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Aff - Belcher, Eunice_8/4/1987� ,. � � STATE OF INDIANA) ) SS: COUNTY OF GZBSON) AFFIDAVIT FOR TRANSFER OF REAL ESTATE HELD BY ENTIRETIES TO SURVIVOR The undersigned being first duly sworn on oath says: 1. That James A. Belcher is the widower and surviving tenant by the entirety of Eunice Belcher, who died intestate .,- MaY 23 , 19 79 2. That on the date of death of Eunice Belcher she and this affiant were the owners of the following-described real estate, situate in Gibson County, Zndiana, to-wit: The south half of Lot Number 7 in Block D in Hall's Enlarqement to the Southwark Addition to the town, now city, of Princeton. 3. That the Estate of Eunice Belcher is of insufficient value to require the filing of a Federal Estate Tax Return. 4. That this Affidavit is made for the purpose of inducing the Auditor of Gibson County, Indiana, to transfer said real estate to this Affiant's name alone on the real estate taxation records maintained in his office. CY�r:,�,. �, ��. %�L c�� James A. Belcher ° SUBSCRIBED AND SWORN to before me a Notary Public in and � for said County and State this 3rd � August day of �i� 1987. ( Tl� r�r �Q�%� —Name) NOTARY PUBLIC My Commission Expires: 4/23/91 I Reside in Gibson County, Indiana. THIS INSTRUMENT PREPARED BY: J. ROBERT KINKLE, ATTORNEY, HALL, PARTENHEIMER & KINKLE, 219 North Hart Street, Post Office Box 313, Princeton, India*�a 47670, P.0 81?,/386-0050.