Aff - Grigsby, Mary_6/23/1977� �
AFFIDAVIT FOR CHANGE OF TAX REC�RD5
STATE OF INDIANA )
SS
COUNTY OF POSEY )
�o �i rF �. GR � G� i3 �l being first duly swarn upon
oath, deposes end says that �-4 C- is the W�Dowa 12
of (� ��RY C • G2� Gs/3Y
wha died on ❑r ebout the /GtQ, dey oP r/ovc'r�l3�2 , 196� ,
the owner oF the following deecribed rael eatete in �r�BJoni
County,Indiana, to-wit:
�r Sw�y N w�y ��i - 35 - iz r.�
Affiant further stetes thet said decedent died
= 3oA.
testate, end
that title to the real estete deacribed above ie now vested in the
following pereone:
e
�,oNri �. G2iG5�j`I
Wherefare, affiant makes this eFfidavit t❑ authorize and request
the Auditor of �l� J o N County, Indiana, to s❑
change the records of said County thet the ebove real estate may
eppear ❑f record for purposes of taxetion in the neme(s) of the
above ❑wner(s).
/ ` �
Subscrihed end sworn ta before ma, this 'Zoc� dey ❑f TU K c �
19 71....
=.� ;� ----- .__ �-�.
HIY�COH.MISSIOiV �EXPIRES
" -- fi�,; � 7B - =
,._ � �
,:. �
�; ,----- - -
. ,-
�� � L d�u� NOTARY
Pl18LIC
�