HomeMy WebLinkAbout90678950066
(04)
STATE OF WYOMING
COUNTY OF LINCOLN
I, Dorothy F. Woods aka Dorothy A. Woods
sworn on oath, depose and say:
AFFIDAVIT
RECEIVED 3/1/2005 at 10:50 AM
RECEIVING # 906789
BOOK: 579 PAGE: 882
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
, being first duly
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 Sandra L. Woods in that
certain WarrantY Deed recorded January 16, 1978 , Book 143 P.R.,
Page 159 in the office of the Recorder of Lincoln County, Wyoming.
at
That I know of my own knowledge that Sandra L. Woods in the said deed
and Sandra Lynn 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
Sandra L. Woods in the following described property:
Commencing at a point North 51015, 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 90o0, West, 275 feet, thence North 000, East, 219.6 feet, thence North
76o28, East, 283 feet, thence South 0°0' West, 285.6 feet back to point of beginning.
37
D-oroth)~ ~.,~¢¢oods
Subscribed and sworn to before me this~ day of /¢ .2005
Comm~plre,' ~/¢W/~,.~~._ -..--
STATE OF COLORADO
HOLD TO LIGHT TO VIEW WATERMARK
"~ :STATE OF ~OLORA~O ::i! ~': 5:; ::: I STATE FILE NUMBER
CERTIFICATE OF DEATH
Sa~d;a [~n~ WO09S J ~e ;eS~ua~7 12~
NUMaER ' ~t~h~y.(Years) ~ Mos ~ ~ys .. I Hfs ' M*~ *' {~onth, Day, Yea~: ~unl~y~
522-66-7502 3b :{ :: ~: ::J ; ' ~:: J'*Janua~y 22, 19~8] ~ton. Wyoming
Montrose Memorial Ho~pit~i" "'i!:i' :::,:i" '!': Montro~e ::': ' : Montr0se
Museum Assistant '} ';'iI Ut~:;rndl~ff M~S~um ';'?~'-/~.:'~: I; Never ~rried I ''
~. RESIOENCE-S~ATE [ ~. COUN~ ',:' ;::~;~., , I~ CI~.TO~,OR~A~ON '; I~. S~RE~ANDNUM~R .
ColoradoI I M°ntr°~e :': I 'Montrose'.?: ' ' I:' 67468 Sunnyside Road
Lowell L. Woods .-?'::~ 'Ford " :: .'.:,[ Dorothy Ford, Mother
m~. m~.,~s~.~ ~Valley La~S C~tory .'~ Montrose, Colorado
~ .,:~:;~-.:: :. ': Moutrose ValleY Funeral Home
505 S. 2nd Street, Montrose, CO z~,: 81401
2~4.
2310 ~ 12 2004 2310 No
- . ~ ~ ~ ~ ' ~:::::
John C. L~bert, M.D. 300 S'. Nevada Montrose, CO zm; 81401
31. NAME OF ATTENDING PHYSICIAN IF OTHER THAN CERTIFIER (Type/Print)
4 33~. DATEOF N JURY 33b. TIMEOE ~33¢. INJURYAT 1'33~ DE$CRIBEHOWINJURYOCCURRED
I (Ment~ Day, Yee~) I INJURY ~ WORK? I
~Suic~:le Manner J33e. P~&.CEOFIN~JR :, i~. ' t, aotMy. '
I
THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF THE OFFICIAL RECORD WHICH IS IN MY CUSTODY.
DATEI$SUED EELq 2 2 2005 RONALOS. HYMAN
-,..', STATE REGISTRAR
Do not accept unless prepared on security paper with engraved bord~'~tisplaying the Colorado state
seal and signature of the Registrar. PENALTY:: BY LAW? Section 25:2-118, Colorado Revised
Statutes, 1982, if any person alte}s, tisesi:attempis to useov furnishes to another for deceptive use
any vital statistics record. NOT VALID IF PHOTOCOPIED.
REV 07/03