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Aff - Ash, Naomi_2/11/2003. � C n STATE OF INDIANA COUNTY OF GIBSON . ) ) SS: ) �� / I Z - //-d 3 AFFIDAVIT OF DEATH OF NAOMI ELIZABETH ASH Comes now Brenda J. (Like) Briegs, who being duly s�vom upon her oath, states as follows: \ ��� That she is an adult female, over the age of twenty-one (21) years, competent to mal:e this Affidavit, and does so �vith personal knowledge of the averments contained herein. 2. That your affiant is the adult daughter of Naomi Elizabeth Ash �vho died intestate on the 17`� day of Mazch, 1992, �i�hile domiciled in �Vilson County, Tennessee. 3. That at the time of her death, the decedent o«ned a life estate in and to the follo��2ng described real estate located in Gibson County, Indiana, to-wit: Lot Number Fourteen (14) in Block Number Ten (10) in Fair Park Addition to the Town of Oakland Ciri. Indiana. in �vhich vour affiant �vas the o�timer of said reai estate, subject to the life estate of I�'aomi Elizabeth Ash by virtue of that R'arranty Deed dated Aueust 1; 1991, and recorded on December 1�, 1992, in Deed Drawer 8, Card I`jo. 1474, in the Office of Recordec Gibson Countv, Indiana. 4. That at the time of the decedent's death. the real estate described above had a fair market value on the decedent's date of death of $500.00, as evidenced bv the attached appraisal of Thomas W. Mason, Mid�vest Appraisal Group, said appraisal being denoted as Eshibit A. �. That the decedent o�vned at the time of her death no other assets in the State of Indiana. 6. That the sole beneficiary and heir at law to the decedent, I�'aomi Elizabeth Ash, �i�as your affian[, Brenda J. (Like) Briggs. 7. That the sole surviving heir and beneficiary, Brenda J. (Like) Briges, was entitled to a $�,000.00 ezemption under Indiana inheritance tax la«�s in 1993. As a result of this exem o�lndiana inheritance taY «�as due and o«�ine the State of Indiana. ���� y fi E B 11 2003 . . _ ._ ;.�� ! 'a�-�-�-�-I' � ^/ SU^:TOR � FURTHER AFFIA,�IT SAYETH NAUGHT. STATE OF NDIA�IA ) ) SS: COLT\'TY OF GIBSON ) � �� ��1 ��Y�, ���.naJ BRENDA J. IKE) BRIGGS Before me, a I�'otarv Public in and for said County and State, personally appeared BRENDA J. (LIKE) BRIGGS, �vho acknowledged the esecution of the foregoing PropeRy Settlement Agreement, and who, having been duly swom, stated that any representations therein contained are true. «�INESS m}� hand and Notarial Seal this // day of February, 2003. /JCl� �cGL. ���li'' BARBARA KOLB, Notary Public Resident of Gibson County, IN My Commission Expires: January 1�, 2008