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Aff - Hofman, Anna L_8/28/2007��_p S- y�1- I a s- 000: a ss-o � � . a�-oc�- 18- ►oo- 000���-o�? STATE OF IND[ANA CO[J\'TY OF GIBSO\� IN RE: ) ) SS: ) The Estate of A\�'A LOU HOF�4A\, Deceased ) ) ) ) ) IN THE GIBSO\' CIRCUIT COURT A\PiVUAL TERVI CAUSE NO. 26C01-0703-ES-�7 AFFIDAVIT OF DEATH AND HEIRSHIP OF ANNA LOU KOLB HOFMAN The undersioned, R. Phillip Hofman, bein� first duly sworn upon hi� oath deposes and savs: l. The undersi�ned ���as personally acquainted with Anna Lou Kolb Hofman for o��er 60 vears and is her son. 2. Anna Lou Kolb Hofman departed this life on Auwst 17, 2007 and at the time of her death, �vas 33 years of age. 3. The undersigned is well acquainted with the family of Anna Lou Kolb Hofman and those who constitute her heirs under the la�vs of the State of Indiana. 4. The follo���in� statements or ans�vers are based upon the personal kno�vled� of the undersiened and are true and correct A. Did the deceased leave a Will? 1'ES : C. Has the ���ill been admitted to probate? No estate �vas administered. YES D. Anna Lou Kolb Hofman was married one time; to Ra�mond Hofman and durine their lifetime, they��ere divorced. Anna Lou Kolb Hofman ��as married ro no other person other than Raymond Hofman durin� her lifetime. E. F C� Anna Lou Kolb Hofman left no unpaid debts. The follo���ing are the children born to Anna Lou Kolb Hofinan durina her lifetime. r.';R�P.hilli �Hofmap, Rebecc Anna�F.la`ck�nd;L=ucinda Ja'ne$Jones`�,;�;:� At the time of her death, all three children n ere li��ing � � � H. Anna Lou Kolb Hofman had no adopted children or any other children bom to her during her lifetime. STATE OF I\`DIANA COUNTI' OF GIBSON ) ) 5S: ) = �I � / �� /� � � � . . ' / � . Subscribed and s�� orn to before me this �g1� day of Auwst, 2007. ,,,,:�..:: ., ,� S \S ' c'' Y' :> , ;` • c."• :'i, � n>. . L�`:-:�'.e'. i%�:' : r _ jt Y i O � ���C. �Q .� ��' : Ti :;}�p•.. ,.�---� : j L;.: ��•.'r.::a n.-;.`:' . . �� : s=. — ,�,;: .:o ; �, c, :'_ � . •,:: ;-'°`'�;'' !%{`` `'�. ��;;i- �' �' � :F�:::. .: _' .... ,.\\l . _ �.t�._:�.' :il ,Ifr.rtlP }'i ... :�'��. ` _:'-�'r M���,J AUG 2 8 2007 �G� G GIBSON COUNTY AWITOR � .�ti�, -�i� , /i i t/ Jo Dunn-�ickerson, Notary Public \4}��ommission Expires: June 6; 20l � Resident of Gibson Counq�, Indiana F��. T�� � R• %/UA.y�.�.�� f oS/ �y. ! FX� � � /��s �ti«v /ti 5/?6�0