Aff - Brines, Geneive_12/14/1979 (2)I
` ' � � •
AFFIDAVIT
GENEIVE BRINES, being first duly sworn, upon oath, deposes
and says:
1. That she is the surviving spouse of Robert Brines who
died intestate as a resident of Gibson County, Indiana, on September
16, 1967.
2. That no estate proceedings were had on the estate of
Robert Brines and that his gross estate did not exeeed $60,000.00
and no Indiana inheritance or federal estate taxes_were_due and.
-- -owing`a"s a result of his death. '
3. That the said Robert Brines was survived by the
following children, each of whom is now an adult:
Sonia L. Clark; Sandra Kay Vore;
. Mary Ann Gaston; Carolyn J. Sneath; — '
, James R. Brines; Robert M. Brines;
Debbie S. Brines; Julie J. Brines;
and Betty J. Arbuthnot `
9. That no children with issue predeceased the said
Robert Brines and this affiant and the.nine children herein named
were his sole`heirs at law. --}
, AI�p FURTHER AFFIANT SAYETH NOT.
' �� �.��-•-C�v7.'`-� . �/�r'�-�j�
� ENEIVE BRIidES
STATE OF_ INDIANA )
, ) SS:
GIBSON COUNTY )
Subscribed and sworn to before me, a Notary Public in
and for said County and State, this � Z�day of _}�/,�,". ,,,. �.,,, 1 ,
1979.
/i
.�a -...��a� ( 'i�- i, c� �,/
NOTARY PUBLIC
Resident of Gibson County, Indiana
My Commission Expires:
� - .
9- i�-' � 3 > - -- - '
. '_� �
. -.-. . �
. - _ �_
THIS INSTRUMENT PREPARED BY JERRY D. STILWELL, ATTORNEY.