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Aff - Karaff, Bridgett A_9/20/2012� ..� �,,.�� naun �/1'//LO1'L 11:59:51 AM PAGE 6/007 FaX Server STATE 0 F TA �>, e�,,� COUNT'(OF lSl�nJ F'IL,�D SE-R 2 0'2012 C.`�.n " V �����7d�IbRB�r RcBpsID:69•18003389 8ridget A, Richardson f/k/a 8ridgett A. Karaff("Affiant"}, being first duly iworn on oath states: 1. That the following is based upon AffianYspersonal knowledge. 2. That Affian[ is the owner of the follOwing described feal estate: Situated in Gibson County,- Indiana: �art of the west half of the southwest quarter of Section 10, township three (3) south, range � z wesr, Gibson County, lndiana, and more pa»icularly described as fol)pws: 7he A1ace of beginnirg may be found at a point on the east Iine of said half quarter section 30.00 feet north af ihe center of ihe lNi. Vernon Branch of Yhe EvansviAe and Terre Haute Aailroad, now Chicago and East2rn Illinois Railroad, wher@ said �aiircatl crosses the above mentioned east line; from said po+rrt oi begirtnrng rurt thence rtorth and along sard easi line 232.D0 ieet; thence wast and parellel to the cen±er line of uid railroad 330.00 �eet; thence south and parellel to said east line 132.00 feet to a point 30.00 feet north of the c¢nterline of said railroad; thence east and paraflel to ihe center line of said railroad 300.00 feet to the pla�e of beginning, and containing 1.p000 acre. 3. That A�ant and lyndell M, Karaff were husband and wife at the time they acquired title as te�ants by tfie entireties to said reaf estate by deed dated fvtay ZZ, I981 and recor�(ed May 28, I98i, in Ins[rument No. 4/8839 in the Office of the Recorder of Gibson County, Indiana. a. Tnat the marital relationship which existed between this AfFiant and �yndef( M. Karaficontinued unbroken from the time they a�quired title to said real estate until ;he d=ath of said spcuse on January 15, Z003, at which time this Affiant acquirec title to said real estate as surlivingtenant by the entireti�s. 5. That all dehts, funeral expenses, and expenses of the last illness of safd decedent have been fully paid and satisfied. o. That the gross value of the estate of said decedent, including all jointly held proper�y, ail gifts made in �on'.emplaticn ot death, or matle �vithin the three years preteding said tleath, tcgether with the value of all investments in joint properties and tenants by the entireties, including the real estate -� �= a,�.� u oa�,K tsi i ii'LU1'L 11 :59:51 AM PAGE 7/007 Fax Server above described, plus the proceeds of all insuronce an the life of said decedent, was an amount whi�h was not subject to a Federal �state 7ax and arknoivledges ihai and if any psfate or inhNritances taxes a�e due, there are suffitient funds available to pay said taxes, 7. i'hat tAis affidavit is bei�g made far the purpose of estabtishing titfe in Che abave descrrbed real estate in the name of the Affiant. INq VUITNESS WHEREOF, 7he Affiant has executed this SurvivOrship Affidavit this �day of ���2D12. �°�/ /J. ' /��' � 7" � �-�'—�� Signat fe Bridget A, Rith2rtlson fka Bridgett A. Karaff /'/GJ �! C � �;J� ��d��d'S O/i Printed N me E(�g,fore me, a Notary Public, in and for said County and State, personally appeared �ji)(t,c��i 1% h-+-�l-i.�i� �0 �n who acknowledged the exetution of the foregoing Survivorship Affidavit on thecd dateof �� �� 2012. ,� DARLA DEE BARTON Notary PuDlic - Seal Slate o( Indiana My Commission Ezpires May 16, 2016 My Commission Expires: S/iL� �'(� J�'(,il.�� ��C.0 �J�l,c.�G �, Notary Publi[ �zE.�-I a: �J� E� 13a��n Printed Name Residing in: 1�' ��Ci1 :7 counr�, Indiana This in;trument was prepared by: Bridget A. aichardson f/k/a Bridgett A. Karaff of 62a7 5. 325 W., Fort Branch, 1N 47648 pAaii Tax Statement to: X�� I affirm, under penalties for perjury, that i have taken reasonable care to redact eac Socral5ecuriry numb=r in thrs dxumeRi, urt�ss teqar�ed bylaw. A�d�R- Pl�n/fi���l° EXHIBIT A Situated in Gibson Counry, Indiana: Part of the west half of the sou;hwest quarter of Section 10, township three (3) south, range 71 wesi, Gibson County, Indiana, and more particularly described as follows: The place of beginning may be found at a point on the east line of said half quarter section 30.00 feei north of the center of the Mt. Vernon Branch of ihe Evansville and Terre Haute Railroad, now Chicago and Eastern Illinois Railroad, where said railroad crosses ihe above mentioned easi line; from said poini of beginning run ihence north and along said easi line 732.00 feet; thence west and parallel to ihe center line of said railroad 330.00 feet; ihence south and parallel to said east line 132.00 feet to a point 30.00 feet nonh of the cenierline of said railroad; thence east and parallel to the center line of said railroad 300.00 feei to the place of beginning, and corfaining 7.0000 acre. So Fyet�m S l�� eN�� � � 8o%q5y73.8043 SouihWES� PinaoH1 Gi�cl��a��1 ������� �� �������� ��� ������� pF5A3� (Page 1 of 1) 8727533094 15:27:22 08-76-2012 2i2 GIBSON COUNTY DEPARTMENT OF HEALTH 800 S. Prince St. Princeton, Indiana 47670 812-385-3831 RECORD OF DEATH T8I9 I8 TO CER2IPY that according to the recorCS ot tde oibeon Couaty Depertment of Health, LYNDSLL M. SARAFF Diefl on ol/15/2003 at 7:52AM Residence � # 1, BoX 514 Fort Branch IN 47648 age at deatL � 51 Years Sex: M r_nrital etatue: Married Color: whita Cnuea oE deathc Mulitple Brain Znjuries (montha), Advanced Hunting[on�s Dieeaee (years), aecurrent Aapiration Paeumonia 8lgned by: Rameshbhai P. Patel, hID 105 N. 2r.d Ave. Princeton IN 47670 Place oY burial walnut xill Cemetery or r�val: Ft. Sranch IN 47648 Date of burial: O1/18/2003 Pnnerel boaes Stodghill Puneral Hone, INC 30a W. Locust 3treet Pt. Branch IN 47648 /� I�.l�^s'�' �` s��C[G/�7�1V(/ Sigaed by � Gibson Coun[y Health CoR¢niseioner S fi A L Princetoa, Indiana 01/21/03 Address Date RecoYded locally in Book No. 14 Page No. 55 Filed: OS/21/2003