Aff - Davis, Herschel_4/10/1997�
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STATE OF INDIANA IN RE: HERSCHEL DAVIS
COUNTY OF GIBSON, ss: decedent
AFFIDAVIT FOR TRANSFER OF PERSONAL PROPERTY
1. That the above-named decedent died intestate on the 19th
day of February, 1997, while domiciled in Gibson County, Indiana.
2. That forty-five (45) days have elapsed since the death of
the decedent.
3. That no application or petition for the appointment of a
personal representative is pending or has been granted in any juris-
diction.
4. That the value of the decedent's gross probate estate, less
liens and encumbrances, does not exceed the sum of fifteen thousand
dollars ($15,000) as provided by I.C. 29-1-8-I, including the costs
and expenses of administration and reasonable funeral expenses.
5. That the following named persons are the only heirs of the
decedent:
Haskell W. Davis------son----Rj{2, Box 298
Oakland City,
Jackie A. Sander------dau----R�'3, Box 33
Oakland City,
IN 47660
IN 47660
6. That Citizens National Bank of Evansville, Indiana has on
deposit in a checking account in decedent's name the approximate sum
of six ttiousand ninety-one dollars and eighty-six cents ($6,091.86)
and a Certificate of Deposit in the sum of five thousand dollars
($5,000).
7. By reason of the above-stated matters, the affiants request
that the above described checking account and CD in the name of the
decedent, Herschel Davis, be transferred to Haskell W. Davis and
Jackie A. Sander the sole and only heirs of Herschel Davis, pursuant
to the laws of intestate succession as provided in Indiana Code,
in accordance with' provisions of I.C. 29-1-8-1.and I.C. 29-1-8-2.
WHEREFORE, the affiants hereby hereby request that Citizens
National Bank of Evansville, Indiana presently in possession of said
checking account and CD transfer the same to said affiants; pursuant
to the Indiana Code and that the distribution of said property
,
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APR 10 1991 -
C�RSnN C U. / YeqUDITOR
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to the affiants herein shall release said Bank from any liability
with regard to the proper application and disbursement of said
personal property; and That the affiants herein Haskell W. Davis
and Jackie A. Sander hereby charge themselves with the responsibility
of Proper disbursement of the funds according to the provisions of
the Indiana Code, and hereby agree to hold harmless said Citizens
National Bank of Evansville, Indiana from any liability with regard
to the transfer of said personal property.
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askell w. Davis
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Subscribed and sworn to before me a Notary Public this lOth day
of April, 1997.
My commission expi�r�e�s
12-22-97
an McGregor, Notary P lic, res
Gibson County, Zndiana.
This instrument prepared by Loren G. McGregor, Attorney.
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