Aff - Brown, Deloris M_6/8/2009�
' STATE OF Indiana
COUNTY Gibson
�
AFFIDAV[TOFSURVIVINGSPOUSE �
OR JOL\T SURVR'OR
��3/75'SQ
Deloris Yt. Brown , being first duly swom,
deposes and says as follows:
1) That Robert H. Bro�vn and Deloris M. Bro�+�n
are joint owners of propem� under a duly recorded suroivorship or tenancy by entire[ies deed.
2) That the properq� is I:no���n as 708 Kennedy Drive Fort Rranch
Street and Cin�
Gibson Counh-, State of Indiana and also kno�vn as Permanent
Parcel Number 26-18-13-] O1-001-118-026 on the records of the Count�� Auditoc The orieinal
Sun�ivorship Deed is recorded in [he records of the
in \'olume , Paee
Counq- Recorder
1 have included the descripti��e information requested below and have attached a full legal
description as an attachment hereto.
"SEE E�I-IIBIT "A" ATTACHED"
FII,ED N
3) That Robert H. Bro���n died on or about b-ta�- >> JUN 8- 2009
1997 , at Deaconess Hospital �� ��
4) That bv virtue of [he death of the party listed in Item #3 abo��e, GIBSON COUNTY AU6IYOF
Deloris �9. Bro«�n is [he fee simple ,.wner of the above described
propem� and requests that this fact be reflected on the land and ta� records of the counrv.
, ���('�t �> � / �c�z��✓
�1'itness Affiant Dcloris D1. Brown
Ce.�S�-c,� l.ea�
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\1'itness
STATE OF Indiana
COUNTY OF Gibson
I aftit��i�UGder the ;x�sln� inr perjury,
that I have taken reaN�n.n!� �yre to redact
each Social Securit�: nwnber in this
dceument unleu reqmred by law.
Name�.l o.n..��^-'u ^� � �
irAyY� G � ��.t y.�-n�
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Swom ro before me and subscribed in my presence this 28th day of A r_ p 1�_, 20 09
TH�$ �1d.�a7'r�hPli'l��r��'tD ��c,c.u(Aill,(�� ,l„/ :"�V
T�'otary Public Darla Dee Barton
BY• ,D � L o21.S M•� 2 D p✓/T�/ �'�Y Commission E�pires: 5/16/16
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20234
VANDERBURGFI COUNTY NEALTN DEPARTMENT
Room 727 Adrninistration Building • Civic Center Complex • One Northwest Martin.Lidher King Jr. Blvd.
Evansville, Indiana 47708-1828
CERTIFICATE OF DEATH REGISTRATION
��jis �ertif ie8, THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT
NAME ROBERT H. BRiXJN
oiei�iN VANDERBURGH COUNTY iNUinNnoN
TIME OF DEATHOI: ZS A. M. MARITAL STATUS MARRIED
SOCIALSECURITY
PLACE OF D[ATH DEACONESS HOSPITAL
MAY 11
sexMALE AcE 70
DATE OF BIRTH 08/02/ 1926
PRIMARV CAUSE OF DEATH GIVEN WAS CANCER-METASTATIC LUNG CANCER
PHYSICIAN OH CORONER L(�ARD FOX, M. D.
PLACEOFBUNIAL EMOVAL SUNSET MEMURIAL PARK
\\\�����
FUNERALHOM��\.� COI�j/aN F�UN[RAL HOME. PRINCETON,ZN
�.�' ,....... 'r
4' � �' f .'•.�!'� t.
CERTIFICATE NUMBER
OR VOLUME ANU'f?AGE O00OO9.SS
�y-'` ..;;sy_ �, .
,< : ����t .i�'u �'' : 'U
AUTOPSVNO
YEAR 1997
RACEWHITE
MANNER NATURAL DISEASE
onr� oF r�ur�wiAS/ 14/ 1997
DATEISSUED OS/29/1997
'� : :y'�; ►t-' '� • �, . NOT VALID UNLESS SIGNED & SEALED
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EXHIBIT A
.
SZTUATED IN TH� COWiTY OF GIBSON AND STATE OF Ii�TDIANA:
LOT NUMBER 14 IN CANDLELIGHT VILLAGE, AS RECORDED IN PLAT
BOOK NUMB�R 2, PAGES 96 AND 97 OFFICE OF TNE RECORDER OF
GIBSON COUNTY, INDIADIA.
Permanent'Parcel Number: 26-18-13-301-001-118-02�p
ROBERT H. BRONN AND DELORIS M. BROWN, HUSBAND AND WIFE
708 KENNEDY DRIVE, rORT BRANCH IN 47648
Loan Reference Number . 12028764/69/04787/FAM
First American Order No: 40317859
Zdentifier: FIRST AMERICAN EQUITY LOAN SERVICES
40I317I8IS9IIIIII BROWN �
IN «'�`\ RECORDED, R,F"I'[�R\ TO:
'FIRST qMERICqN ELS EQlJ17YlA'3`vSERNCES; �`G
AFFIDpyI7 OF SURVIVING SPOUSE IfczevEr��� orflo �s�Q�
IIIIVIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIfI ����o,>u�cn��c-r��!
Acmmmodaeon Rero�diag Pcr C]ient Rcqucst