Aff - McLemore, Lora Ethel_9/11/1969RECORD OF DEATH . •. . • . • _
�« 'v '. � GIBSON• COUNTY DEPARTMENT OF HEALTH
� � - � -� - - PRINCETON,INDIANA � � _��
THIS IS TO CERTIFY, that our records sho�v_
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month '. day ' � year
LOi?A ETHEL MCLEMORE
of
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rinceton, Ind.
atreet, hospital, rural
Age'at Death 69 �eX Female _Color - White j'�arried
y�� � . _ �� _ write whether. married or single
Primary cause of death given was ACUte Congestive Heart Failure
Signedby william E: Dye, h1D Oakland City, Ind.
__ �phpsician or_coroner , . " � � address �
.. . - . > . .^�- _ . .� - . - . �Jca. .._.._ ;...-� � ' —°"�— — — . . .. - � -- . . . ... -
Place of burial or removal Ma� 1 P H; � � CemPt.Pry Princetcn, Ind.
� � . � name of cemetery. . � address _ �
Date of: buria� o/ t h/ n 5.
, • � - '. � Funeral
SEAL�';���-- i � Signed
G�.�6Y,F �4
- =. � Gibson unty Heal[h Commissioner
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�� ` . ?���'�G Prinoeton, Ind. 9/11/69
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Record'e��cally in book A�o: °: � page No. 74 ��led: h���/65
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STATE OF' � INDIANA
COUNTY OF GIBSON
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JAMES G. McDONALD, JR., being first duly sworn upon
his oath says:
1. That he is one of the attorneys for the Estate
of Lee McLemore pending in the Gibson Circuit Court under cause
No. Pr 68-39 in said Court, and is authorized and does make this
affidavit for and on behalf.of said Estate.
2. That the Decedent Lee McLemore died seized of the
following described real estate situate in Oakland City, Indiana,
to-wit:
Lot Number Seven (7) in Block number one (1)
in Beasley and McConnell Addition to the town
(now City) of Oakland City, Gibson County,
Indiana.
3. Affiant says further that Lora McLemore prede�sased
Lee McLemore all as shown by the death certificate attached hereto
and made a part hereof.
4. That this affidavit is made for the purpose of
transfering the above described real estate into the name of
Lee McLemore for tax purposes.
, ��.
Subscribed and sVTorn to before me a Notary Public in and
for said County and State, this the j/ �� day of September, 1969.
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/l /��m<t r���.�.� �
o ary u ic
h�y Commission Expires:
,� 3-7.�