Aff - Miller, Jean_8/26/2005STATE OF INDIAI�IA
COUNTY OF GIBSON
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AFFIDAVTT OF SURVNORSHIP
Daniel Adlai Miller, II, by his Personal Representative, being first duly swom upon his oath, deposes
and says:
That Daniel Adlai Miller, II is the o�vner in fee simple of the following described real estate
located in Gibson County, Indiana, to-wit:
The East Half of lot I�TUmber Seventy-nine (79) in the Original Plan of the To�vn (now City) of
Princeton, except ahvays 55 feet off of the north end thereof.
and that Daniel Adlai Miller, II and Jean Hart Miller now deceased, (the "decedent"), were husband and wife at
the time they acquired title, as tenants by the entireties, to said real estate by Wananty Deed dated May 27,
1957, and recorded June 3, 1957, in the Office of the Recorder of Gibson, County, Indiana.
2. That the marital relationship which existed behveen said affiant and decedent continued
unbroken from [he time Ihey so acquired title to said real estate until the decedent's death on /Y1u�cl. ay� da�v> at
which time this affiant acquired title to said real estate as surviving tenant by the entireties.
3. That the gross value of the estate of decedent, as determined for the purpose of Federal Estate
Tax was less than the value required for the filing of a Federal Estate Tax Retum; and that the decedent's estate
�vas not subject to Indiana Inheritance Taxes.
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Daniel Adlai Miller, by his Personal Representative
Kent Earl Miller
SUBSCRIBED AND S WORi\' to before me this �*'= day of August, 200�.
My Commission Expires:
Sentember 24, 2008
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Dana Y. Mars all, \'otary Public :'
Residing in Morgan County, II�i `-
This instrument was prepared by: Roger P. Ralph, Attomey at La�v, 1213 North Arlington Avenue, # 205,
Indianapolis, Indiana 46219, (317) 353-6131.
Retum To: Kent Earl Miller,8475 N. Park Avenue, Indianapolis, Indiana 46240
Send Tax Statements To: Kent Earl Miller,S475 N. Park Avenue, Indianapolis, Indiana 46240
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