Aff - Cleveland, Elizabeth I_8/5/1977� `��' �
J
o` �
�p P AFFIDAVIT FOR CHANGE �F TAX RECORDS
STATE OF INDIANA )
: SS
COUNTY �F P�SEY.)
L LIZ.qgt�'Tl1 Z', CL!'rUEL19ND heing firet duly sworn upon
oath, deposes end eays thet SN E is the
1�.(�ao� of �u2TMl�l CLC-UE6AN�
who died on or about the 13n� dey of _ TV�� 19�7,
r
the owner of the Pallowing deecribed reel eetate in �1/3 S��
County,Indiene, to-wit:
_�'ottnlSoN Tot+�NSM�P'
��,� � ��y y�G. 31, �ownISHIP 3 Sour�
-R�u�c ►t 4.� � -$-oA-- — - --
Affiant further atetes thet eeid de�edent died �wl testate, end
thet title to the reel eetete deacrihed ebove ie now vested in the
following pereone:
� L� 2 l� /3 ETH y.
�oSL.Nr��Ei
C (. E U � � N^��
I�+a y�'-�
Wherefore, effiant mekes thia effidavit to authorize and.requeat
the Auditor of G l �,jO�y County, Indiana, to so
change tlie re�orda oP seid County that the e6ove reel estate may
eppear ❑f re�ord for purposes of texetion in the neme(s) of the
above ❑wner(e).
X � , l;
1�Suhscri�ed end sworn to before me, thie $ dey of A U 4. ,
:1 V'l '��
. '� � s�-: � - �a.n l�-� L d�-�.tt�+�
- `�, - NOTARY
'=�=. MY COMMISSION EXPIRES PUBLIC
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