Aff - Cleveland, Robert J_11/28/2005�� ���d�� ��
HEIRSHIP AFFIDAVIT
�
That AFEIANT, SCGNA J. CLEVELAND, bcina first duly swom upon hcr oath, dcposcs
and statcs as follows:
1. That SCB\'A 1. CLGVELAND and �ir�[tK G CLBVGLA\D, respcctively as thc wifc
and only child of RO[3GRT J. CLEVELAND, arc thc solc hcirs of ROBLRT J. CLEVGLAND, ���ho
is the rccord titic o��ncr of an undivided hvo-[hirds (Z/3) intcrest in the follo�l�ng described real
cstatc located in GIBSON County, Indiana:
The �Vcst Half of thc Northcast Quarter of Section 31, To�+mship "Ilirec (3) South,
Range Eleven ( I 1) �Vcst, containing 80A acres, morc or less.
2. "I'hat ROBLRT J. CLEVELAND dcpartcd this lifc on thc 9"' day of Octobcr, 2005.
3. "Ihat the abovc dcscribed real estatc vested in SCENA J. CLEVELAND and'�iARIC E
CLEVELAND upon thc dcath of ROBERT
administration.
i .
J. CLEVELAND �aithout thc neccssit�� ofprobate
4. That there ���as no inheritancc or es[ate tax duc as a resul[ of the death of ROBERT J.
CLEVELAND.
�. lliat thc purposc of this Ai7idavit is to sho��� thc dcath of DECEDENT, ROBERT J.
CLEVELAND, and to transfer o«mership in the above dcscribed real estatc from ROBERT J.
CLEVELAND to SCENA J. CLEVLLA\'D and �fARK L. CLEVELAND.
Funhcr, Affiant sailh naught.
I �� - /
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SCE\A J. CLEVELA\'D
STATE OI� [NDIA\'A )
)SS:
G113SON COUNTI' )
Beforc mc, a\�otary Public in and for said Counp� and Statc personall�� appcarcd AF�IA\T,
SCE\'A J. CLEVELAI�'D, ��ho ackno�ti�ledged the execution of the foregoin�„ and who, having becn
duly swom, stated that any representations therein contained arc truc.
�Vitncss mJ• hand and Notarial Scal this���day of /' ;J� � r_ , 200�.
MY COIvIMISSION E�PIRES: ( �j �' ." '.L< i �� �j JI (n� 7--
SIGNATURE F NOTARI' PUBLIC
�, -�-� � v�t.�� �I �-I,���,-
coul.rrv or aESi�E��ce:
Glvi`c�n�
PRI\�TED NAML' OF NOTARY PUBLIC
This instrument ���as prepared by Gr1RY G. TAYLOR, Attorneti� at Law, 9010 Carciage Ln.,
Indianapolis, Indiana 46256.
l� -;!` .;i� '1 '+�,
Send Tax Statements to Scena J. Clevcland, RR 3, Owens��ilic. IN 4766�;�i� ?;_� �;--{ '� !
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iJ0!� 'l a' 2005
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c!�sso,: cuutar� nuurro�;