WITNESS my kand and official seal.
Notary Public
/70 /I
AFFIDAVIT FOR DISTRIBUTION
ESTATE OF MICHAEL EUGENE RILEY
Page 2 of 2
.
STATE. O F...WYO M I N
DEPARTMEN~ OF HEAL'I?H
, 200
!' :' - " :~7::. .......DEPARTMENT OF HEALTH
LOC^LF~LE~UMaEa t012 CERTIFICATE OF DEATH ST*T~r~E.U~.
G~ley, Texas Ir~ ~ .......... :: N~n~ ": ~ ': : :' ':: ~.~
.... · ..... . ....... i: ~ ,~ .... :;:: ? :::" ~:~. ?.::. "~:.::
Found choking, emergency crew~ were ri'et able to resesitate.
This is a line and exac[ reproduction 0f the document on~ file in the office o1' Vital
. - Depuly ~lal~ R~gislra~
This copy is not valid unless prepared un paper wilh ~ engraved border displaying tnc date. seal and s~gnaturc of~he Depuly Slate Rc~sLrar
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