Aff - Lindauer, Ewin A_9/2/2011�
'�I���.��'I�I Record and Return To:
ISGN Fulfillment Services
P.O. BOX 2590
LINDAUEfl, JUNE P ChICegO, IL 60690
STATE OF I\DIANA ) �
) SS:
COUNTY OF GIBSON )
AFFIDAVIT OF DE:�TH AND SUCCESSION TO ENTIRETIES REAL ESTATE
(Indiana)
The undersiened, lune Phyllis Lindauer (the '`AFFIANT"), ��•hose residence address is 301 S Center St,
Fort Branch IN, 47648-I �01, being first duly swom, states as follows:
1. That the AFFIANT is the surviving spouse of Edwin A. Lindauer (the "DECEDE\'T"), who
died a resident of Gibson Counn-, in the State of Indiana, on May 28, 2010. A copy of the death certificate is
attached hereto as Exhibit B.
2. That AFFIANT and the DECEDENT, at the time of the death of the DECEDENT, were married
ro each other and were the o�ti�ners, as tenants b}� the entireties, of the real estate (the "Real Estate") in Gibson
County, Indiana described in the attached Exhibit A.
3. That by virtue of the death of the DECEDENT, the AFFIANT is the fee simple owner of the
Real Estate and requests that this fact be reflecred on the land and taK records of the couniy.
�� � ��` .
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SI( NATUEZE OF AFFIANT
STATE OF NDIANA )
��� ) SS: KATIE L. ELLIS
COUI`'TY OF ) Sea� Resident ot Glbson County, IN
�O� Commission Ezpires: Feb. 18, 2017
Subscribed and sworn to before me, a Notary Public in and for said County and State, this :Zt����
day of u /�, _ , 20�. /
_� �6��0.�.�
No ry Public ,C�lih� ��I, s
Residing in -� s.:.. County, Indiana
�ty Commission Expires: .� - /3 � .� O/ �-
[ affirm, under the penalties for perjury, that [ have taken reasonable care to redact each Social Securitv
1�'umber in this document, unless required by la�v. Dana Ledford
This instrument ��as prepared by Kimberly ivtoman of Old National Bank; 1 Main St, Evansville, I�l
a»os.
�: ,J
SEP 2 2011
c.�.m�
GIBSON G4UNTY AUDITOR
"Eachibit A"
Owners: Edwin A. Lindauer and June Phyllis Lindauer, husband and wife
Lot Number Two Hundred Thirty-two (232) in the Pritchett's Enlargement to the
Town of Fort Branch.
Being the same real estate described in Deed Drawer #l, Cazd 351, Office of the
Recorder of Gibson Counry, Indiana.
;:EXHIBIT B"
� VANDERBURGH COUNTY F�EALTH DEPARTMENT 12578
Evansville, Indiana
CERTIFICATE OF DEATH
��j i 5 Lertif i e5 � THnT ACCORDWG TO THE RECORDS OF THE HEALTH DEPARTIdENT
NAMC EDN'IN �. LINDAUEF
DIEDIFJ VANDERBURGH COUNTYINDIANAON htal' �>5 YEAR �010
i IME OP DEATH O? : I O P. M. MARITAL STATUS I�LARI�I ED SeX AL�1I.E AGE ! 4 FlAC't �i7-II TE
SOCIALSECURIN DATEOPBIRTH I��O��I9�S
?LACEOFDEATH DE.iCO�SS HOSPITAL
PRIMARV CAUSE OF DEATH GNEN WAS MUI.TIPLE SPSTEM ORG.M FAILIIF'�E
SEPSIS
ACUTE OR CHI20NIC CHOLECI'STITIS
?HYSICIANORCORONER ;jD$j,.�,N Cr1RTEF, M.D. nuroasv IVO
PLACE OF BURIAL Oa FEMOVAL HOLI� CROSS CFhiETEFY MANNER NATUR,AI. DI SE.ASE
:UNERALHOME STODGHILL FU.NERAL. HOhL�; FT.BFA?dCH.Ii�� DATEOFBURIAL OG�O2�ZOlO
I CEFTIFICATE NUAtBER "
ORVOLUMEAND?AGE p0000991 DATEISSUED 09/16/2010
I
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, � , NOT VALID UNLESS SIGNED 8 SEALED
' � ��r� � �
I � �LD.
j VANDE98URGH COUNTY HEALTH OFFICER
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