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Home My WebLink About20243301.tiffCERTIFICATE OF CONVEYANCES STATE OF COLORADO COUNTY OF WELD Land Title Order No. CASS WELD COUNTY DEPARTMENT OF PLANNING SERVICES The Land Title Guarantee Company (TITLE INSURANCE or ABSTRACT COMPANY) hereby certifies that it has made a careful search of its records, and finds the following conveyances affecting the real estate described herein since August 30, 1972, and the most recent deed recorded prior to August 30, 1972. Legal Description: ALL OF SECTION 33, TOWNSHIP 7 NORTH, RANGE 62 WEST OF THE 6TH P. M., COUNTY OF WELD, STATE OF COLORADO. CONVEYANCES (if none appear, so state): Book 1430 Page 282 Book 1430 Page 283 Book 1430 Page 284 Book 1561 Page 109 Book 838 Reception No. 1760061 Book 854 Reception No. 1775510 Book 891 Reception No. 1812608 Reception No. 2600747 Reception No. 3638892 Reception No. 3653447 Reception No. 4564973 Reception No. 4565047 Reception No. 4565111 This Certificate is made for the use and benefit of the Department of Planning Services of Weld County, Colorado. This Certificate is not to be construed as an Abstract of Title, nor an opinion of Title, nor a guarantee of Title, and the liability of Land Title Guarantee COMPANY, is hereby limited to the fee paid for this Certificate. It Witness Whereof, Land Title Guarantee Company, has caused this certificate to be signed by its proper officer this 2nd day of July, 2024 at 5:00 o'clock P.M. LAND TITLE GUARANTEE COMPANY SEP•-2.1 1955 • Recorded Ni.aoaKl434 FasE23 ,- •Rcepti 2l383U • .. AnR Spomar, Recorrlr- WARRANTY DEED IN JOINT TENANCY' KNOT ALL NEN BY THESE PRESENTS, That Mary Bridget 0tToole, Margaret Winifred O'Toole, and Agatha Elizabeth 0tToole, of the County of Muscatine and State of Iowa, for the consideration of Ten Dollars. and other valuable considerations in hand paid, hereby sell and convey to John Thomas O'Toole and Ruby -C. O'Toole, of the County of'Weld and State of Colorado, to pass to the said John Thomas O'Toole and Ruby C. O'Toole, not in tenancy in common but in joint tenancy, the survivor of them, their assigns, and the heirs and assigns of such -survivor the following real estate and property, situate in the County of Weld and State of Colorado, to -wit: Parcel No. 1 An undivided three -fourths interest in the following described property: The Northeast Quarter (NEtI) of Section Twenty Eight (28) and the Northwest Quarter (NVi) of Section Twenty Seven (27), Township Seven (7) North, Range Sixty Two (62) West of the Sixth Principal Meridian, reserving, however, unto the grantors a three -eighths interest in and to all oil, gas, and other minerals in and under the same hereby conveying to the grantees an undivided three -eighths interest in and to all oil, gas, and other minerals in and under the same. Parcel No, 2 An undivided three -eighths interest in and to the Southwest Quarter (SW -4) of Section Twenty Six (26), the Southeast Quarter (SEY) of Section Twenty Seven (27) and the Northeast Quarter (NE`) of Section Thirty Three (33), all in Township Seven (7) North, Range Sixty Two (62) West of the Sixth Principal Meridian, reserving, however, to the grantors three — eighths of all oil, gas, and other minerals and under said Parcel No. 2 hereby conveying'to the grantees no mineral interests in Parcel No. 2 together with all its appurtenances, and warrant the title to the same, subject, however, to the following: 1. Rights of way for roads and ditches noia existing. 2. 1955 taxes payable in 1956. - Signed and delivered this • 3rd STATE OF ION1A ) SS COUNTY OF MEIT CATINE ) day of September. 955. Seal) ��,&,(S eal) • The foregoing instrument was acknowledged before me this 3rd day September , 1955, by Mary Bridget O'Toole, Margaret Winifred O'Toole and . '4 tY(a(E ,izabeth O� Toole. W2TUESS my hand and official seal. k11 commission -expires: 1:: J145;It 1957. Notary >ublic ••41i( f .\ This . deed is made to partition• -real estate betwe the parties. The actual money consideration for'this'deed is less than $100.00. SKLD, Inc. LG SKL15975 WE 1213830-1955.001 SEP r a 211955 `OF i ... a oxi430 ' E283 Recao,. 1 1-38 3l Ann Boom&, WARRANTY DEED IN JOINT TENANCY KNOW ALL MEN BY THESE PRESENTS, That Mary Bridget OtToole, Margaret Winifred OtToole,.and Agatha Elizabeth OtToole, of the County of Muscatine State of Iowa, for the consideration of Ten Dollars and other valuable considerations'in hand paid, hereby sell and convey to John Thomas OTToole and Ruby C. O'Toole, of the'County of Weld and State of Colorado, to pass to the said John Thomas'OtToole and Ruby O'Toole, not in tenancy in common but in joint tenancy, the survivor of them, their assigns, and the heirs and assigns of such survivor the following real estate and property, situate in the County of Weld and State of Colorado, to —wit: An undivided three -eighths interest in and to the Northwest Quarter (NW) and South Half (Si) of Section Thirty Three (33), Township Seven (7) North, Range Sixty Two (62) West of the Sixth Principal Meridian. • . together with all its appurtenances, and warrant the title to the same, subject, however, to the following: 1. Rights of way for roads and ditches now existing. 2. 1955 taxes payable in 1956. 3. Reservation of all mineral rights to Union Pacific Railroad Company by deed recorded in Book 445, page 22 of the Weld County records. Signed and delivered this 3rd STATE OF IOWA ) ) SS COUNTY OF MENCATINE) day ofSept,'1955. The foregoing instrument was acknowledged before me this 3rd day of• September 1955, by Mary Bridget O'Toole, Margaret Winifred O'Toole and Agatha Elizabeth O'Toole. !,14TNESS my hand and official seal. t commission expires: ' — July 14, 1957. • T v _ -LA Notary Public .This deed is made to partition real estate between the parties. The actual money consideration for this deed is less than $100.00. SKID, Inc. LG SKL15975 WE 1213831-1955.001 se - 211955 _ 'J�eco2Jed s7� r�paattry _ _ _017,- gooK1430 PaGE�+8Reception _1 x.3832 Ann Spomer. •' WARRANTY DEED (Gift:'in.Joint Tenancy) also known as John T. OlToble KNOW ALL KEN BY THESE PRESENTS, That John Thomas OtToole,tof the County . of Weld and State -of Colorado, for and in consideration of natural love and affection, does hereby sell and convey to John Thomas O'Toole and Ruby C. OtToole, his wife, to pass to the said John Thomas O'Toole and Ruby C. O'Toole, his wife, not in tenancy in common but in joint tenancy, the survivor of them, their assigns, and the heirs and assigns of the said survivor, the following real estate and property, situate in the County of Weld and State of Colorado, to -wit: Parcel 1. The entire interest in and to the Southeast Quarter (SE4) of Section Twenty-eight (28), and the Southwest Quarter (SWa) of Section Twenty-seven (27), Township Seven (7) North, Range. Sixty- two (62) West of the Sixth Principal Meridian Parcel 2. An undivided five -eighth (5/8) interest in and to the Northwest Quarter (Ni-)Gand the South Half (Si) of Section Thirty-three (33), Township Seven (7) North, Range Sixty-two (62) West of the Sixth Principal Meridian. Parcel 3. An undivided five -eighth (5/8) interest in and to the Southwest Cuarter (SW) of Section Twenty-six ,(26) and the Southeast Quarter (SE§) of Section Twenty-seven (27) and the Northeast Quarter (NE-) of Section Thirty-three (33), all in Township Seven (7) North, Range Sixty-two (62) West of the Sixth Principal Meridian. Parcel 4. An undivided one-fourth (4) interest in and to the Northeast Quarter (NE4) of Section Twenty-eight (28) and the Northwest Quarter (1M) of Section Twenty-seven (27), Township Seven (7) North, Range Sixty-two (62) West of the Sixth Prin- cipal Meridian with all its appurtenances, and warrants the title to the same subject, however, to the following: 1. Rights of way now existing on said premises or as created by instru- ments of record. 2. Reservations and exceptions validly created by instruments of record. Signed and delivered this /;7 day of September, A.D., 1955. pF COLORADO) CO 'DF WELD ) SS m:A ,, .:__-- .E foregoing instrument was acknowledged before me this 19th day of Sep- ; "G ix ,` l955, by John Thomas O'Toole, also known as John T. O'Toole. �°✓J'y-'. ::WITNESS my hand and official seal.• My commission expires: My Commission expires Au Publi SKLD, Inc. LG SKL15975 WE 1213832-1955.001 (SEAL) S, 195% Kecordcd'at �o c(rxiC :A.� �g 3 29%t3 y,)P 27 96[� BOOK1561 PAGE109 . Rec. r1o.,_—,,.�:_,.:(n gamer, ecorder, DEPARTMENT OF HEALTH. 1'- SrATr' D ORADO EDUCATION: AND WELFARE ' r PUBLIC HEALTH SERVICE `'-' STANDARD CERTIFICATE OF. DL-.fK`• State File No. Registrars No. 546 Dist. 238 1. PLACE OF DEATH a. COUNTY. Weld 2. USUAL RESIDENCE (Where deceased lived. If institution: Residence before a. STATE b. COUNTY , admission) Colorado Weld b. CITY. TOWN, OR LOCATION Cornish -rural c. Length of Stay in lb 47 years a CITY, TOWN, OR LOCATION COrni ch d. NAME OF ' (If not in hospital, give street address) . HOSPITAL OR INSTITUTION d. STREET ADDRESS. c. IS PLACE OF DEATH INSIDE CITY LIMITS? YES ( ) NO (x) c. IS RESIDENCE INSIDE CITY LIMITS? YES ( ) NO.( X E. IS RESIDENCE ON A FARM? YES (X) NO ( ) 3. NAME OF First Middle Last • ECEASED (1Type or Print) JOHN THOMAS ..O'TOOLE 4. DATE Month Day , Year OF • DEATH December 9, 1959... 5. Sex 1 P 0. Color or Race White 7. Married (X) Never Married ( ) Widowed ( ) Divorced ( ) S. Date of Birth 9-24-1883 9. Age (In Years Ins Irthday) �Ig If Under 1 Year Months I Days If Under 24 Hrs. Rents I lMill.Ma 10a. Usual Occupation (Give kind of work done during most of working life, even if retired) Rancher 10b. Kind of Business or Industry 1f. Birthplace. (State or foreign coucntry) Letts, Iowa 12. Citizen of What Country? USA 13. Father's Name Patrick O'Toole 14. Mother's Maiden Name Mary Griffin, 15. Wns Deceased Ever in U. S. Armed Forces? (Yes. no.oror unknown If yes, give war or dates of service) 16. Social Security No. 17. INFORMANT Address RUBY O'TOOLE, CORNISH, Colorado MEDICAL CERTIFICATION IS. CAUSE OF DEATH (Enter Part 1. Death was Caused Immediate whichConditigav, it any, .which gave rise to above cause (a), stating the under- lying cause last. " only one cause per line for (a), (b), and (c).) • Fr By: M oeardial Insuffici llc Cause (a) Y.__.._._..._...._. Y _ - Arteriosclerosis of Coronary Artery Duc to(b).»..._..._....._.»..............._ Duc to(cl.__.�.___._....___..._._........__.._..---...._ — INTERVAL BETWEEN l gr T0DDPGATHQ 1959 ;) - i , L Part II. Other significant conditions contributing to death but not related to the terminal disease condition given in Part 1 (a) _ . 19. Was Autopsy Performed Yes ( ) ?'No t1 20a. Accident Suicide Homicide • O (1 () 20b. Describe How Injury Occurred. (Enter nature of injury in Part I or Part II of Item 18.). U 20c. - Time of Hour Month, Day, Year Injury a.m. p.m. • O 20d. Injury Occurred While At Not While Work ( ) At Work ( ) 20e. Place of Injury (e.g.. in or about home. farm, factory, street. office. bldg., etc.) 20f. City. Town, or Location County State • • - •' O 21. I attended the deceased from2-t6r51._.__._..._....___..._..._.__.._..__, to_....1_2_-9_cJ.9...........and last saw htr alive on....1.2-4-59 -. him Death occurred at ......_...........7:_30._AM m. on the date stated above: and to the best of my knowledge, from the causes stated, 22n. SIGNATURE (Degree or title) DR. E. J. LEE, D.O. 22b. Address . Greeley, Colorado 22c. Date Signed .:12--.12--.59 . 23a. Burial, Cremation, Removal (Specify) Burial 23b. Date 12-12-1959 23c. Name of Cemetery or Crematory Linn Grove 23d. Location (City, town, or coanyi).-,,:_. •;;. (State) ' •"` •' Greeley; 'C°olo -fad. - : • ' LU r 24. Funeral Director Address Greeley RFP'D P. ADAMSON. Adamson MortuarvrColo 25. Date Reed By Local Reg. 12-15-1959 26. Registrar's ISiRSatal jf;4 J'j-. J. H. WHILTE`�;W ! _=__ _' :J. STATE OF COLORADO s s. County of Weld I •+ • I. J. H. WHITE, M.D., Loal Registrar of Vital Statistics for, the County of Weld. State of Colorado, do hereby certify that ..the'r4tv JOHN THOMAS O'TOOLE 'r correct copy of the record of death of in my custody, and now on file in my office. Given under my hand and seal this 23d day of Local Registrar of Vital Statistics (Name) December Registration District No. 235. Weld County, Colorado. SKID, Inc. LS SKI15975 WE 1332903-1960.001 (SEAL') Vl Erma u,tci.rt' nuurse g1641 n«wdedo,_in o'cio* >w JUL 13'1978 Arc. Nc...._.l' 6OO--'l �• Haar Ann FwnhM. Recorder STATE OF COLORADO DEPARTMENT OF. REVENUE _. INHERITANCE TAX DIVISION 201 EAST COLFAX AVE. DENVER, COLORADO 00203 RELEASE OF INHERITANCE TAX LIEN v - - Estate of Ruh y -('rrnl 1 n 0' Tnnl n - Dateof Death Pebruary 14 1978 • Grose Estate$. .184,678 • 18 • - It annearing to the Executive Director, Department of Revenue that It is not necessary to preserve, Q - the Hen granted by'theColorado-inheritance•tan law against the hereinafter• described real estate, in o which the above named decedent had an interest, by virtue of the authority vested in one.under the pro-- • visions of Title 3D-23-166, CRS 1973. I•ito hereby forocet' release and discharge the inheritance tax lien .., against: the followingg-described real estate,. to -wit: • - All of Section 33; the 'East of .Section 28:011 of . Section 27,•except the ,NE. and the Slli:i of 'Section Township • 7 North, Range. 62 West of the Etli p'.bf: , I all ., in Weld County, Colorado beingapproximately 1000 acres including: one house.., EXECUTIVE DIRECTOR Idtet'tue P,ra p Noll, —This relent° must Ito recorded In the office of the Burk and rncndter of Chu eouty In.'whleletho property Is situate. lamas ISIS. l.r. S-il a.k... ii inirra.nr•T., 1Arn . nrn,nnnl l'ublaleiw I;n.. iiti_Io 41>i° Otto-, 0.•n,-rr. cuinrnk-0.14 .tAletti._ Tr, i SKLD, Inc. LG SKL15975 WE 1760061-1978.001 cr 854 R.co,d.d ot �� o'clock jtiL SEC 12 19O3 1'775510 a -f Slot. of Colorado, Wild County Clark. G R.cord.r DEED OF DISTRIBUTION BY PERSONAL REPRESENTATIVE THIS DEED made by Helen M. Cass.as Personal Represent- ative of the Estate of Ruby Cecelia O'Toole, deceased, Grantor,. whose address is 42085 Weld County Road 80, Briggsdale,... Colorado 80611 to Mary G. Reed -and Helen M. Cass, Grantees, O . 0 . whose addresses are 2200 37 Street 83, Evans, .Colorado 80620 c:, t•' and 42085 Weld County Road 80, Briggsdale, Colorado 80611, '- respectively. ri WHEREAS, Grantor is the qualified Personal Representative LIJ a of said Estate, Probate No. 1.4236, Weld County, Colorado;. and WHEREAS, Grantees are entitled to distribution of the hereinafter described real property. THEREFORE,'Grantor conveys, assigns, transfers and releases to Grantees the following real property in Weld County, Colorado; Parcel .1. The entire interest'in and to the Sou - east Quarter (SE≤) of Section Twenty-eight (28), South- east d the Southwest Quarter (SW%) of Section Twenty-seven (27), Township Seven (7) North, Range Sixty-two (62) West of the Sixth Principal Meridian. Parcel 2. The entire interest in and to the North- West Quarter (NWh) and the South One-half (Sh) of Section Thirty-three (33), Township Seven (7) North Range Sixty-two (62) West of the Sixth Principal Meridian, excluding all mineral rights reserved to the Union Pacific Railroad 'Company by Deed recorded in Book 445, Page 22 of the Weld County. Records.,, Parcel 3. The:.entire interest in and to the South-. west .Quarter (SWts) of _Section Twenty-six (26) ,:the Southeast Quarter.'(SE') pf Section Twenty-seven (27)-, the Northeast Quarter .(NE$) of:Section Thirty. -three (33), Township Seven (7)„ North, Range Sixty two !62) Westof the. Sixth PrincipalMer.idian, except thre-, eights (3/8) of all oil, gas, and other minerals,. reserved by Deed recorded in Book 1430, Page 282, Reception No. 1213830 of the.Weld.CoUnty Records.' Parcel 4. The entire interest in and to the North east Quarter =(NE1)- of Section, Twenty. -eight (28), and the Northwest. Quarter (NW4).of Section Twenty seven. (27), Township Seven (7) North, Ringe Sixty- two (62)`,West,of the Sixth ' Principal Meridian, excepting Three-eights'(3/8) of all oil,, gas, and other minerals,.reserved,by Deed-_ recorded. in Book 1430,''; Page 282, Reception No. 1213830: of the -Weld. CountyRecords - SKLD, Inc. LG SKL15975 WE 1775510-1978.001 1.. Rights -of -way now existing on said premises ed;by instruments of record. Executed this ._]5.day of December, 1978. e en M. Cass as.Aersonal Representative of the Estate of Ruby Cecelia O'Toole;. deceased. , : ^"''The foregoing instrument was acknowledged -.1-;k:°-Z-74,6\ y-Z7 �"•. day of December, 1978 by Helen M. 01 Jt1YT�Eg66my hand and official seal.. �PUpl1�f My.atemmission expires: September 20, 198 SKLD, Inc. LG SKL15975 WE 1775510-1978.002 ivrl>a 7� K1 1.R�4ti^ re`F M�1 "'• ra6t ` �y� tlt�r �yrr 'it '� 16• �.tS)'r l 1,4 -qt 4,441r7di� �� +.trdkf it is 5 891 ltecorrled at . ,'cock A M. DE tV Reception \'o.. il3126Qn.. ....... :.licjru Colorado for the eoneldoration of other valuable consideration and Ton and no/100 — — dollnrs, in hand paid, hereby sell(.) and cnnvey(e) to HELEN M. CASS and WAYNE N. CASS 42085 Weld County Rd. x/809 iriggsdale, County of • , and State of Colorado the following. real property in the County of WELD and State of Colorado, to wit: An undivided one—half (1/2) interest in and to the following • described property, situate in WELD County, Colorado: The Southwest Quarter (SW) of Section Twenty—six (26); the Southeast Quarter (SEI%) and the•West Half (WS) of Section Twenty-sevon.(27). the Southeast Quarter.(5E%) and the North- east Quarter ((Nit43 of Section Twenty-eight (28); and all of Section Thirty -throe -(33), all in Township Seven (7) North, Range Sixty-two (62) West of the 6th P.M., EXCEPTING and RESERVING unto the grantor herein an undivided-5/16ths of all the oil, gds and other minerals lying in and under and that may be produced front the following described property: The Southwest Quarter (Sw;i) of Section 26; the Southeast Quarter (SE%) and tho Northwest Quarter (NW)4) of Section 27; the Northeast Quarter (NE%) of Section Twenty-eight (28), and tho Northeast Quarter (NE%) of Section Thirty-three (33), all in Township Seven (7) North, Mango Sixty-two (62) West of the 0th P.M.; *to the 1070 taxos, payable in 11)50. • with on ne nppurtonnncca, and warrwd(s) the title to the name, subject to previous res. line as provided iiislrumenicrecordeduinelook 1501,rpagei543 of the Weld County Records• to reservations and exceptions contained in the. 'hilted Status Patents; to notice of Weld County Zoning and Subdivision regulations; to ell and gas lenses of record;• to rights - of -way for public highways and to any and all rights -of -way and, onsomontM however t'videnced over and across said property; and* Signed We lay of December ,1979. C.`a.1ur' 4 Miry G. 'Reed 9'hi' fm n.h1it 01,1, Inlet WIll MI(IRIWledg„d before nu' Ibis /, day o(.•'". nlbur , In 7N , by MARY 0. RIMED. �S,yy ronuni,elon titer }l!lbteee nt,Y hats nd nl th•Ia) . i ni, o •cut' • DN. in. w.rrr.lr II,.5,,d 14611. ,, re. 1,11.11.71 .1 ei,.t, arolur.4o '.14tt SKLD, Inc. LG SKL15975 WE 1812608-1979.001 No Doc. Fee 7L !-111II3II1!IIII! !Ilu !III !IE !111!1 !II-1Iu-Ilu-!III- 2000747 03/19/1998 01:37P Meld County CO 1 of 1 R 6.00 D 0.00 JA Suki Teukamoto WARRANTY DEED KNOW-ALL MEN-3'fTlIESE PRESENTS; That -We; WAY -NE -N: CASS and -HELEN - M. CASS, whose street address is 42085 Weld County Road 80, Town of Briggsdale, County of Weld, and State of Colorado, for the consideration of other good and valuable considerations and Ten and No/100 Dollars, in hand paid, hereby sell and convey WAYNE N. CASS and HELEN M. CASS, whose street address is 42085 Weld County Road 80, Town of Briggsdale, County of Weld, and State of Colorado, as Tenants -in -Common, the following described real property situate in the County of Weld, State of Colorado: An undivided interest in and to: The Northeast Quarter (NE1/4) and the Southwest Quarter (SW1/4) of Section Eighteen (18), Township Seven (7) North, Range Sixty-one (61) West of the 6th P.M., AND The South Half {S1/2) and the Northwest Quarter (NW1/4) of Section Thirteen (13), Township Seven (7) North, Range Sixty-two (62) West of the 6th P.M., AND The West ten acres (W 10) of the Southeast Quarter (SE1/4) of Section Eighteen (18), Township Seven (7) North, Range Sixty-one (61) West of the 6th P.M., AND All- of- Section- Thirty-three- (33),- Township- Seven. (7). North,. Range- Sixty-twa (62) West of the 6th P.M., AND The- Northeast -Quarter (NE -1/4)- of -Section- Twenty-four- (24); Township- Seven - (7) North, Range Sixty-two (62) West of the 6th P.M., AND The West Half (W112) and the Southeast Quarter (SE1/4) of Section Twenty- seven (27), Township Seven (7) North, Range Sixty-two (62) West of the 6th P.M., AND The Southwest Quarter (SW1/4) of Section Twenty-six (26), Township Seven (7) North, Range Sixty-two (62) West of the 6th P.M., AN D The Northwest Quarter (NW1/4) of Section Twenty-four (24), Township Seven (7). North,Range Sixty-two (62) West of the 6th P.M., with all appurtenances and warrant the title to the same subject to reservations, exceptions, restrictions, conditions, and easements existing or of record; and 1998 taxes due and payable in 1999. Executed this 11' day of March, 1998. lift )7 Ca -,d - 2,7 Wayne N. ass Helen M. Cass STATE OF COLORADO COUNTY OF WELD ) ss. ) The foregoing instrument was acknowledged before me thin 1998, by Wayne N. Cass and Helen M. ass, and each of them.-) official seal. My Commission expires NOTARY P • ;of March, 'nay- _pand and SKLD, Inc. LG SKL15975 WE 2600747-1998.001 WA rF 2_ 3 4 5 CAUSE OF DEATH ti STATE OF. COLORADO COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT HOLD TO LIGHT TO VIEW WATERMARK 1. DECEDENTS NAME (Fire; MiddIe. Carl) Wayne Nolen 4. SOCIAL SECURITY 8- WAS DECEDENT EVER IN U.S. ARMED FORCES? ❑Yea RN° 9b. FACILITY NAME II/ noflnslltulion. give sheet and numbed Anschutz Inpatient Pavilion / UCH 10a. DECEDENTS USUAL OCCUPATION (Give hind°, work done during most °t workingIlle. Do no( use retired.) STATE OF COLORADO CERTIFICATE OF DEATH 50, UNDER I DAY 5e. AGE - Last 81rthdday (Yeas) 5b. UNDER 1 YEAR Mos 1 Days Be. PLACE OF DEATH (Check only ono) HOSPITALS' OTHER 'p inpatient 0ER/Oulpetlent O 00A 1 0 Nursing Home ❑ Residence O Other(Spedr/1 CASS Hrs ;Minn STATE FILE NUMBER 2. SEX Male fi DATE OF BIRTH (Month. DOE Year) December 04, 1916 del 3. DATE OF DEATH (Month. Day, Year? June 22, 2009 7. BIRTHPLACE (City and Stan or Foreign Country) Briggsdale, Colorado Rancher Farmer 13e. RESIDENCE-5',AiE I lbb. COUNT. Colorado Weld ISe. INSIDE CITY LIMITS? .OYes 2No 7. FATHER -NAME (First, M/ddla, Lesl) 131.2 P CODE 80611 William A. Cass g1. CITY, TOWN, OR LOCATION OFDEATH Aurora 106. KIND OF BUSINESS/INDUSTRY Agriculture tae, CFO, TOWN, OR LOCATIS: Briggsd8.le 14. WAS DECEDENT OP HISPANIC ORIGIN? (Specify ye specify Cuban, Iceo, Puerto Rican X No OYes Spew)? 200. METHOD OF DISPOSITION id Burlet 0 Cremation 0 Removal )horn Stele 0 Donelion OOther )SpCo/yr 210. SIGNATUR- s F FUN RAC. VEEC PERSON r 11. MARITAL STATUS Married Divorceda(Sed, ll/Hdowed, Married 13d STREET AND NUMBER ed. COUNTY OF DEATH 12. SPOUSE U/ wire, give maiden nem0) Helen O'Toole 42085 County Road 80 16. RACE American Indian, Black. Whke. etc. (50.0/10) White 18. MOTHER -NAME (Pvn1. N/OAle, Lee Weldon Marne)) Maggie J. Nolen 2Cb PLACE OF DISPOSITION µlame of vemetary, crematory, or other pl.eel IS. DECEDENTS EDUCATION (SpeoUyonlyh(ghost q d, comp/atod) Elementaryor secondary 10 through 12) Cdbage 113 through 18 or 17+) 12 ig. INFORMANT -NAM£ and relellonsn)a to deceased. Helen Cass - wife Sunset Memorial Gardens TINE Ala SUCH TIR'Sr � � 23. FDEA -) 24. DATE PRONOUNCED DEAD T Month Day 2 45 M June 22, 2$. To the BE COI 2oc. LOCATION - City orTown. Slate Greeley, Colorado 14 NAME AND ADDRESS OF FACILITY: Adamson Funeral & Cremation Services a Year 2009 PLETED ONLY BY CERTIFYING PHYSICIAN , d9e, moth occurred at the line, dote and piece, end due to eaa ld. lux P40 28. DATE SIGNED (Mon .Oa 1) June 23, 2009 2000 47th Avenue eD634 Greeley, Colorado 7. ZIP' "225. DATE FILED (Mon Day Y n U ..�t 0 ZUUS 255.. WAS CORONER NOTIFIED? Hour (Yes or No) 2145 f Yes TO BE COMPLETED BY CORONER 27. On the baste °lesamht Ion and/or Investigation, In myopinlon death occurred aline time, date and pin e, ejd duetonthe cause( and manner fated. Chief Slgnererepa, 28. DATE SIGNED`jMontit, Day, June 24, 2009 30. NAME•TITLE AND MAILING ADDRESS OF CERTIFIER/CORONER (Typo/Print) Robert T. Neumann MD 12605 East 16th Avenue, Aurora, Colorado 31. NAME OF ATTENDING PHYSICIAN IF OTHER THAN CERTIFIER IType/Pdnt) ,32. MANNER OF DEATH DNatury OPmanilOntlon O Aoc)dent O Selcide O Undetermined wooer D Homicide PART IN CONDITIONS DUETOO ASAi> eaueNce OF GAIF ANY WHICH q/ /y�. IMMEDIATE TO EC ibl MAO �([a(t.4G t� STATING ATECAU3E DUE T OR AS A CONSEQUENCE STATIND THE 334. DATE OF INJURY (HOME Dey- Yur) 33b. TIME OF INJURY M 331. INJURY AT WORK? OYea 0 N 330. PLACE OF INJURY -Al home,farm, street, Iactary. office bAEding,.10.(Spes)lH 334. 'DESCRIBE HOW INJURY OCCURRED Coroner ZIP' 80045 33L LOCATION (Sheet and Number or Rural Soule Number, ply, GounN.Stale) 34. IMMEDIATE CAUSE (ENTER ONLY ONE CAUSE PER LINE FORW. (N. AND (o)) Do not enter mode °)dying (e.g. GMlse or ReepirtlorY Arreet)olane. UNDERLYING CAUSE .� //R"E:/ A.4 P/. !-� PAST OTHER (N �� 10C/Y PART OTHER SiGNIFICANTGONOiT NS-Conditio contributing to death but not related to eaves in 35. AUTOPSY II PART I (e.g., eicohel abuse, obesity, smoker). (Yee or No) No Interval between onset and death Hours Interval between onset d death Days Interval between onset and death Days 38. IF YES ware Itndinge considered th determining cause of death? d /Ales+{ "JUL 0 6 2009,.,61 s �'D�hpf t.a-a•._ DATE ISSUED THIS IS A TRUE CERTIFICATION OF NAME AND FACTS AS RECORDED IN THIS OFFICE. 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 25-2.1 IS, Colorado Revised Statutes, 1982. if a person alters, uses, attempts to use or furnishes to another for deceptive use any vital statistics record. NOT VALID IF PHOTOCOPIED. 4 eta i k ..,.. y ty t" a1; RONALD S. HVMAN STATE REGISTRAR 1111 11 S L 4 1 0 9 4 9 8 REV 01/07 .en II Adams O▪ EM 0 aS = Voej = U - C MIMEU = a as mom maw ▪ ct T T � • O -OQ O O IglO O c.4=3 O I:: CD _O� 0.4 _1T CO me m`o CD MIME / f≤� SKID, Inc. LG SKL15975 WE 3638892-2009.001 11111111111111111111111 111111 III 1111111 III nm II i III \T 3653447 10/09/2009 01:17P Weld County, CO 1 of 1 R 6.00 D 0.00 Steve Moreno Clerk & Recorder PERSONAL REPRESENTATIVE'S DEED (Testate Estate) THIS DEED ::s made by Helen M. Cass, as Personal Representative of the Estate of Wayne Nolen Cass, a/k/a Wayne N. Cass, a/k/a Wayne Cass, deceased, Grantor, to Helen M. Cass, whose legal address is 42085 WCR 80, Briggsdale, CO 80611, for life, with the remainder at the time of her death to Jerry W. Cass, Grantee, whose legal address is 37401 WCR 79, Briggsdale, CO 80611. WHEREAS, the above named decedent in his lifetime made and executed his last will on the 18th day of March, 1998, which will was duly admitted to informal probate on July 30, 2009, by the District Court in and for the County of Weld and State of Colorado, Probate No. 2009PR276; WHEREAS, Grantor was duly appointed Personal Representative of said Estate on July 30, 2009, and is now qualified and acting in said capacity; and WHEREAS, Paragraph 4 of decedents last will provides that certain property shall be devised to Helen M. Cass for life with the remainder to Jerry W. Cass, NOW THEREFORE, pursuant to the powers conferred upon Grantor by the Colorado Probate Code, Grantor hereby sells, conveys, assigns, transfers and releases to Helen M. Cass a life estate with the remainder to Jerry W. Cass, the persons entitled to distribution, Grantee, the following described property situate in the County of Weld, State of Colorado. All of the de:cedant's undivided 1/2 interest in and to the following described property: All of Section 33, Township 7 North, Range 62, West of the 6th P.M. The Northeast Quarter (NE]/4) of Section 24, Township 7 North, Range 62, West of the 6th P.M. With all appurtenances Excepting and reserving all oil, gas, hydrocarbons, and other minerals underlying the lands above described. Executed: October 7, 2009 STATE OF COLORADO ) ss. COUNTY OF WELD Helen M. Cass Personal Representative of the Estate of Wayne Nolen Cass, a/k/a Wayne N. Cass, a/k/a Wayne Cass, Deceased. The foregoing instrument was acknowledged before me this 7th day of October, 2009, by Helen M. Cass, Personal Representative of the Estate of Wayne Nolen Cass, a/k/a Wayne N. Cass, a/k/a Wayne Cass, Deceased. Witness. my hand official seal. My commission expires: November 25, 2012. NOTARY PUBLIC [KATHERINE A. PERKINS I NOTARY PUBLIC STATE OF COLORADO My CoarnISSion Exoires 11-25.2012 SKLD, Inc. LG SKL15975 WE 3653447-2009.001 y t d �`�� cl�r14 41C ;Z�,vfA d`�¢„;?i- "'tF 1i- �Y .'`fi"- It 1fC FT j,. j}.. f, r�i` 1 A z-5 `4. tri K. y _ y 4 z I'+s r.y yF: a 11{" l�f.'�iGi4 4t.g I,r -r- 'STATE OF' COLORADO t� l i�� a 1 �� J E TIFICATI . N • F vrr•L — EC • — . ,!tit,it `� 0 , �o P� I't d 9� w � `� �-1i s. f! ."�9 Vil ✓ � :. I 1 1111x. r t'.. ,� ti -1 �� ft L13t..r�Fk�l .�bA3'' . ;-I,'>zxEr�,t�°'}s.', Yi^ �_i'�.t�. as'rrt4_M' �'�`"c>�':fit.8" tY1kk�.Y :3 ��i.94�k)`1s:'Lp<t nr.:yn daSa....� &1�'�'g'ZSv€... t� . CERTIFICATE OF DEATH STATE FILE NUMBER 1052019033948 L � `E r- _ i t c Jr4y 8( �t , va "'' ) j DECEDENTS LEGAL NAME HELEN MARGARET CASS ; : `' _: DATE OF DEATH NOVEMBER 09 201:9 : � II " tu??'r SOCIAL SECURITY NUMBER AGE -Last Birthday (Years) UNDER 1 YEAR .UNDER 1 DAY ., DATE OF BIRTH (Nip/DaY/Yr) ,. BIRTHPLACE (Slate or Foreign Country) C --;.--;1,,,--- FEMALE: 101 Mohths Days Hours Minutes APRIL 16 1918. COLORADO IF DEATH OCCURRED IN HOSPITAL IFrDEATH OCCI)RRED:SOMEWHERE'OTHER THAN -A HOSPITAL. NURSING HOME/LONG TERM CARE FACILITY•';:.,, Facility Name. (If not institution, give street & number) GRACE POINTE CONTINUING CARE. SR CAMPUS SKILLED NURSING "..CITY,,T0WN OR LOCATION OF>DEATH :: GREELEY COUNTYOF DEATH 1NELD RESIDENCE- STREET AND NUMBER :`-: :: ": `; .::,.. 42085 WCR 80�::-.;: ': - : --: APT. NO. -` ZIP CODE 80611 INSIDE CITY LIMITS NO RESIDENCE STATE ' ' .:' - COLORADO -- COUNTY :;:: �' ;' -' - :, WELD r' " ,..- CITY:OR. TOWN." BRIGGSDALE: ` e.. DECEDENTS USUAL OCCUPATION (Give kind of work done during most of working life. Do not use retired) SECRETARY ' .:" '.:. ... KIND OF-BUSINESS/INDUSTRY - - FOREST SERVICE � :DECEDENT'&EDUCATION 'ASSOCIATE DEGREE DECEDENT OF -HISPANIC ORIGIN , : ;- NO DECEDENTS RACE VJniie 3 EVER IN US ARMED FORCES .NO - MARITAL STATUS AT TIME OF DEATH-:= WIDOWED '.:::1NAYNE -:SPOUSEiPARTNER NAME (If wife:givaname poor to first marriage) NOLEN CASS: :'.. .,,.- FATHER'S:NAME JOHN 0 TOOLE :: ' ::. �. :: - ';:: � MOTHER'S NAME PRIOR TO FIRSTMARRIAGE: - RUBY RUNYON INFORMANTS NAME ` JERRY CASS >:: :' • ..:,. ;.,;:: ._._..`-' INFORMANTS RELATIONSHIP TO DECEASED : `':.'I - - G`11LO.: ..'.:. . : W NAME OF FUNERAL HOME ADAMSON FUNERAL AND CREMATION SERVICES ..::`. -. .. :-CITY AND STAT£ 0F:FUNERAL HOME:. - - GREELEY COLORADO WAS CORONER NOTIFIED ' YES 3. METHOD OF DISPOSITION : � BURIAL - CEMETERY 'PLACE OF DISPOSITION � � SUNSETMEM0RIALGARDENS LOCATION - CITY, COUNTY, STATE S 5 INJURY AT WORK IF TRANSPORTATION-RELATED,$PECIFY .- DATE OF INJURY .:TIME OF INJURY. PLACE OF INJURY LOCATION OF INJURY (Street & Number, Apt NO., City orTown,'County, State. ZipCode) s3 DESCRIBE HOW INJURY OCCURRED -.. ...• --�- : `T WAS.DECEDENTUNDER HOSPICE CARE • ACTUAL OR PRESUMED TIME OFAEATH':: DATE PRONOUNCED DEAD (MO/DAY/YR) TIME PRONOUNCED DEAD _ - 06:5OAM ••':; ,:.. NOVEMBER (19, 9-- 9 201. ::: `.-- 06:50 AM OF DEATH - - - NATURAL. :'..-: WASANAUTOPSY PERFORMED , NO.: .. .: • :- _ 'WERE AUTOPSY FINDINGS CONSIDERED IN DETERMINING ,: THECAUSE.OF DEATHS.... .> CAUSE OF DEATH'' PART I _ _ Enter 11e•chaln of eveni§. dlseaaes Injuriep or compllcatlons•that directly caused the death. Approximate Interval: IMMEDIATE CAUSE (Final Glsease or a:--1-:' CARDIOPULMONARY FAILURE ��:' . .: :condition resulting In death) -.'": : Onset to death IMMEDIATE - - s .. .: .. :_:` :`:. -. : b .:: ACUTE CVA .., ... .. :. DAYS Sequentially list conditions if any, .• rs Ieatling to the cause listed onilne a. Enter the UNDERLYING CAUSE (disease or injury that initiated the : — •' events resulting In death) d: .. :r., .: .. .... .. .. PART II Enter other significant conditions contributing to death but not rebulOng in the udderlyingoause:given in PART t �. �:: -' - ADVANCED AGE TITLE,NAME,ADDRESS, ZIP CODE AND COUNTY. OF PHYSICIAN---`:,:.. '` DATE SIGNED - STAN WILBUR-MD 5023 W 120TH:AVENUE E312 WESTMINSTER'CO NOVEMBER 09, 2019 s' _ TITLE, NAME; ADDRESS, ZIP CODE AND COUNTY OF CORONER:'' DATE SIGNED DATE FILED BY REGISTRAR - - �� :'�:" --� �)'� NOVEMBER 12, 2019 `4564973 02107/2020 03;40 PM,:,:' Total Pages: 1 Rec Fee: Early :Koppes - Clerk NOVEMBER 14, 2019 and $13.00' ;„ Recorder, Weld County, CO 'f DATE ISSUED g Cp I. ,RA' -(%®;r THIS IS A TRUE CERTIFICATION OF NAME AND FACTS AS A. dLEx C]UINTANA a RECORDED -IN 1H S UNr1Cl JJo not accept!, es:prepared:on .._ .. security paper with engraved bottler displaying the.Cotorado_srate.seal :- . and signature of the Registrar: PENALTY BYLAW, Section.25 118 Colorado Revised Statutes,1982, if a erson alters uses attem is to r P P �f� ��Ill I IIII use or furnishes to another for deceptive use any vital statistics record • NOT VALID IF PHOTOCOPIED.:: STATE REG STRAR REV01/19 .. fl11 9 SKLD, Inc. LG SKL15975 WE 4564973-2020.001 4565047 02/10/2020 09:36 AM Total Pages: 1 Rec Fee: $13.00 Carly Koppes - Clerk and Recorder, Weld County, CO STATE OF COLORADO SUPPLEMENTARY AFFIDAVIT COUNTY OF LARIMER IN THE MATTER OF TITLE TO REAL PROPERTY HELD AS A LIFE ESTATE Corey W. Moore, being first sworn states that he is of legal age and states that he has personal knowledge of the fact that Helen Margaret Cass, a/k/a Helen M. Cass, a/k/a Helen Cass was at the time of her death on November 9, 2019, an owner of a life estate of which Jerry W. Cass was granted the remainder interest in an undivided one-half (1/2) interest in and to the following property situate in Weld County, Colorado: All of Section Thirty -Three (33), Township Seven (7) North, Range Sixty -Two (62) West of the 6th P.M. The Northeast Quarter (NE1/4) of Section Twenty -Four (24), Township Seven (7) North, Range Sixty -Two (62), West of the 6th P.M. All in Weld County, Colorado and that affiant has no record interest in the above -described real property. Helen Margaret Cass, a/k/a Helen M. Cass, a/k/a Helen Cass who died on November 9, 2019, as set forth on the Death Certificate recorded in the office of the Weld County Clerk and Recorder at Reception No. 4564973 on February 7, 2020, is the same person who was at the time of her death an owner of a life estate in the above -described property. grey W. Moore The foregoing instrument was acknowledged before me this 2020, by Corey W. Moore. Witness my hand and official seal. Notary Public My Commission Expires: c) "A - 0-00- ( day of February, DIANE R. GODDARD NOTARY PUBLIC STATE O1• COLORADO NOTARY ID 19,2:!311-OOO963 MY COMMISSION EXPiRES FEB. 8, 2021 SKLD, Inc. LG SKL15975 WE 4565047-2020.001 4565111 02/10/2020 10:26 AM Total Pages: 2 Rec Fee: $18.00 Carly Koppes - Clerk and Recorder, Weld County, CO PERSONAL REPRESENTATIVE'S DEED TESTATE ESTATE THIS DEED is made by Janice M. Waymire, as Personal Representative of the Estate of Helen Margaret Cass, a/k/a Helen M. Cass, a/k/a Helen Cass, Deceased, Grantor, to Jerry W. Cass, Grantee, whose address is 37401 County Road 79, Briggsdale, CO 80611. WHEREAS, the Last Will and Testament of the above -named decedent was made and executed in the lifetime of the decedent, and is dated May 27, 2010, which Will was duly admitted to probate on December 18, 2019 by the District Court in and for the County of Weld and State of Colorado, Probate No. 2019PR30736. WHEREAS, Grantor was duly appointed Personal Representative of said Estate on December 18, 2019 and is now qualified and acting in said capacity. NOW, THEREFORE, pursuant to the powers conferred upon Grantor by the Colorado Probate Code, Grantor does hereby sell, convey, assign, transfer and set over unto said Grantee, as the person entitled to the distribution, an undivided one-half (1/2) interest in and to the following described real property situate in the County of Weld, State of Colorado: All of Section Thirty -Three (33), Township Seven (7) North, Range Sixty -Two (62) West of the 6th P.M. The Northeast Quarter (NE1/4) of Section Twenty -Four (24), Township Seven (7) North, Range Sixty -Two (62), West of the 6th P.M. All in Weld County, Colorado Excepting and reserving all oil, gas, hydrocarbons, and other minerals underlying the lands above described. With all appurtenances, subject to covenants, easements and restrictions of record, and subject to general property taxes for the year 2020, and subject to N/A. As used herein, the singular includes the plural and the plural the singular. Executed r,i>; rd cs r 6, 2020. WT Jan4e�e M. Waymire, as Personaepresentative of the Estate of Helen Margaret Cass, a/k/a Helen M. Cass, a/k/a Helen Cass, Deceased SKLD, Inc. LG SKL15975 WE 4565111-2020.001 4565111 02/10/2020 10:26 AM Page 2 of 2 STATE OF COLORADO ) ss. COUNTY OF Lo r; ) The foregoing instrument was acknowledged before me this 6 day of fe 6 r u a ,- y , 2020, by Janice M. Waymire, as Personal Representative of the Estate of Helen Margaret Cass, a/k/a Helen M. Cass, a/k/a Helen Cass, Deceased. WITNESS my hand and official seal. My commission expires: "43 C JOAN T. GALE NOTARY PUBLIC STATE OF COLORADO NOTARY ID 19874067906 MY COMMISSION EXPIRES AUGUST 13, 2021 SKID, Inc. LG SKL15975 WE 4565111-2020.002 ob9 c, b ,„ .% O oe O PERSONAL O „O 02/10/2020 10:26 4565,x( Tgta ages: 2 Rec Fee: y Koppes - Clerk ar 0O SENTATIVE' S D TATE ESTATE O0% OQ OQ OQ 0% THIS DEED is ma Janice M. Waymire ersonal Representatve%f the Estate of O@ en Margaret Cass, a/1 elen M. Cass, a/k/a * Cass, Deceased, Gra t , to Jerry W. Cass, O� rantee, whose addr37401 County Roa riggsdale, CO 806 O O O O00 100 ecorder, Weld Cou. oO WHER executed in t to prob of Coldo, WHEREAS, Gr ecember 18, 2019 a%. cos NOW, T BEFORE, pursuant �tpowers conferred ,•o Grantor by the Col Probate Cod antor does hereby sell bnvey, assign, transfer rry set over unto said Gras, as the persontitled to the distributi fl an undivided one-hal /2) interest in and to tl following descri real property situate i e County of Weld, St Colorado: 00 Two (62) the Last Will and fetime of the deceden n December 18, 2019 Probate No. 2019 ent of the above- d decedent was ma4 d d is dated May 27, 20 , which Will was duly .t itted the District Court in for the County of Wand State 736. was duly appointe now qualified and a rsonal Representati in said capacity. 00 @ @ @ . All of Section Thi hree (33), Township n (7) North, Range Si, O West of the 6th O OO OO The Nort ,G �P •t Quarter (NE1/4) of ion eTwenty-Four (24 North h ge Sixty -Two (62), of the 6th P.M. 'n Weld County, Colo oQ� A O O g` all oil, gas, hydrocas, s, and other minerals i erlying the lands said Estate on Excepting and rese ▪ ove described. With all rtenances, subject to enants, easements subject to gene roperty taxes for the 2020, and subject to 00 used herein, the singulcludes the plural and 00 00 00 Executed kly, 7;id6 x wI 22020. 4 OOQ 00 O O O� O� wnship Seven (7) strictions of record, plural the singular. O 00 C?4,c.re.e, 00 0J e M. Waymire ° ersona epresentat� • f the Estate of Hele argaret Cass, a/k/a H- M. Cass, a/k/a H @0 ob Cass, Deceased 04 00 ob O� O� ob ob o'. o'. STATE COLORADO CI TY OF Lci The foregoi Fr r y Margaret Cass,a Helen M. Cass, a/k/len Cass, Deceased. O 4565A 02/10/2020 10:26 P of 2 O _O 4 OQ0� 4 Q0 di. yy0 O O O Instrument was ac olleedged before m s 6 day of%0 0 0, by Janice M. Way Personal Represe 't ve of the Estate of Hel NESS my hand and o 1 E yy commission expir � -1,3 c/ *)- O O O 'al seal. O 4 JOAN T. GALE 4 NOTARY PUBLIC STATE OF COLOR O NOTARY ID 198740906 MY COMMISSION EXPIRE UST 13, 2021 O Public O O�' %. and that affiant h Helen Mart Cass, a/k/a Helen 2019, as set fo n the Death Certific Recorder at ption No. 4564973 of her deh an owner of a life est OQ O ob The fore The N Nort O�0 STATE OF CO O COUNTY (ARIMER 45651 02/10/2020 09:36 (i)Q Tgta ages: 1 Rec Fee: 1?00 y Koppes - Clerk a• Recorder, Weld Cou t CO 0> 0 SU ► MENTARY AFFII QIT v -=?. 4 IN dMATTER OF TIT O OQ PROPERTY S A LIFE ESTATE O� O� Corey W lore, being first swo tes that he is of le personal knove of the fact that He argaret Cass, a/k/a was at the tiii of her death on Novenr 9, 2019, an owner of kit was gral the remainder intere an undivided one -h situate in Weld Cou t( olorado: All of Section Tkik West of the 6tthkM. % ast Quarter (NE1/4) /4) ange Sixty -Two (62), 4 4 11 in Weld County, C ado i record interest in th ass, a/k/a Helen Cas corded in the office ruary 7, 2020, is th 1/2) interest in and to hree (33), Townsshhi en (7) North, Range O 0 ction Twenty -Four Township Seven (7) of the 6th P.M. @O -Two (62) e and states that he <I M. Cass, a/k/a Hel Tass e estate of which Jerry . Cass following 4 ( ve-described real prgq ty. no died on Novernbe e Weld County Cle: e person who was at time 04 in the above -described roperty. g instrument was ac 2020, by CoW. Moore. ness my hand and off‘l seal. My C 4 O 0O fission Expires: 0 4 orey W. Moore rO\i' O wledged before me t day of Feb 4 4 kittei g - Ts` Notary Public 4 ddaA 4 DIANE R. GODDA NOTARY PUB STATE CA- CO! ' NOTARY ID i MY COMMISSION EY JO JC,963 S F 3. 8, 2021 i1HIII 11111 111111 II i IIIIIIIIIIIIIIIIIIII�� 3653447 10109120(1 1:17P Weld County, C 1 or 1 R 6.00 0 Steve Moreno Cler ,j:\ ecorder PERSONAL SENTATIVE'S D estate Estate) (D.g e e THIS D s made by Helen M. as Personal Representati ;' o f the Estate of Wayne Cass, a/k/a Wayne Cass, a/k/a Wayne Cass,. ased, Grantor, to Helen 3•. ss, whose legal address 085 WCR 80, Bri jsale, CO 8061 I, for life, wit e remainder at the time (=der death to Jerry W. Cass, ntee, whose legal ess is 37401 WCR 79, Brr. ale, CO 80611. Oe ve named decedent in h. time made and executed as duly admitted to infor0 robate on July 30, 2009, to of Colorado, Probate 9009PR276; WHE AS, Grantor was duly a po ed Personal Represents ve said Estate on July 30 now qualrt' ® and acting in said capaciid WHEREAS, th March, 1998, which County of Weld (°�u OQ OQ @ WHEREAS, Paragraph 4 Q�ecedents last will provide certain property shall be .ised to Helen M. for life with the remaind rJerry W. Cass. � �� O�O NOW THERE , pursuant to the powe Onferred upon Grantor b Colorado Probate Cod I �� Grantor hereby sells; eys, assigns, transfers an eases to Helen M. Cass a estate with the remaind � Co Jerry W. Cass, 1he.cr- ns entitled to distribution ® ntee, the following descr property situate in the Co, o Weld, State of '. e ado. All of i. - decedant's undivided % intest in and to the followinde' -ibed property: �Q oQ AQ �Q 9 All of Section 33, Townsh `� North, Range 62, West of 6a' P.M. 64. �O� The Northeast r (NE]/4) of Section 24 ship 7 North, Range 62, of the 6th P.M. e � o� ooWith all appurt�:s �� 4 asst will on the 18th day e District Court in and for 20U9, and is Exceptin • �'f. reserving all oil, gas, by `E (o� xecuted: October 7, 2009 STATE OF COI,O. COUNTY Pers Witness. my hand o My commission ) ss. bons, and other mineral rIying the lands above de* (I d. 7/) \-/ Helen M. Cass Personal Repres-'t ive of the Wayne Nole , a/k/a Wayne N. Cass4 a/k/a Way s, Deceased. o foregoing instrument w9knowledged before me th day of October, 2009, epresentalive of the Estaty' • Wayne Nolen Cass, a/k/a �,ryne N. Cass, a/kla Wayne Q w seal. es: November 25, 2012. KATHERINE A. PERKINS NOTARY PUBLIC STATE OF COLORADO My Comrnission Ezoires 11-2 OQ Q� Q� @O Estate of OQb len M. Cass, Deceased. ATE OF DEATH DECEDENT'S LEGAL N HELEN MARGA;I STATE FILE NUMBER 10'3133948 DATE OF NOV R 09, 2019 ' FEMALE SOCIAL SECURITY NU AGE -Last Birthday (Years) 101 - UNDE Month ays ". UNDER 1 DAY DATE OF BDay/Y ) .APR (State or For ntry) x7 COLORADO � Hours Minutes IF DEATH OCCURRED IN k1OSPITAL DEATH OCCURRED SOMEWHERE:OTHER'TWAN AHOSPITAL NURSING HOME/LONG TERM CARELLIIJJJJTY- Facility Name (If n bon, give street & number) - GRACE POINT NTINUING CARE SR CAMPUS SKILLEDSING -- - (\n `:ern.. CITY, TOWN OR LO 1('t OFDEATH GREELEY K COUNTY OF DEATH WELD RESIDE �E-: REET AND NUMBER �°� %'.ITY n'+� � 420 80 % APT. NO. 0 11 INSIDE CNO LIMITS ORADOSTATE n - ECOUNTY - n WELD CIT �o �WN n� DECEDENTS USUAL OCCUPATION • ""d of work done during most of working life use retired) SECRETARY \mil ^`'�l KIND OF"BUSINESS/IN.. °- ' - FOREST SERVIC,E"'JJ � DECEDENT'S EDUCATION ASSOCIATE DEGREE DECEDENT OF HISPANIC O�GIN"l . NO DECEDENT'SNACE�\` White EVER IN US ARMED S NO MARITAL STATUS AT TIME OF SPOUSE/PARTNER NA(e, give name prior to first marriage) O WIDOWED WAYNE NOLEN C �MOT NAME PRIOR TO FIRST MARRIAGE JL %C.- JOHN LE �f1 ° RUNYON. t1� hilANT'SNAME Off/ J FORMANTSRELATIONSHIPTODECEnA$EffJ O� Y CASS �� - CHILD - ` l��iii 0?)?NAME OF FUNERAL HOME - /� �\\..> Qig1 CITY AND STATE.OF FUNERAL ADAMSON FUNERAL AND CREf 4T10N SERVICES GREELEY COLORADO C WAS CORONER CM D Y METHOD OF DISPOSITION � BURIAL - CEMETERY PLACE OF DISPOSITION �J - LOCATION - CITY, COUNTY, STATE SUNSET MEMORIAL GAR f S GREELEY WELD COLORADO' INJURY AT WORK O IF TRANSPORTATION RELATCIFY DATE OF INJ TIME OF I PLACE OF INT LOCI,iTiA OF INJURY (Street & Number, Apt. No., City�h�wn, County, State, ZipCoda) ECCRRIIJBE HOW INJURY OCCURRED DAY/YR) �� E WAS DECEDENT UNDER HOSPIC 4ry ACTUAL PRESUMED TH DATE PRONOUNCED D� TIME PRONOUNC 0 OM NOVEMBER 09, 2019��//// 06:50 AM MANNER OF DEATH 4 ' NATURAL WAS AN" AUTOPSY PERFORME�j� WERE AUTOPSY FINDINGS CONSIDEREC¢1�(1�PETERMINING MO <cJ " THE CAUSE OF DEATH? �c) CAUSE OF DEAT- PART I er the;.chain of events: -diseases injuries, or Iications-tha directly caused the death. DIATE CAUSE (Final disease or �°,.�a CARDIOPULMONARY FAILURE -_. - dition in death) V V Approximate interval: Onset to death IMMEDIATE resulting CS (6) b ACUTE CVA < DAYS O - - l Sequentially list conditions, if any, \j leading to the cause listed on li e a) I G O O Enter the UNDERLYING CA (disease or injury that Initia t events resulting in death d- PART II Enter other siarj fic nl�donditions contributing to death but not rest) i he underlying cause given in PART I _ O� ADVANCED AGE OO TITLE, NAME, AD x .S, ZIP CODE AND COUNTY OF PHYSICIA �C 4 DATE SIGNEICJ 120THAVENUE/`TER Co 80031 -. 2019 TAN WILBUR,P3ID 5023 W STLE, DNO DE NA4nr �- RESS, ZIP COANDCOUNTY OF CC O RDATE ' l�� ED BY REGISTRAR `-' `- V' AMBER 12, 2019 473 -02/07/2020 034iPM DATE ISSUED NOVEMB , 2019 dal Pages: 1 Rec Fib $13.00 arty Koppes - Cler THIS IS A TRUE CERTIF TION OF NAME AND FACTS RECORDED IN THIS OF E. Do not accept unless, prepar-d 0rP security paper with e border displaying the Colorado and signature of the trar. PENALTY BY LAW, Sectio -118, Colorado Revis< tes, 1982, if a person alters, us t-mpts to use or furnis another for deceptive use any vitatics record. NOT VA L PHOTOCOPIED. REV 01/19 d Recorder, Weld a�pao�p�c Hello