Aff - Holzmeyer, Raymond W_6/16/1987�_ �
STATE OF INDIANA )
) SS:
COUNTY OF GIBSON )
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AFFIDAVIT OF SURVIVORSHIP
Lorraine M. Holzmeyer, being sworn upon her oath, deposes
and says as follows:
1. That Raymond W. Holzmeyer and Lorraine M. Holzmeyer
took title as husband and wife to the following described real
estate in Gibson County, Indiana on or about August 20, 1966:
Lot Number one hundred seventeen (117) in Walter's Addition
to the Town of Fort Branch, Indiana.
2. That the said Raymond w. Holzmeyer and this affiant
were husband and wife on the date that they took title to the
aforementioned said real estate and remained husband and wife
continuously until the date of death of Raymond W. Holzmeyer.
3. That they remained the owners of the afore described
real estate continuously from the date they first took title
thereto until the present date.
4. That Raymond W. Holzmeyer died on May 25, 1987, a
resident of the Town of Fort Branch, County of Gibson, State of
Indiana.
5. That the undersigned Lorraine M. Holzmeyer, survived
her husband, Raymond W. Holzmeyer, and therefore Lorraine M.
Holzmeyer is the sole owner of the above described real estate
by virtue of said survivorship.
6. That this affidavit is made to induce the Auditor of
Gibson County to change his tax records so as to show that
Lorraine M. Holzmeyer is the sole and only owner of the
aforementioned real estate as of this date.
1987.
Further affiant saith not.
Executed at Fort Branch, Indiana, this /oZ� day of June,
�.wvs.� J !Y� . /`'�/-�,.nry.�—cJ
L rraine M. HolzmeyeL7—�
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State of Indiana )
) ss:
County of Gibson )
Before me the undersigned, a Notary Public for Gibson
County, State of Indiana, personally appeared Lorraine M.
Holzmeyer, and she being first duly sworn by me upon her oath,
says that the facts alleged in the foregoing instrument are
true. � Signed and sealed this .�-�' day of June, 1987.
_ ` �
nette R. Dr ey, Notary P lic
My commission expires:
May 24, 1991
and I reside in Gibson County, IN
This instrument prepared by Ray M. Druley, Attorney at Law
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