Aff - Wagner, Wilfred L_8/18/1969�
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s�aTF• ou t��i�n�n)
COUNTY OF GrgSON) s''
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ArFIDAVim FOR TRA�S"r']?i 0�' ASSE`TS
WI`PHOU'P ADMIP!I:S'i'RA`PiO�'
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oath, deposes and s��vs;
1. `Phat (� � c ied or. the �% � day of
' , l9c 9 testate �� i.ntes'ta te )-tivhi l:e-1'tv.in�. in
Gio�,r, County, Indiana.
2. That Il0 D2t;1ti_GI? iOr the aDDO_!1LRiBf1t Or 2 j�B!^S0:121 ro_
present2tlVE? Of h1S�!1@!' eStBLe iS Pe7lG�lt1' OT` Y12S heen �rante^,
3. Tha� more than •'�"`�� c6�j days have elapsed si;�ce the
death of said dececient, ,
�k. `Phat the value of the entire asset;s o� the est:ate oT the
decedent does not exceed :r',°�,�OO.00. �
5. That; this affiant is a(widow)(�.��idoa;er)(riistri.outeel o� saic
decedent and is entitled to receive �::ithout admin.istration the fol-
lowi.ng listed propert,y from the person, �irm-or coreorat.ion listed- --
below:
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real, peraonal, wa�es valtie, irom :vh2,: sourc�
THIS AFFIDAVIT IS h7AD� POR Ti{E PURpp•g Op IPIDUCiPiG ?}ii�
ABOVB NA�Ell NOLDERS 0:' DECrDEVT'S PRO?�RI'Y TO �UR\ �ATD
PROPERTY OVER 'Pp 'PHI`i nrYTAN'P ;i5' PF;OVTDFJ�3, LA':.�
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Si�n�ture o� A;i18[1L
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.4ddress of ;:f; i�n�—
Suoscribed and sv:orn to be?:ore me this � day o£ �"'�,/%�9,
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Commission expires: March 28, 1972
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