Aff - Nolcox, Rita Jean_10/12/1978' 'C.s: "�
The a:.`i�av`_: ic::�ishr_d s:'._- be si�ilar tc [he following:
STATE OF IPIDIANA j ,
COiJYTY OF GIBSON �SS:
AFFIDAVIT FOR TFANSFER OF ASSETS
4dITH0UT ADPtIiVISTRATION
Rita Jean Nolcox� being first duly sworn upon her
oath deposes an�' says:
1. T1iat C died on thc � day oi
19 testate), (intesta[e) while domi-
ciled n ibson County, Indiana.
2. Tnat no petition for the appointment of a personal repre-
sentative of i�is estate is pending or has been grar.ted.
3
4
That forty-five (45; days have elapsed since the desth of
said decedent.
T�e value of the gross orobate estate less liens ar.c- enciun-
brances thereon does not exceed :ive thousand dollars ($5,000).
S. Tnat [his affiant is a(widow) (widowcr) (discribucee) of
eaid decedent and is enti[led to receive without administra-
tion the following listed property fron the person, firn or
corooration listed opposite said proper[y subject�to the
liens and encumbrances thereon.
NAPfF. AND ADDRESS OP
LIEid OR Pi:RSON, FZR*f :?�
KIND OF WHERE ENCL'�IBE2ANCES CORPORATION HOLDING
PROPERTT LOCATED VALUE IF A,�Y PROPERTY OF DECEDENT
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5�3. �9
Tnis affidavi[ is made for
holders of said decedent's property
f-:ant as provided by law.
the purpose of. inducing the above , a^�ed
to turn said property over to [hie af-
, ..
R.�v
AFFIAA'T
Xa Fu7DR'SL s
S•sz^_r_`�e.�. and sworn to before me this 12th day of October 1978
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��` �; _.. __^ Yotary Pu lic
;'-." �'' � - Melanie A. Smith
�'^` `, ._�cp y 1980 I reside in Gibson County, Indiana.
;;,; Corcnissioc'e`_ ires Ma 17,
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