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AFFIDAVIT
STATE OF WYOMING
COUNTY OF L1NCOLN
RECEIVED 3/1/2005 at 10:48 AM
RECEIVING # 906787
BOOK: 579 PAGE: 878
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, VVY
I, Dorothy F. Woods aka Dorothy A. Woods
first duly sworn on oath, depose and say:
, being
That I am a citizen of the United States of America over the age of 21
years, and a resident of Montrose, Colorado
That I was well and personally acquainted with Lowell L. Woods
in that certain Warranty Deed recorded May 17, 1957 , Book 78 P.R.,
at Page 203 in the office of the Recorder of Lincoln County, Wyoming.
That I know of my own knowledge that Lowell L. Woods in
the said deed and Lowell L. Woods mentioned in the attached
Certified Copy of Certificate of Death was one and the same person.
Lowell L. Woods
This Affidavit is intended to terminate the joint tenancy (the life estate) of
in the following described property:
Commencing at a point North 51 °15' West 4865 feet from the Southeast Comer of Section
Eighteen (18), Township Thirty-seven (37) North, Range One Hundred Eighteen (118) West and
running thence South 9000, West, 275 feet, thence North 0°0' East, 219.6 feet, thence North
76o28, East, 283 feet, thence South 0°0' West, 285.6 feet back to point of beginning.
Dorottiy- F, Woods
Subscribed and sworn to before me this~S~day of ¢/5 P/~{ff/~/~ ,2005
Residing in: "~/j~'//~./L'~; re/~~ Notao Public-
Commission expires O/~/~a ~ ~:~;c,-~' "
~ms 10~11
~nded
~. Dir.
10/18/76-
~2,.. Burial
DATE
OCT 1 1976
3q66
CERTIFICATE OF DEAT~I~ STATE
STATE DEPARTMENT OF HEALTH
Lowell .. Woods.
..c~ ................. ~ ......... .o~ .............. ~' J'. i"~le h. Sept. 22 1976
o[i ~ oaf J DATE OF BIRTH ¢~ON ~ D~V ~COUNTY OF ~f~
~ Ru~b
o ~ J,.. Yes ,~ Rugby
~TAT[ OF ~IR~ i If -Ol I~ -.-..,I~ ........... ~ ~--.z. _ ~ ~ ~ ~
SOCIAL SeCURR NUMBER J USUAL ~CL;PATION iow ", o,.---jAW .................. ~-- . _:e Doroth~ Fomd
?. 520-16-3173 J,~. : lela Engineer J., R..~o,. ~ :~
RESIDENCE--STATE ICOUNTY Ir ......... ;.~. I ....... u,.-~_ U~
_ Ul// uK L~A/IUH ~INSlBJ Cl~ U~"S STREET AND NUMtER -
~. __. l~red '"Woods J,,. Bertha Brown
/PART I DEATH WAS CAUSED BY % ENTER ONLY ONE CA ~
' ' ' ~ ~ - ~ ~ ~f ~ ~ ~ ;j; '
...... ., ..... { ;
t-'l m - ~ j ......... "-'
C: , ~ ~ '~ ' :, '~ :4: ~:_/ ~' / '" '~- 5~ '"~ ,.. No
~CCIOE~, ~UICID~, HOmICIde,~DAT[ Of I~Y ~r~, ~, ~-~ HO~ [ HOW
OR UNDETERMINED ISPECI~I J INJURY OCCURRED ~ ENIE~ NAru~[ O~ l~Ju~ ,~ e*~ . o~ ~I .. n~ Ill
(~PJCl~ YJi olNo) Jo~cJ ~o ~TC. ~sr~l ' ' (STREETOR R.F.D. No.,CITY ORCOUNTY, STATE)
Year 2lb. CERTIFICATION -- CORONER
t .... ~ 'N ~' ~ ~ ) /'~nd On th~ basis of Ih ..... Jnatlcn DE the body ~d/or the l
I ~Hended the dec~sed fro~ ~ /~ ' /(- to '. .... /g. ~ ~ ' '
/ . ~ Month DaZ Y~r
last saw him/~r alive on -] ' 'L .,_ - ~ I (did, ~id not) view the opinion deat~ occurred ~t_ · ~., ~n~thq dale ~nd due to the cau~
body after d~ath Dea~ o'curr~d at //) i'~ ~ M at th - 4 * ' ' ' ~ ~ ~ ~
..... ~ · · p,a., an. dine ana on stat~d above. The decedent was pron~uDc~d dead o~at
the date stated above and to the best o'f my k~owl~ge due to th~ causes stated. '~ ' ~ ~' ~ ~i~nth Doy Year
22q. PHYSICIAN ~ SIGNATU~'h ~22b. CORONE~ ~ SIGNA~R~_
23.. PHYSICI~ -- NAME ' ' 'U~P. or ~rint] - ' / /23b. CORONE~:~ '~a' q~ Print) =~
~. ~ ~-~l j · ~ ~ r~ /' l .... k I J ' . ~ '~ . . ,
I ': ' u/mi / / ' ' ":~/(/~ ~
23c. MAILING ADDRES~ ~ P~y~JcJon ~r Corone~ ~. - ' ~ ~ ~¢ 'r ff '
- = .... ...~-~,: ....... :,. ~: h...-~ '"' ~,~..,.. -
- -,, 'L~ ~... >...~
. ~.,~, ,~__ ' ~'~
C~ERY OR CRE~TORY--NAM[ ' 4-' LaoTIaN c~ o~ tow~
u~. Mnntrose Cemeter? ". ~RtroDe Colorado
I FUNERAL H~ME--NAME AND ADDRESS I [l~[[f O~ a.F.O. No., ch% s~tE. Zl~ I
I"". Berg Pmneral H0raes Inc. ~~., N. Dak.
12~"'JOward nurn~~F~_~._ Sept. 30, ~976