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Aff - Dixon, Saddie_10/10/1966�� ._ - ' _ --- - STATE OF IAIDIANA SS: COUNTY OF GIBSON . � AFFIDAVIT AS TO DEA7H AND HEIRSHIP .� The undersigned, Saddie Dixon, being first duly sworn on oath deposes and says: That ahe is more than seventy-five (75) years of age, that she resides at R.R. #/1, Hazleton, Gibson County, Indiana. 1. That she is the surviving widow of Loren E. Dixon, who died intestate, a resident of Gibson County, Indiana, on or about September 26, 1966; that said decedent died leaving this affiant as his surviving widow; no children nor descendants of any pre- deceased child, no Father and no Mother; and that as said aurviving widow this affiant is the sole and only heir-at-Law of said Loren E. Dixon, deceased. 2. That the said Loren E. Dixon, as of the date of his demise, was the owner of the following described separate parcels of real estate, sitvate in Washington Township, Gibson County, State of Indiana, towit: TRACT (A) Lot #7 - Buena Vista - D.R. #75 page 582 (December 27, 1912) �.cT cs) TRACT (C) Assessed at $5.00 - Fair Market Value September 26, 1966 - $ 30.00; Lot #8 - Buena Vista - D.R. #90 page 492 C July 8, 1922) Assessed at $5.00 - Fair Market Va1ue, September 26, 1966 - $30.00; Lot #9 - Buena Viata - D.R. #75 page 582 (December 27, 1912) Assessed at $10.00 - Fair Market Value September 26, 1966 - $50.00; TRACT (D) Lot #10 - Buena Vista CPart) D.R. #95 page 412 (Ju1y 8, 1926) l yf Assessed at $5.00 - Fair Market Value September 26, 1966 - $30.00; TRACT (E) Lot #16 - Buena Vista - D.R. #75 page 582 (December 27, 1912) Assessed at $1,035.00 - Fair Market value - September 26, 1966 - $4000.00; TRACT (F) Lot #15 - Buena Vista - D.R. #75 page 582 <December 27, 1912) Assesaed at $5.00 - Fair Market Value September 26, 1966, $30.00; . TRACT (G) � Pt. Location No. (2), 1t�p. (1) North, Range (10) West, � 1 1/2 acres - D.R. #75 page 582 - Dece mber 27, 1912; ( TRACT (H) ( S 1/2 acres - D.R. #f95 page 125, February 15, 1926. ' Assessed at $130.00 - Fair Market Va1ue, 9-26-66 -$500.00. ; �� .� This affiant further says that as the sole and only heir- decedent, � at-law of /the above deacribed real estate, title to each of the above separately designated parcels of real estate vested in this affiant as decedent's surviving widow and sole and only heir-at-law. 3. This affiant further knows of her own knowledge that said decedent died the owner of the following described real estate situate in Pike County, Clay Township, State of Indiana, towit: TRACT I Undivided One-half <1/2) part in value -(26) acres off . the West Side - Southwest Quarter (SW;) of the North- west Quarter CNWa) Section 18, Township 1 North, Range 9 West, - Deed Recocd #51, page.201, Recorder of Pike County, Indiana - March 12, 1929 - Assessed at $305.00 - Fair market Value 9-26-66 -$1,000.00 This affiant further says that.upon the demise of said Loren E. Dixon, as of September 26, 1966, title to said last above designated interest in real estate descended to this affiant as the surviving widow and sole heir-at-law.of said decedent. 4. This affiant further says that as of September 26, 1966, the decedent and this affiant owned the following described interest in real estate situate in Pike County, Clay Township, State of Indiana, towit: 1i2ACT J Undivided one-half (1/2) part in value -(26) acres off the West Side of the Southwest Quarter (SW;) of the Northwest Quarter (NW;) - Section (18), Township (1) North, Range (9) West - D. R. 53 page 448, Office Recorder of Pike County, Indiana (April 27, 1934) - Assessed at $305.00 - Fair Market Value, September 26, 1966 --- $ 1,000.00. That upon the death of said decedent as of September 26, 1966, this affiant as the surviving owner became vested with.the title to the Last above designated interest in real estate under the Deed creating the tenancy by the entirety. S. This affiant further says that the Indiana Inheritance Tax LiabiLity on decedent's.estate was determined by the Gibson Circuit Court at Princeton, Indiana - in Estate Dkt. No. PR 66 - , Office of the Clerk thereof and said decedent's estate found not liable for an Indiana Inheritance Tax. 6. This affiant states that this affidavit is made for the purpose of establishing the date of the death of the said Loren E. Dixon, and whom he left as his heir and/or heirs-at-law; and is for � 0 � the primary purpose of abtaining a transfer in the Auditor's Office of Gibson County, Indiana on the Tax Duplicate of Washington Township from the name of Loren E. Dixon to Saddie Dixon; and, for the pur- pose of obtaining a transfer, Office of the Auditor of Pike County, Indiana, on the Clay Township Tax Duplicate lik.ewise from the name of Loren E. Dixon to the name of Saddie Dixon. Further this affiant.sayeth not. Subscribed and,sworn to before me this lOth day of October, 1966. My Commission Expires: November 7. 1968 - notary THIS INSTRUMENT PREPARED BY: JOHN W. BALLARD, ATTORNEY, = ' ,. . Princeton, Indiana.