Aff - Davis, Michelle A_11/17/2011. ir
Prepared by and retum to:
Catherine Van Sprange
TFA National Operations
2943 Fuller Avenue
Grand Rapids, MI 49505
FILE #1492223
FILED
NOV 17 2011
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GIBSON COUNTY AUDITOR
SURVIVORSHIP AFFIDAVIT
GREGORY A. DAVIS ("�ant"), being first duly swom upon an oath, deposes and says:
l. That �NICHELLEA. DAVIS ("the Decedent") and Affiant held uUe, as joint tenants with
right of survivorship, ro certain real estate by deed to Integra Bank Y.A., dated April 25, 2003, filed for
record May 08, 2003, and recorded in Instrument Number 200300004127 , Recorder's ORice, Gibson
County, Indiana, to secure 5245,000.00. Assignment of blortgage to EverBank, recorded June 8, 2007 in
tnswment Number 200700003806. And also to Integm Bank National Association, dated October 24,
2006, filed for record December 04, 2006, and recorded in (nswment Number 200600007712 , Recorders
Office, Gibson County, Indiana, m secure S75,000.00 and more particularly described as follo«s:
The follo�sing described real estate in Gibson County, State of Indiana, to-wit:
Lot 13 in Country Ayre Estates No. 2, a subdivision of part of ihe Southeast Quarter of the Northwest
Quarter of Section 16, To«nship 4 South, Range 10 West, as recorded in Pla[ Cabinet A-149 in the Office
of the Remrder of Gibson Counry, Indiana.
The address of the real eshte is commonly Imown ar I2444 S BROOI�E DR IN HAUBSTADT. N 47639
2. Thu the relationship which existed benceen the Decedent and AtFiant wn[inued unbroken
from the time they so acquired tiUe to said real estate undl the death of the Decedent on FEBRUARY 14, 2008,
at �rhich time A�ant acquired tiUe tn said real estate as surviving trnant by the en[irety.
3. That all debts, estate and inheritance taxes, funeral expenses, and e.�cpenses of the last iliness
of the Decedent have been Cully paid and satisfied, or that there is sufficient funds availabie to pay them in full
upon request.
4. That all of the above representations are ave. f -
'2 ��1( ��
GREGORYA.DAVIS ( �
STATE OF ��
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COUNTY OF � E7G �
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Before me the undersig�ed, a Notary Public in and for said County and Sta[e, 'personally appeared
/'Sr L¢;'x v 1� �,s.9i-3 ���ho, being fust duty sw�om by me upon an oath, states tha[
the facd�a � the foregoing Survivorship Afl�idavit are true.
WI'[�tESS my hand and Notazial Seal this _� day of !�l/) U G'tv�y^✓ , 201 l.
My Commission Erpires: �{�i�,u{,��j � �
NANETTE F. BEqCI � INDIANA � rC�G"�.�" �
RESIDING IN VANDEf48URG� L �V : ,
MY CONRAISSK3N EXPIRES MARCH 21. 2014 � G't'<'�l�C �'%
Notary Public ;
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