Aff - Davidson, Shelia P_10/29/198071u. �fi id.�vi.0 f urr.i::lic<1 Fncui.d be s::�ilar [n t:hr ;ol.l.owinq:
STi��!? CF' i:•:DI�Ap"A� �
cou::-�• or...�;G��ss:
AFFIDAVIT GOF. TFA\SPi:R OF ASSF.'CS
WI'CHOUT AD,II�71SfR.1TI�Y
s�����
�eing P.f.rs[ dul.y sworn upon � �l
oati� deposc:: and says :
„ • \ . �
1. 7har� died on thc _/� day of
19 O itestace), (,intestate) while domi-
cile in ��e_,�` Coun[y, Indiana.
2
3
t;
That no petition for the appointment of a personal repre- �
sentative of his esca[r_ i.s pending or has bren granted.
7hit fnrty-fivc (h5) days h�ve elapsed since r.hc death of
sairi decedent.
T;ie value of. the gross probate cscate less liens and enc�n-
brar.ces thereon does not excced t:ive thousand do7lars ($5,000).
i. 7nac t:�is n[fi.:inC i� a(ti•idoca) (widowci-) (di.strihutcc) of
said decedent ;�nd is eliti.[led to recei.ve widiout administra-
," ti.on the fol.lowing ].iste+l propert�/ from the person, firm or
corporar.iun listed opposite sa.id prop��rty siibjecc to the �
].icns nnd encumbrnnces ti�c.rcor..
NA;•0•: A�!D ADDRF.SS OF
L7.i•.'� �R Pf•:RSOY, PTRtf OR
K1i:D OF lJ}ig�: � IsNCIPIl3'fv1NCL5 CORPOFZ•\'CION NOLDIt<G
PRU.°'r.R'[1' I.00ATF.D VALUIi IP A.`+l' PFOPIiRTT OF DECEDEIdT
,.._
�� � --
,
3G�
a ��
p..t�.z9�rYS°
'ii�is nfflciavit Ls made foc Che purpose of. inducing the above nnmed
holr.crs of ::aid dcr_edent's pr.operty co turn said property ovcr Co [hie .[-
fian[ as provided by l:�w. :,'. !
� l //� (% / //.�,� �!` -.-'s -
AFPIA\1 ' `: __ ��"., ^, _
`4' '� _.i..J:/
� , � a � 9_---. . .. .;,�-;
�
• twurcc» �: /� ":------�„-= • .
�`'. -� ��
Subscribed and sworn Co before ne tiiis � day of D��i. _19�""
.-„
Nntnry Publ.
�ty (:��;�mifcsi�n expi.res _ � ��