HomeMy WebLinkAbout903262STATE OF WYOMING
COUNTY OF LINCOLN
RECEIVED
AFFIDAVIT OF SURVIVORSN~(PLN COUNTY CLERK
SS.
Janet A. Moore, of PO Box 1041, Thayne, Wyoming 83127, and upon her oath deposes
and says:
0654
1. That John Madison Moore, Jr., aka John M. Moore, the decedent mentioned in the
attached copy of Certificate of Death, is the same person as John M. Moore named as one of the
grantees in that certain Warranty Deed dated the 22nd day of May, 1995 executed by Joe B.
Pacheco, Jr., and Rochelle S. Pacheco, husband and wife, grantors, to John M. Moore and Janet
A. Moore, husband and wife, as tenants by the entireties, grantees, and recorded May 30, 1995, as
Instrument No. 802745 in Book 368 PR, page 593, of the Official Records of Lincoln County,
Wyoming, covering the following described real property located in Lincoln County, Wyoming, to-
wit:
Lot 57 in Star Valley Ranch Plat 3, as platted and recorded in the official
records of Lincoln County, Wyoming.
Subject to reservations and restrictions contained in the United States Patent
and to easements and rights-of-way of record or in use
Together with all improvements and appurtenances thereon.
2. That the undersigned affiant is the same identical person as Janet A. Moore, named
as one of the grantees in the above-described Warranty Deed, that she and John M. Moore were
husband and wife at the time of the execution and recording of the Warranty Deed described
above, and that as the surviving cotenant and spouse of John M. Moore, named in said
conveyance, the undersigned, Janet A. Moore, became on July 29, 2004, the date of the death of
the aforementioned decedent, the owner of the lands or the owner of any interest of John M. Moore
in the lands described in the foregoing, subject to any then existing liens and encumbrances.
DATED the 15th day of September, 2004.
/ Janet A. Moore
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Subscribed and sworn to by Janet A. Moore, before me this 28th day of September, 2004.
Witness my hand and official seal.
My commission expires: February 26, 2008.
NO-I~RY,~'UBLiC
2
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DEPARTMENT OF HEALTH
tOCAL mLE.U~aE. CERTIFICATE OF DEATH
STATE FILE NUMBER
1937~
~ 26 WEREA~TO~YF~INGSAVAI~B~TOCO~ETH~CAU~E~D~T~ .: ;~.' '~ ~DT~USECO IRBUTETODEATH~ .... . .
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This is a true and exact reproduction of the document on file in the office of Vital
Records Services, Cheyenne, Wyoming.
DATE:ISSUED: 6 LUC n~a McCaffrey /
Deputy State Registrar
Th s copsf s not v~l d un ess repared on paper w th an engraved h0rde~ s a n t~ da C sea a d s ' u e of he De u State Registrar.
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