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Aff - Besing, Kelly Joe_10/16/2009�. _fi _..� ' � _� ' ?nsirument: PG 1 QF _ 2iliicii0�lii51 %o li(.� 1 6 2��9 STATE OF INDIA�IA ) IN THE GIBSON CIRCUIT COURT ) SS: '`:: •.:.; .:: ."-. ANNUAL TERM COLTN"fY OF GIBSON ��A��,:; �-; ;,,.•, ��pir��AUSE NO. 26CO1-0909-EM-70 I�i RE: THE MATTER OF ) 2p09Uiqip6l i 5 - ) Fil_d for Record i❑ "rhe Estate of ) SIBSON �:pUHT'i� IHDIANA DF.BBIE 5 UETHIPIGT[Ifl RAMONA M. BESII�'G, ) 1?-Oi-?009 At lu:?o:�l nm. Deceased ) '+� F1�,avi7 1`.�i�i AFFIDAVIT OF DEATH AND HEIRSHIP OF RAMONA M. BESING The undersigned, Kelly Joe Besing, being first duly swom upon his oath deposes and says: 1. The undersigned a-as personally acquainteci with Ramona M. Besing for over 30 years and is her son. 2. Ramona M. Besing departed this life on July 7, 2009 and at the time of her dea[h a�as 71 years of age. 3. The undersigned is well acquainted with the family of Ramona M. Besing and those who constitute her heirs under the laws of the State of fndiana. 4. The following statemen[s or answers are based upon the personal knowled�e of the undersigned and are true and correct A. Did the deceased leave a Will? YES I� C. Has the will been admitted to probate? No estate was administered. YES D. Ramona M. Besin� was married two tunes during her lifetime, to a Mr. Lenart and to Jerry Besing. She and Mr. Besing were divorced at the time of her death. Ramona M. Besing was married to no other person other than Mr. Lenart and Jerry Besing during her lifetime. E. Ramona M. Besing ]eft no unpaid debts. F. The following aze the children bom to Ramona M. Besing during her lifetime: Michael E. Lenart, Jef&ey Scott Besine, Victor Gordon Besing and Kelly Joe Besing. ?ni ioLnliqi517E. BDB Y.INV;L[ F'.0. P�JX 13 F'fiINCETON IN 4?b7D G. H. In<traro?nt F'G 2 OF _ 2pp9p� �itn6175 At the time of her death, all four children were living Ramona V1. Besing had no adopted children or any other children bom to her during her lifetime. STATE OF INDIAl�'A ) ) SS: COUNTY OF GIBSON ) Subscribed and swom to before me this _/� day of October, 2009. . �� � I affirm, unAer ihe pznalues for perjury, that 1 have �aken reasonable care �o redaet zacp Soc.. t Secumy number in [his dncume i unle.c� ro ui d ��• Name THIS INSTRUt�fEN7 pF�Pb1flED . �'." V � /� �6�iJ.C��_ �Y e 2. Ro6ert Kinkle, \`otary Public/ My Commission Expires: April 30, 2016 Resident of Gibson County, Indiana �� �f . ; c: :i1 ; '�: �: �' `4