Aff - Heiserman, Maud M_7/15/1992OpIGINAL
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STATE Of ARIZONA
DEPAHTMENT OF HEALTM SERVILES - OFFICE OF VI7AL RECOROS �EqTH NO.
CERTIFICATE OF DEATH 0 702-
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MAUD MARIE HEISERMAN FF1�tALE °f'`TM MAy
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SCA1'E OF INDIANA )
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COI7M'Y OF GIBSOY )
A F F I D A V I T
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Dtzxine I. Woods, being first duly sworn upon her oath states:
1. TT�at she is the daughter oE Pfaud M. Heisem�an.
2. That by tJarranty Deed dated May 17, 1979, same being recorded the
same date in the Office of the Recorde Gib� County, Indiana, as Card No.
BO51, Instrument No. 38556, id Maud M. Heisecman veyed to her certain
real estate located in the City of Prince �n, i son County, Indiana, more
particularly described as follows:
" A part of Lot Y 18 in Clarksville Addition to the Tou�n of Princeton,
Indiana, described as follows: Beginning at a point in the North Line
of Lot 4t 18, 106.5' vest of the NE rnrner of said lot, run thence vest
42' to the {Jest side of said lot, thence south 50', thence east 42',
ttence north 50' to the Point of Be�inning, Provided; that the
GranWr herein reserves unto hezself the fu11 use, control, incane and
pc•ssession of the described pranises for and during her natural life."
3. That Maud M. Heisecman departed this life on May 24, 1992, as shown
on STATE OF ARIZ(��A, CER'CIFICATE OF DEATH, certified by Pima County,
Arizona, Health Department, same being incrorporated by reference herein,
m�:de a part hereof, and attached hereto.
4. That fran the date of the aforenentioned conveyance of said real
to the date of the death of hfaud M. Heisecman there vas no change in
tFe ownership of said real estate.
5. That she is nov the sole oxner of said real esWte.
FLrther affiant sayeth not.
�/'//IG�fiCP. V �. `C//l/(/ r^,'
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Pfa�cine I. c�oods
Su6scribed and svorn to before me, a Notary Public, this ISth day of
July, i992.
1,�LU %7 i' �,urr�^�
Alberta PI Mervin
Gibson Coun[v
(Printed) Residing In County
My cannission e�cpires Sep[.21,1993
This Docw�ent Prepared by Eldon C. Woods, Attorney at Iaw.
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