Aff - Collins, Merlin F Sr_7/30/2007�
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JUL 3 0 2007
GIBSO�p�N�� ITOR
SURVIVORSHIP AFFIDAVIT
State of Indiaj�a
County of i/CQ,(�t�j�r�,�,�
Comes, no�v Jo Anne Collins and Merlin F. Collins, Jr. by Jo Annc Collins, as
Attorne}'-in-Fact, being duly swom upon his/her oath, deposes and says:
1. Merlin F. Collios, Sr, Jo Anue Collins and Merlin F. Collins, Jr. were ves[ed
asjoint tenants �3�ith right of survivorship until the of death of Merlin F. Collins, Sr. on
Septembcr 21, 2002, which at the time of death, Judith A. Mitchem and Mcrlin F.
Collins, Jr. , became the sole o��mer of the insured real estate listed belo�v.
A Southeast part of the North«�est Quarter and a South�rest part of the Northeast
Quarter of Section 33, Township 1 South, Range 10 West, in Patoka To���nship,
Gibsou Counh�, Indiana aod furthcr described as follows: Begin at a point in thc
east line of the Northwest Quarter of Section 33, Township 1 South, Range 10 �Vest,
206.73 feet north of the southcast corner thereof; thence measure north 83 degrecs
48 minutes 35 seconds west, a distance of 49.87 feet to a 5/8 inch iron seh, thence
measure north 4 degrecs 14 minutes 02 seconds west, a distance of 244.28 feet to a
5/8 inch iron set; thence measurc oorth 89 degrecs �9 minutes 12 seconds east, a
distance of 314.54 feet to a spike set in the Carithcrs County� Road; theoce
measuring along said road the following courses and distances; thence south 26
degrees 11 miuutes 51 seconds �vest, a distance of 47.30 feet; thence south 29 degrees
12 mioutes 45 seconds west, a distance of 75.18 feet; thence south 41 degrees 43
minutes 07 seconds «•est, a distancc of 81.48 feeh, thence south 53 degrees 30 minutes
35 seconds ���est, a distance of 74.69 feet; thence south 52 degrccs 23 minutes 44
seconds west, a distance of 64.13 feet to a spike set; thence leaving said road and
measure north 83 degrces 48 minutes 35 seconds ��•est, a distance of 24.41 feet to the
point of beginning and containing 1.250 acres, but subject to the ��•est part of a
county road right-of-way off thc cast sidc thercof.
Morc commonly known as: 52 Rural Routc 3 Princeton, IN d7670
The total value of the estate of said decedent for Federal Estate Tar purposes, including
the proceeds of life insurance and interest injointly owned real estate; was insufficient to
necessitate the payment of Federal Estate Ta�.
Affiant further saith not this"1�l��' day of �1,�(4i , 2007. �'Cj I�i��
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Jo Anne Collins
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Dlerlin F. Collins, Jr. b�� Jo Anne Collins,�as Attorne��-in-Fact
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Before me, a Notary Public in and for said County and State personally appeared
Jo Anne Collins and Mcrlin F. Collins, Jr. by Jo Annc Collins, as Attorncy-in-Fact ,
who being first duly sworn by me upon his/her oath, says tha[ the facts in the foregoing
affidavit are true.
Signed and Sealed this�day of � l�((�� , 2007.
.���v�. SrATEOF�rtDw[�btaryPublic
�+��` ' '� _ NOTAfiY PUBLIC
o Issl ,i Expkea 29-07
County of Residence: =�� .� R' t N�r.rric n
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Commission Expires: - �aiiene Satpi a
This Instrumen[ prepared by: Ray Summeier, Trusnvorthy Land Tide, Co., Inc. 3101 \'. Green
River Rd. Evansville, IN 47715.
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each
Social Securitv number in this document, unless 1equired by la���.
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