HomeMy WebLinkAbout906558 RECEIVED 2/17/2005 at 2:43 PM
[~0 9 ::" RECEIVING # 906558
BOOK: 579 PAGE: 209
. JEANNE WAGNER
~~- ~ LINCOLN COUN~CLERK KEMMERER
~;~,.~;~: 2' ~:;/ DECEDENT ' S PERSON~ PROPERTY
../~??~;;~3~$~¢..~.unders~gned, being f;rst duly sworn, on osth depose
that we a~e making th~s affidavit pursuant to Section
2-1-201, W.S.A. (2003), on behalf of ourselves as distributees, as
hereinafter set forth, and that we make the following statements in
connection therewith:
o
o
o
That OLIVERA-RIGOBERTO CEBALLOS died on February 24,
2004, in Lincoln County, Wyoming, and was a resident of
Lincoln County, State of Wyoming, at the time of his
death; that said decedent died intestate; that we are the
sole and only parties entitled to the property of the
decedent pursuant to the laws of the State of Wyoming.
That the value of the entire estate subject to
administration wherever located, less liens and
encumbrances, does not exceed $150,000.00.
That more than thirty (30) days have elapsed since the
date of death of the decedent.
That no application or petition for t)~e appointment of a
~ersonal representative of said dece.'lent is pending or
has been granted in any jurisdiction.
That the only personal property owned solely by said
decedent not otherwise disposed of is the following:
a) 1993 Chevrolet Pickup (VIN #2GCEK19K7Pl168890);
b) 1996 Chevrolet Sedan (VIN #1G1LD5540TY255689);
c) Ail benefits payable under the Elkhorn Construction
Inc. Employee Stock Option Plan; and
d) Miscellaneous tools and a genera~or.
The undersigned request as follows'
That the certificate of title to said 1993
Chevrolet Pickup (VIN #2GCEK19K7Pl168890) be
transferred to Jose Ceballos;
(b)
(c)
(d)
That the certificate of title to said 1996
Chevrolet Sedan (VIN #1G1LD5540TY255689) be
transferred to Rosa Maria Guerrero;
That all benefits payable under the Elkhorn
Construction Inc. Employee Stock Option Plan be
distributed to Anna Ceballos, Elizabeth Ceballos,
Jose Ceballos, Fernando Cebalios and Rosa Maria
Guerrero, as Conservator for Rigoberto Ceballos,
Jr., in equal shares; and
That the decedent's miscellaneous tools and
generator be distributed to Xavier Ceballos in full
and complete satisfaction of any claim he may have
related to the decedent's funeral expenses.
DATED ~q~ day of
ANNA CEBALLOS
ELIZ'A ETH EBALLOS-
J~E CEBALLOS
ROSA MARIA GUERRERO, as
Conservator for Rigoberto
Ceballos, Jr.
THF,'~..STATE OF ~
COUNTY OF
The above and foregoing instrument was acknowledged before me
this ~7 day of ~ta~~ , 2004, by Elizabeth Ceballos.
My Commi
THE STATE OF ~
COUNTY OF
this
My Commission Expires:
and official seal.
Notary Public
T~.above and f~°~)~_.going instrument was acknowledged before me
~ day of __~ , 200~, by Jose Ceballos.
WITNESS my hand and official seal.
N$~a~Y Publ~ ~
E*: 5
THE STATE OF WYOMING
counTY OF
this
My Commission Expires:
The above and foregoing instrument was acknowledged before me
~ day of _k_~~ , 200~ by Fernando Ceballos.
WITNESS my hand and official seal.
~g~:~?,T~'~, STATE OF WYOMING
COUNTY OF L,k~/,
The above and foregoing~ instrument was acknowledged before me
this
day
of
~l~ , 2004, by Rosa Maria Guerrero,
~~ervator fOr Rigoberto Ceballos, Jr
t- JOSEPH B ~~ ' //
/
My Co~ss~n--~~--~y' t -'
Mexico
City:
On this day of , 2004,
appeared, known to me to be the person
the within instrument, and by me being
acknowledged to me that (s)he executed
and uses herein expressed.
Anna Ceballos personally
who signed and executed
duly sworn, manifested and
the same for the purposes
Seal
NOTARY PUBLIC OR OTHER OFFICER
QUALIFIED TO TAKE OATHS.
--- ANTE MI, LICENCIADO EMILIO GOMEZ PEREZ NOTARIO POBLICO NUMERO 63 SESENTA Y TRES DE
GUADALAJARA, JALISCO MEXICO, COMPARECIO PERSONALMENTE: ................................................
--- LA SEI~ORA ANA CECILIA CEBALLOS VEGA, MEXICANA, CASADA, AMA DE CASA, ORIGINARIA DE LA
CIUDAD DE COLIMA, ESTADO DE COMMA MEXICO; EN DONDE NACI0 EL DiA 29 DE NOVIEMBRE DE 1976,
CON DOMICILIO EN LA CALLE JUAN MANUEL GARCIA NOMERO 62 COLONIA BUENOS AIRES, EN
TLAQUEPAQUE, ESTAD0 DE JALISCO; MEXICO, SE IDENTIFICA CON SU CREDENCIAL PARA VOTAR CON
FOTOGRAFiA NUMERO 0314160221093 EXPEDIDA POR EL INSTITUTO FEDERAL ELECTORAL.- .................
--- EL SUSCRITO NOTARIO POBLICO, POR MEDIO DE LA PRESENTE CERTIFICA y RATIFICA LO SIGUIENTE:--
--- 1.- QUE EL PRESENTE DOCUMENTO HA SIDO OTORGADO EN ESTRICTA CONFORMIDAD A LAS LEYES
MEXICANAS: ..... ~--'. ............. i .....
--- 2.- QUE POR AS! SOLICITARMELO LA COMPARECIENTE V!JELVE A RATIFICAR LA FIRMA DEL PRESENTE
DOCUMENTO' F!RMANDO EN MI PRESENCIA DE SU PUiilO Y LETRA A LAS : 9: 00 'NUEVE HORAS '
DEL DI'A 27 VEINTI IETE DE SEPTIEMBRE DEL 2004 DOS MIL CUATR0
· .BAJO RATIFICA(
LIC. E~EREZ ',,>;'
NOTARIO P~ 64 DE GUADALAJARA
JAL~CO IqEXICO
5
STATE. OF. :WY. OM.lNG
2 0 0 ti - ,',, 0
STATE OF WYOMING
FILE NUMBER ~4 CERTIFICATE OF DEATH STATE FEE NUMBER
· ' .:' R!~OBERTO CEBALLO~ OLIVE1C4 ':i~. ::i:'/~ .... .... ~.~^T~o~.,~.,,~o.,.~u~.,~,~
Male::~ ..' Feb,'u~i-y"' 24, '~00'~ .:::' ".~:'
537-39-9624 {['"*~49 ~ I~ .... I ..... January 13 1955
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~m 1411 9th Street Room 19 '; :.~': }).5";':::: 'R0~k :Springs ~ Sweetwater
P huamo Jalisco ~cxmo ',: .,'~ ' .... · ', ~ ,. _. : ~' ? -.::".--':~ .....
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~ PART ~ ~nle, ~r~antc~it~tr~ul~ ~'~lh bul~ ~ul~.~me ~r~mg~b~ ~ p~ ' ::'*'" ': : :' :' :' 25 W~ANAU~OPSY:
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:" FebFu'ii'y 26. ":2q04: ~He~'S..rMhjgan~!~ich~' 'CEunty Cgf6ner,:::4'2t::.''B'37' St., 'godk SpringS;' WY'.' 82901 ...
~ REGIST~R~~ ~S SI NATUR[" ::~ ~' ~:: ]:.: :::::] :~] j~: :;::::. :[~: ~:[ ~ DATE ~C[IVED BY REGI$[RCR
This is a true aha exact reproduction of the document on file in the office of Vital
Records Services, Cheyenne Wyoming,
FEB 1 5 2005
DATE SSUED:
valid unless prepared on seal and signature of the Deputy State Registrar
Lucinda McCaffrey /
Deputy State Registrar