Aff - Cook, James H_8/17/1995. . . ooy- ���$ •
STATE OF LYDI?iNA )
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COCNTY OF Gibson)
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AFFID�VTT OF SURVIVORSHIP
Ione Bertalene Cool� being of legal age, and duly sworn on his/her oa:h, deposes and
says:
EIRST: That Ione Bertalene Cook is the owner in fee simple dde of the following
described real-estate located in Gibson County, Indian� to-cvit:
See Attached "QUTT CLAIM DEED"
SECOND: Affiant fiilly swears that Ione Bertalene Cook and James H. Cook now
deceased were husband and wife at the time they acquired title to real estate until the
death of James H. Cook on October 31st, 1988, at which time this affiant acquired title
to said reai estate as a surviving tenant by the entireties. Indiana State Board of Health
Medical CertiScate of Death m Book 55, Local Yo. 2006 issued November l lth, 1988.
THIRD: There has not been any administration upon the estate of the s�id James H.
Cook deceased, nor is any administration contemplated.
FOURTH: The estate of James H. Cook was not subject to any Federal State Tax.
FTITH: Affiant makes this affidavit for the purpose of causing the proper-transfer of the
_ real estate in the offices of the Auditor of Gibson Counry, Indiana.
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' Ione Bertalene Cook
On the �� day of �,._...1... 19�, before me, the undersiened, a Notary
Public in and for said County and tate, personally appeazed
known to me (or proved to me on the basis of satisfactory evidence) to be the persons
whose names ue subscribed to the within instrument, and sworn to me in and for the said
County, and executed the same.
IYZTN�SS my hand and official seal.
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� blic ignature v
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Printed � . •
My Commission Expires `F � 2 � ��
� My County of Residence�� �1e� L.
-.. �. - This instrument prepared by: S1'EVE A. HEINING, Attorney At Law, 7998
� - ` GEORGETOWN.ROAD, SUTTE #200, IiYDIAi�1APOLIS, IN 46268, 800 837-9008
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