Aff - Rexing, Bernice M_11/2/2009�; �
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AFFIDAVIT FOR TRANSFER OF REAL ESTATE ON AUDITOR'S RECORDS
RAY J. REXING (hereafter "AffianY'), being first duly sworn upon oath, states:
1. Affiant is a competent adult.
2. Affiant has personal knowledge of the matters stated herein.
3. BERNICE M. REXING (hereafter "DecedenY') died a resident of the State of Indiana, on
or about November 15, 2008.
4. At the time of DecedenYs death, Decedent, Kent G. Rexing, Brian R. Rexing, and this
A�ant, were the owners as joint tenants with rights of survivorship, of the following described real
estate located in Gibson County, Indiana:
The North Half of the Southeast Quarter, and the East Half of the Southwest Quarter, all
in Section Twenty-two (22), Township Three (3) South, Range Thirteen (13) West.
(hereafter "Real Estate").
5. That this Affiant executed a Disclaimer of his right to succeed to any of the undivided
interest in the Real Estate owned by Decedent at the time of DecedenYs death, which Disclaimer was
executed by this Affant on August 13, 2009, and recorded on August 14, 2009, as Instrument No.
200900004199 in the O�ce of the Recorder of Gibson County, Indiana.
6. That as a result of the execution and filing of the Disclaimer, the undivided one-fourth
(%) interest in the Real Estate owned by Decedent at the time of DecedenYs death vests entirely in
Kent G. Rexing and Brian R. Rexing as a result of the death of Decedent; and that as a result of such
vesting of Decedent's undivided one-fourth (Y<) interest in the Real Estate in Kent G. Rexing and Brian
R. Rexing, the ownership of the Real Estate is now as follows:
AUDITORS OFFICE
USE ONLY
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�1?QP � 2009
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J
GIBSON CCUNTY AUDITON
.
Owner
Ray J. Rexing
Kent G. Rexing
Brian R. Rexing
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Undivided Ownership Interest
1/4
924
9/24
7. The Auditor of Gibson County, Indiana, is requested to show transfer of DecedenYs
undivided one-fourth ('/<) interest in the Real Estate to Kent G. Rexing and Brian R. Rexing, in equal
shares, on the transfer records of the Auditor's Office in said County pursuant to this Affidavit.
8. The property tax code number for the Real Estate is as follows: 26-16-22-300-001.896-
023 and 26-16-22-400-001.867-023; and the property address for the above-described Real Estate is
as follows: Rural Route, Gri�n, Indiana. The Real Estate is unimproved real estate.
9. Henceforth, a property tax statement for Real Estate should be sent to Affiant at the
following address:
Ownership Name:
MAILING ADDRESS:
City, State, Zip Code:
Ray J. Rexing
428 Bradley Drive
Haubstadt, IN, 47639
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STATE OF INDIANA
COUNTY OF VANDERBURGH
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Before me, a Notary Public in and for said County and State, personally appeared RAY J.
REXING who acknowledged the execution of the foregoing A�davit of Transfer of Real Estate on
Auditor's Records, and who, having been duly sworn, stated that any representations therein
contained are true.
Witness my hand and Notarial Seal thisa� day of ��� , 2009.
My County of Residence is:
County,
State of Indiana and
My Commission Expires:
I AFFI
TO RE
LAW.
Sig
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Notary P LC MARSHA J. FISHER
s`^- ; Hesider� of Warrick CouMy, IN
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(Printed)
This instrument prepared by John P. Broadhead, Attorney at Law
Bamberger, Foreman, Oswald & Hahn, LLP
P. O. Box 657. Evansville. IN 47704
THE PENALTIES FOR PERJURY, THAT I HAVE TAKEN REASONABLE CARE
I SOCIAL SECURITY NUMBER IN THIS DOCUMENT, UNLESS REQUIRED BY
L:�LI B\DOCSU` 2049U2EALE SllRD0437. DOC
John P. Broadhead
Printed Name
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