Aff - Derbyshire, Ruth_6/7/1993�' � !
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Return Instrument To: TAX IDENTIFICATION NO.:
Charles Derbyshire �3�� ` �� — p !DO
8128 Corto Calle
Fort Wayne, IN 46815
AFFIDAVIT OF SURVIVORSHIP
STATE OF INDIANA, .
. ss:
COUNTY OF .
The undersigned, being first duly sworn, alleges and says the
following:
1. My name is Charles E. Derbyahire, and I reside at 8128
Corto Calle, Fort Wayne, Indiana, 46815;
2. I am the natural and biological son of RUTH DERBYBHIRE,
who along with me, was an owner, with right of survivorship, in
certain real property in Gibson County, Indiana, more accurately
described as follows, to-wit:
Situated in the County of Gibson and State of Indiana,
to-wit:
The east part of Lot No. 20 in the original plan of the
Town of Princeton, now the City of Princeton, State of
Indiana, bounded as follows:
Beginning at the northeast corner of said lot, and thence
running south one hundred three and one-half (1032) feet,
thence west thirty-five (35) feet, thence north thirty-
five (35) feet, thence east nine (9) feet, thence north
thirty (30) feet, thence east six (6) feet to the middle
wall, thence north thirty-eiqht and one-half (38Z) feet,
thence east twenty (20) feet to the place of beginning.
3. My mother, Ruth Derbyshire, one of the previous owners of
the aforementioned real property, died in Madeira Beach, Pinellas
County, Florida on November 28, 1982.
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JUN 7 1993
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AUDITOR
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4. The purpose of this affidavit is to provide evidence of
her death in the chain of title to the aforementioned real property
so that, upon her death on November 28, 1982, title vested in me as
the remaining survivor of the aforementioned real property.
Further Affiant sayeth naught.
� a�' 9 � ��
DATE: � �✓�`•
�8 E. DE 8 ZRE
STATE OF INDIANA,
. ss:
COUNTY OF �LEN .
Before me, a Notary Public, in and for said County and State,
personally appeared the above named Charlea E. Derbyshire, who
acknowledged the execution of this instrument to be his free and
voluntary act and deed, and that the representations contained
herein are true and accurate.
IN WITNESS WHEREOF, I have hereunto subscribed my hand and
affixed my official seal this 28th day of MAY
1993. '
THIS INSTRUMENT PREPARED BY
AND TO BE RETURNEO TO:
Gregory M. Antalis, •2431-98
Attorney at Law
MfWSFlELD 8c ANTAIJS
25 Merrill Lynch Plaza
130 West Main
Fort Wayne, IN 46802
:ary Yublic - St of Ind
Commission Expire : 1 17 95
IcANU M. SPITNALE
My Commission [r.pires 1/17/9J�
Residence-Allen Co., IN