Aff - Mauck, Mary O_2/3/1999, ,.
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STATE OF INDIANA
COUNTY OF GIBSON
IN RE:
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MARY ORILLA MAQCK
Deceased.
says:
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AFFZDAVIT FOR TRANSFER
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Fc�3 � 1999
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Jan Blackburn, being first duly sworn upon oath deposes and
1. That the above decedent Mary Orilla Mauck died intestate
on October 19, 1998, as a resident of Gibson County, Indiana.
2. That no Petition for the appointment of a Personal
Representative of said decedent is pending in an_y Court and more
than 95 days have elapsed since the death of the decedent.
3. That the decedent died intestate and had no surviving
spouse at her death. That the decedent was survived by and the
heirs of the decedent were her adult children, Jan Blackburn and
Patricia Sutton.
9. That the gross value of the decedent's estate, less
liens and encumbrances, does not exceed the sum of $25,000.00.
• 5. That among the assets owned by the decedent at her death
was the following described real estate situated in Gibson
County, Indiana, to-wit:
Lot Number Seven (7) in Block number thirteen (13) in
Trusler's Addition to the Southern Enlargement of the Town
of Oakland, now Oakland City, in Gibson County, Indiana.
6. That the heirship of said decedent and the persons
entitled to ownership of said real estate are as follows:
Jan Blackburn
one-half
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Patricia Sutton one-half
7. That said heirship herein is determined pursuant to
Indiana Code 29-1-2-1.
8. �This Affidavit is made pursuant to Indiana Code 29-1-8-
3.
� IN WITNESS WHEREOF the said Jan Blackburn has executed this
Affidavit for Transfer this
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STATE OF INDZANA )
) SS:
COUNTY OF GIBSON )
!,2- day of December, 1998.
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AD BLACI URN
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Before me, a Notary Public in and for said County and State,
this L a n`day of December, 1998, came Jan Blackburn, and
acknowTe3ged the execution of the foregoing instrument.
WITNESS, my hand and official seal. �
Q�.��Q�,n� �.
Notary Pu ic ;
My Commission Expires: .
Fl.,t��s7 2����T �R I 2ic-r'ck. S. I�iSPoaE
Printe Name o Notary
County of Residence: Gibson
This instrument prepared by Jerry D. Stilwell, Attorney.
Send Tax Statements to: Jan Blackburn, 2119 North St.,
Logansport, Indiana 96997