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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: �a j 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 � ,r.a...._�R..,�.::.-e.,r...,�.,..�-«.�.r.�v.a._.��_....,�.,_..,� �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 . , � .., ,.�.....s�.�.�_:��..�-�.. �x....=.�.� �;Va1D IF A�LiEREO:OH ERAS�c��NQT�AUO UNLESS C_ERTIFIED BY HERtiHiDEPARTh7ENT: <��.m+ixc.r�us� �v..ar.- --,.�.sl,�.�.._ .�.�