Aff - McCain, Jean_12/29/2010--�
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STATE OF INDIANA
COiJNTY OF GIBSON
I�] RE: THE MATTER OF:
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The Estate of
AUDREY JEAN MCCAN
Deceased
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IN THE GIBSON CIRCUIT COURT
AN'iVUAL TERM
CAUSE NO. 26C01-0904-EM-41
AFFIDAVIT FOR TRANSFER OF REAL ESTATE FOR TAXATION
Janice McCain, whose address is 5841 North U. S. Hwy 41, Patoka, Indiana 47666, being
first duly swom upon oath deposes and says:
1. Affiant is the adult daughter of James K. McCain and Audrey Jean McCain, husband and
wife, both of whom aze now deceased.
2. James K. McCain died 3—I 19�I 3 , a resident of Gibson County, [ndiana, leaving
Audrey Jean McCain as surviving tenant by the entirety of the following described land:
010-00645-00 PT E IZ 1 1 l 11.52 AC
Parcel Number 26-04-12-200-000.645-018
010-00644-00 PT LOC 169 l-]0 6432 AC
Parcel Number 26-OS-48-169-000.644-018
3. Audrey Jean McCain aka Jean McCain died March 30, 2009, a resident ofGibson Counry,
Indiana, and was at the time of her death the owner of the following land in White River Township
in addition to the pazcels identified next above:
010-00327-00 PT E 18-1-10 177.40 AC D-l2 G1
Parcel Number 26-OS-18-400-000.327-018
4. By her last will and testament admitted to probate in the Gibson Circuit Court April 27,
2009, Cause No. 26CO1-0904-EM-41. all of the above described real estate was devised to the
Affiant Janice McCain, whose address is 5841 North U. S. Hwy 41, Patoka, Indiana 47666.
5. Affiant makes this Affidavit for the purpose of cansing the Gibson County Auditor to
transfer for property tax purposes all of the above descriJ�ed land to this Affiant. 1
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McCain, Affiant
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I affirm under the penalties of perjury that the foregoing representations aze true.
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Ja ' e McCain, Affiant
SUBSCRIBED AND S�i'ORN to before me this � day of r.�1,�r, , 2010.
C,�v�� �- �a��,hn�.o
Notary Public: h Vi Sf I riG. �.• Q,rrt�rN
Residing in Gibson Co., Indiana
My commission expires: �' - Z3� � 1
This instrument prepared by: VERi\'ER P. PARTENNEIMER, #l5627-26, Hall, Partenheimer &
Kinkle, 219 North Hart St., P. O. Box 13, Princeton, IN 47670, Telephone: 812-386-0050
REDACTION STATEMENT
I affirm; under the penalties for perjury, that [ have taken reasonable care to redact each
Social Security number in this document; unless requir by law.
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CF.RTIFICATE OF DEATH:
f:NOti COL`YTY HEAL1'H UEY9RTMENT:
102 NORTH SEVENTH STREBT. GINGENVF,S I\DI.ANA:
'fhi.s Ceitities, that in the recorcts of the i:nox County- Hea]_th Department:
�r1CIF OP DECEASED: JAh1E5 KE?r':VETH McCAIN D:1TE OF DEATH: March 1, 1993
:1GE: 71 SEI: MALE RACE: WF[I9'E MARi'PAL STr1TliS: PIARRIED. JEA[. GOLUFUIN McCAIti
CAifSE OF DEA'CH: DILATFU CARDIOMYOPATHY. CHRONIC ORSTRL'CTI�'E PUTMONARI DISEASR
ldI'P}i COR PIJLMONALE. .
CECIETERI-ADDRFSS: PIEMQRIAL P:�RK l'INCENNES, INDI;�NA
PLACE OF DE:1'CH: GOOD SAPL\RCTAh HOSYlTAL ViNCENNF.S, INDIANA
HOUR OF DEATH: 8:02 P�1 P.UR7:1L DaTE: March 5, 1993
FUNERAL llIRECTOR-.aDDREtiS: GARD.\'ER & SON. VINCE:VNES, 1NDIANA
PIiYSICIAN/CORONER-ADDRESS: PH:CLIP D. WATSON, D.O. VINCENNES, IVD].ANA
BOOK NG.: CH-29 YAGE �0.: 17 ].SSUIi UATF.: :�pril .L9. 1993
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SEAL:
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K\OY COUNTY HEAL7'II Ol'FTCFR:
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