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HomeMy WebLinkAbout9050870°7i THE STATE OF /-h"{ ~. or',. ¢~' ) )SS THE COUNTY OF AFFIDAVIT TERMINATINC I.~TATE BY JOINT TENANCY August Borino, being of lawful age and first duly sworn according to law, upon my oath, depose and state: 1. That Katie Hangich died on December 22. 2003 in Kemmerer, Wyoming. 2. That on June 25, 1991 for Valuable consid(,ration Katie Hangich by her Warranty Deed of that date, which deed was duly filed for record ~] the Office of the Lincoln County Clerk on June 25 1991 in Book 298PR on page 165, conveyed Luria Katie Hangich and August Borino, as joint tenants with full rights of survivorship, the following described real property, to wit: Lot 8 of Block 60 of the Second Addition to ~(, Town of'Kemmerer, Lincoln County, Wyoming as described on the official plat thereof. 3. That by reason of the said conveyance, Katiu I langich and August Borino became the owners of the real property as joint tenants and title themt() w~sted in them continuously from said date of conveyance as described in said Warranty, until the date of death of Katie Hangich on December 22, 2003 at which time title to the above ch~,~ ribed real property vested absolutely 'n August Borino in accordance with the provisions of §2-9-102, W.S. (1980). 4. Affiant avers and certifies that deceased is the identica party named with Affiant in the aforementioned deed Whose death terminated her i~derest, title and estate in the said real property; and Affiant attaches hereto and makes a par~ of this Affidavit a copy of the official certificate of death of decedent, duly certified by the publk authority in which said death certificate is a matter of record. Dated this /']'Ct'of November, 2004. State of ~-~'['g-O)-,-o~ ) )ss County of /Vk~.d'Vt..ofc,,..- ) The foregoing instrument was subscribed and swarm to me by August Borino this day of November, 2004. August Borino Witness my hand and official seal. Ncgary P~blic State ol ArizO~ Pinal County Belinda L Hansen F. xp~r~ ~ 0,5 2007 My Commission Expires: Notary Public RECEIVED 12/8/2004 al 3:56 PM RECEIVING # 905087 BOOK: 574 PAGE: 271 JEANNE WAGNER LINCOLN COUNTY CLERK. KEMMERER, WY TYPE OR PRINT FIRST ~oi~ ...." :i~ ......... ' iili. 8-02 6M OF.WY©MING DEPARTM~i~Ti?OF HEALTt:[ STATE OF WYOMING DEPARTMENT O~.HEALTH CERTIFICATE OF DEATH STATE FILE NUMBER 520 - 05 - 2761 88 ~ rl ,~,ll~n( D ER;/Outp~illenl South Linco'~n Nursin Center Kem~erer I 11. WAS DECEDENT I (Specify y&s or noj LAST 2. SEX 3. D.~TE OF DEATH (Mo., Day, Yr.) "ii?::"::::i..Hangich : Female.' D~ember '22, ".:2003".¥:~. f :~': !i 10. SURVIVING SPOUSE (t(wif(~ g~ver~ :' ..." Domestic 15 RACE - Amedcan Indian.. Black, While. Etc. ~ i t e :: - : ~:? :::~ catartna~ -' Segalla STATE ~metery ' · -.:~ ';~. ~-- ' '.-'. ddt Crand~l:l Fu~6ral · Home 28 H any. leading to Immediate cause. 11 Onyx M DA, EJanuaryRECEIVED BY RE J';~T~R5, EO03{Mo':";DaY'2004'V"/:'? ' ..... !:i :$." :$. :i:: ~nset afl~ Dearth. - ' :$. :$ "?/ Lucin~a ' Deputy Siate Registrar This is a true and exact reproduction of the document on fde ,~ the office of Vital Records Services, Cheyenne, Wyoming ~ATE i::~S~E~i'''i!? ~ .E'"~ "")R'%'] ~his copy is no Y8[ d un.ess ~?pared on paper with an cngra~ cd [ crder disp ay ng th¢.dat~ Seal a.o mgnaturc or (he D~puty State Rg~ rar . .