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Aff - Phillips, William_3/20/2009�
STATE OF INDIANA
SS:
COUNTY OF GIBSON
says:
�
AFFIDAVIT OF CAROL HALE
CAROL HALE, being first duly sworn upon her oath deposes and
1. That she resides at R.R. #1, Oakland City, Gibson County,
Zndiana.
2. that she is an adult child of William L. Phillips and
Ethel Phillips.
3. That William L. Phillips died on March 10, 1963, in
Gibson County, Indiana, as shown by Record of Death attached hereto
and marked Exhibit "A".
4. That Ethel Phillips died on October 18, 1984, in Gibson
County, Indiana, as shown by Record of Death attached hereto and
marked Exhibit "B".
5. That the decedents, William L. Phillips and Ethel
Phillips, died seized of the following described real estate
located in Gibson County, Indiana, to-wit:
Lot Number five (5) in Shoptaugh's Addition to the Town of
Francisco, Gibson County, Indiana.
6. That William L. Phillips and Ethel Phillips, husband and
wife, died lea�gBa�� �rs the following:
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g
MAR 2 0 200S
��,��
GIBSON COUN1`Y AUaifiOk
�
(1) Carol Hale, daughter;
(2) Imogene Padgett, daughter;
(3) Eugene Phillips, son.
�
7. That this Affidavit is made for the sole and express
purpose of heirship and of transferring title to the hereinabove
described real estate to the heirs listed above.
C_ _�� "`„'�
STATE OF INDIANA
SS:
COUNTY OF GIBSON
Before me, a Notary Public in and for said County and State
personally appeared CAROL HALE, who acknowledged the execution of
the above and foregoing Affidavit, and who, having been duly sworn,
stated that any representations therein contained are true.
Witness my hand and Notary Seal this � day of %'Y a.�:,e.,
2009. �� � , !,
S I GNATURE : +��YX��
PRINTED: C /,✓r.2� L:' NxWr"le �c
NOTARY PUBLIC, GIBSON COUNTY,
IN
My Commission Expires:
V1 �,t �..�r�-�.. l�,� ���
THIS INSTRUMENT WAS PREPARED BY JAMES G. McDONALD, III, ATTORNEY AT
LAW, 120 S. Main, Princeton, IN 47670
I affirm, under the penalties
reasonable care to redact each
document, unless required by law.
Tie to: Deed Book 123, Page 560
for perjury, that I have taken
Soq'r�l S�urity number in this
GIBSON COUNTY DEPARTMENT OF HEALTH
•800 S. Prince St.
Princeton, Indiana 476�
812-385-3831
RECORD OF DEATH
THIS IS TO CSRTIFY
that according to the records of the Gibson County Department of Health,
WZLLIAM LSWIS PHILLIPS
Died on 03/10/1963 at 10:30pm
Gibson General Hospital
1806 Sherman Drive
Princeton IN 47670
Aqe at death . 78 Years Sex: M
Marital Status: Married Color: White
Cause of death: Pulmonary Emphysema (years)
Signed by: William R. Wells, NID
510 N.Main St.
Princeton IN 47670
Place of burial Z.O.O.F.
or re�oval:
Francisco IN 47649
Date of burial: 03/13/1963
Funeral home: Colvin & Son
S E A L
425 N. Main
Princeton IN 47670
.�� �- G. ����f/�1 /
Signed by % '�`✓
Gibson County Health Commissioner
Princeton, Zndiana 03/13/09
Address Date
Recorded locally in Book No. 50 Page No. 23 Filed: 03/11/1963
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�UOID IF ALiERED OR ERASEO"NOT VA� LI� UNLESS CERi1PIE0 BYiHEALiH OEPAHiMBdi�
�r,.o!�-,,x�,���t _. �—�, — -
GIBS� COUNTY DEPARTMENT OF HEALTH
800 S. Prince St.
Princeton, Indiana 476�
812-385-3831
RECORD OF DEATH
THIS IS TO CERTIFY
that according to the recorda of the Gibsoa County Department of 8ealth,
BTHSL S PHILLZPS
Died on 10/18/1984 at 8:35AM
home
306 Wood Street
Francisco IN 47649
Age at death . 88 Years Sex: F
Marital.Status:._Widowed.
Cause of death: Congestive heart failure, xenal failure;
Arteriosclerotic Vascular disease
Signed by: william E. Dye, M.D.
412 Main "
Oakland City IN 47660
Place of burial I.O.O.F.
or removal:
Francisco ZN 47649
Date of burial: 10/20/1984
Funeral home: Colvin Funeral Home
S E A L
425 N. Main
Princeton IN 47670
���".� G. /��
Signed by
Gibson County Health Commissioner
Princeton, Indiana 03/13/09
AddreSS Date
Recorded locally in Book No. Page No. 131 Filed: 10/23/1984
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�;Va1D IF A�LiEREO:OH ERAS�c��NQT�AUO UNLESS C_ERTIFIED BY HERtiHiDEPARTh7ENT:
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