Aff - DeLong, Lori A_2/7/2011?i i 1 i Ol00i1699
F;i?� for F?cord in
GIE�SON COUNTYr INDLANA
C�Ef•BIE S WETNIt3GTONr REC:ORDER
n2-07-2011 At �)��?1:11 am.
(�FFIDAVIT Ii•Ci!�
Zn1100u0�1h99
TRUSTWOF"(HY �AND TITLE CUt1F'NNY
31i?1 N GREEIV RIVEfi RD
STE 14Q
C\�ANSVILLE IN 47775
O� a �_�a-o�-�y-�«s. ���1 -oa g
�� SURVIVORSHIP AFFIDAVIT
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State of Indiana p
Countyof V�L�e-�l���r�4�
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Comes, now Lori A. DeLong, being duly sworn upon his/her oath, deposes and states:
D4ark V. DeLong aud Lori A. DeLong, husband and wife, were the vested oµmers of the
property listed below�, from January 14'h, 1991, until the of death Mark V. DeLong on
October 27�h, 2010, which at the time of death, Lori A. DeLong, became the sole owner
of the insured real estate listed below.
Lot Number Eleven (11) in Elizabeth Smith's Addition to the Cih' of Princeton, except the
south 55 feet thereof.
D1ore commonly known as: 701 S. Prince Street, Priuceton, IN 47670.
The total value of the estate of said decedent for Federal Estate Tax purposes; including
the proceeds of liFe insurance and interest in joindy owned real estate, �vas insufficient to
necessitate the payment of Federal Estate Tax.
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Affiant further saith not, this� day of J A*l�Art.Y , 2011.
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Lori A. DeLong
Before me, a Notary Public in and for said County and State personally appeared Lori A.
DeLong, who being first duly sworn by me upon his/her oath, says that the facts in the
foregoing affidavit are true. �
Signed and Sealed this !� day of vfb�(,� , 20� ^_ �
County of Residence: 'V A'� �2-lZ��l�+'`�
Commission Expires: /O" � �'— ��
'R�is Instrument prepared by: Lori A. DeLong
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Vande�burgh CouMy
A{y �o:nmissim E�ires
Ocrober12.201?
I afiirtn, under the penalties for perjury, that 1 have taken reasonable care to r d ct e ch Social Security number in this
document, unless required by law. �
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FEB 7 2011
c.�.m�
GIBSON COUNTY AUDITOR
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