HomeMy WebLinkAbout90678850066(04)
STATE OF WYOMING
COUNTY OF LINCOLN
AFFIDAVIT
RECEIVED 31112005 at 10:49 AM
RECEIVING # 906788
BOOK: 519 PAGE: 880
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
I, Dorothy F. Woods aka Dorothy A. Woods , being
first duly sworn on oath, depose and say:
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 Donald L. Woods
in that certain Warranty Deed recorded January 16, 1978 , BOok 143 P.R.,
at Page 159 in the office of the Recorder of Lincoln County, Wyoming.
That I know of my own knowledge that Donald L. Woods in the
said deed and Donald Le Roy Woods mentioned in the attached
Certified Copy of Certificate of Death was one and the same person.
This Affidavit is intended to terminate the joint tenancy (the life estate) of
Donald L. Woods 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
76028, East, 283 feet, thence South 0°0' West, 285.6 feet back to point of beginning.
Dorothy F. Wff'ods
me this~,y~, ~P~day of
Subscribed and sworn to before .fi~///~_t~,~54/~ ,2005
Residing in: 7~V~~'~ ~~' Public
STATE OF COLORADO
{
STATE OF COLORADO I STATE FILE NUMBER
Donald "Wood)?' Woods CERTIFICATE OF DEATH
Donald L. Woods
ReA 195 Dist 160 Bk 74
Roy WOODS MALE Dec. 30, 2001
Donald Le
4. SOCIAL SECURfr~ _~. AGE - Last. 5b. UNDER t YEAI~ 5c. UNDER I DAY B DATE OF BIRTH ?. BIRTHPLACE (Cily enl~ State o~ Foreign
520-44'2380 I u ' : I- : JAuKust 29, 1941 Afton, Wyoming
9C. C11~ TOWN OR LOCATION OF DEATH Sd COUN~ OF DEATH
Montrose Memorial Hospital Mo t se Montrose
1Da. DECEOENT'S USUAL OCCUPATIONI IO1~, KiND OF BUSiNESS/INDUSTRY 11. MARITAL STATUS ' MarrieD. t 2. SPOUSE {11 wile. gwe m~ide~ nllmel
I
Production Mana§er J Manufacturing :.:::;r IWid°wed Joyce Larson
13~* RESIDENCE*STATE I 13b' COUNW I I ~c' CffY. TOWN. DEl LOCATION 13d. STREET AND NUMBER
Colorado Montrose .? Montrose 808 North 9th St.
13e. ~I~i~DE 13L ZIP CODE .~..W~A~ ..0~EC~,~E~[~E,~TOI~: .H. JSp,~.tC (~pJ(~lJ~J?, J j~: RACE: Ai111~cil~ i.~ljl~' lB' DECEDENFSEDUCATiONjSpJclvonlrAigheS,
ay,, 81401 ' ~No O~o, White .~
. ' (F' , i~ile. LasO *:';" I lB, MOTHER:H~J~E ~rst.~d~le J;a~l (Malden Name 19 NFOR~,4ANT-NAME&ndrea ~shp O deceased
~Lowell LeRoy Wo0~d=s''''~'; "]'Dorothy Fo:rd' .:":!'" : ~ ~ynette Hammett, Daughter
............ r/ I:~r~ud~l O~' m ti ~ 2=: ~ :. othe~c~ : " ' : ' '
mOonation mOmmISpe~t~ i~?:: . ': : Valley Lawn Cemetery . . Montrose, Colorado
~ ~ ~ .: ~7 ,L.~ , = ::::. ! · I ~ontrose Valley Funeral Home, Inc.
~~'~'~/~ ~'~ { ~05 S ~ 2nd SI?.'' Montrose, Co z,P~140].
"~~:~" ~ ~/'-~ !i:~"::"' ~::i:ii:: :: I JanUary 2, 2002
1617 December ::%30,"L~2001 - 1617
m : To B{'COMPLJETED ONLy B¥:iCEB:'riEYING ~'HY$ICIAN : { ' TO BE COMPLETED 8Y COROrd ER
January 1, 2002 J
Robert Patterson, D.O. 800 S.' 3rd St. Montrose, Colorado zm. 81401
4
5
THIS IS TO CERTIFY THAT TH IS IS A TRUEAND CORRECT COPY OF THE OFFICIAL RECORD WHICH IS IN MY CUSTODY.
JAN 1 /~ 2002
DATE ISSUED
RONALD S. HYMAN
-~T,'-'STATE REG STRAR
Do not accept unless prepared on security paper with engraved border displaying the Colorado state
seal and signature of the Registrar. PENALTY BY LAW, Section 25-2-118, Colorado Revised
Statutes, 1982, if any person alters, uses, attempts to use or furnishes to another for deceptive use
any vital statistics recorcL NOT VALID IF PHOTOCOPIED.