Aff - Richardson, Carolyn_6/13/1985L�(1� 2:i1udY1� =li1i11511°u oROU1Q DE. S1i11dL �O Lh° IOIIOYilIIf�: `%��� A
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��� S?':�T� OF Ii:DI�1i•?�1 j „
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COU�TY' Or G/,qSO/t/ )S
�1FFIDAVZi FOR TRA,�'SFER OF ASSETS
i•?ITHOUT ADhIii�IS'L�ITION
�y������eing firsc du1�� sworn uoon /�l
oath deaose and says:
1. Tnat [C�w.Q� F-�-c�-«ae�3 on tne � dav oi
19 ,$'(testate), (iltestate) cohiie domi-
ci d in Count;, indiaaa.
2
3
i.
Tnat no petition fo: the anpointment of a persoaai repre-
seatative of his escate is pending or has bee� granted.
Tnat forty-`ive (4�; days nave elansed since the cea*_h of
>aid d�ceden�.
Tae �;21ue c_ :he gross o_ob2te esLat� less l-e;is and eacL.-r.-
braaces thereoa does no= e::ceed iive thousaad dollars ($�,000).
�. T"�at [nis af�ian� is a i�aidccaj (caidow�r) (distrioute�) o_
said decedent and is en�itlee to rec=it�e c:itnou= administra-
tion the follo;ain� lisced oropertv fro� tne Nersoz, firn or
cornoratioa listed oonesite said ��'operty subjec_ to tne
liens and encu-braaces =hereon.
AIND OF
P ROP E.°.T1'
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iIx?�� 0�
k�l! F� L• N CU?i3 RAI�: CE S
LOCATED eA.LL�E IF ii�1
�-�
��
ii�?f a\D ArJDP.ESS OF
Pc?SOi•', FiRi�i OR
COP.�'OPATZOA HOLDI\G
PnOPERTY' GF DECEDEt1T
i�is a_"idavzt is nade `or tne nur�ese c,'. induci_no the 2oove named
holders of said der_edent's pr.operty to turn said proper[y over to this af-
fiant as nrovided by law.
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��.',��C��� �.l �'. ����s
ADDRESS / - _-
Suoscribed and sworn to be*ore ne this �3�i(, dav of 19�jr :� �„'_ .
I•f, Co,—i_=s�o,^, e�:�ires �S-�lri
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ho r. blic =_i' r"` -
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