Aff - Sollman, Herman C_5/20/1964\
j
1
� �•
STATE OF INDIANA
COUNTY OF GIBSON
�
. .�" ,
� "` \ `
�_-�-'�`_`�-�
��.
�`� �
' . � 0����� ` �.
SS: oq �`�' �966'
bp�lo �
AFFIDAVIT AS TO TENANCY BY ENTIRETY R�
C
Herman C. Sollman, being first duly aworn upon his oath, deooses
and says:
That he is Fifty-three (53)•years of age, a resident of Haubstadt,
Gibson County, State of Indiana, and his occupation is a Farmer.
That he is familiar with the following described real property
located in Gibson County, State of Indiana, towit:
Fifty (50) feet off of the South side of Lot No. 36 and ltoenty-Five <25)
feet off of the North side of Lot No. 35 in the First Addition to West
Heights Subdivision of the Town of Haubstadt.
ALso, Part of the Northweat Quarter, Southeast Quarter of Section 36,
Town 3 South, Range 11 West, being also a 15 feet_wide strip out of the
mid-portion of Lot #35 of the First Addition to West Heights Subdivisio�
of the Town of Haubstadt, Indiana, as Recorded September 20, 1955, in
Plat Record Book #2, page #67, in the Gibson County Recorder's Office
and further described as foLLows: •
Begin at a point in the East line of Lot �i35 of the First Addition to
West Heights Subdivision of Haubstadt, Indiana, which point is 25 feet
South of the Northeast corner of said Lot #35; and from said beginning
continue South along said East line for 15 feet; thence run West parallel
to the South line of said Lot �i35 for 125 feet to the West line of said
Lot; thence run�No�th along the said West line for 15 feet; ttience-run
East for 125 feet to the place of beginning and containing 0.043 acres,
and being the same real estate described in Deed Record No. 159 page 456,
Office of the Recorder of Gibson County, Indiana;
and that he knows of his own knowledge that said above described real
property was formerly owned by Herman C. Sollman and Elnora M. Sollman,
husband and wife, as tenants by the entirety.
Affiant further states that he knows of his ocon knowledge that said
Elnora M. SoLlman, died on or about August 29, 1963, and that said
Herman C. SolLman and Elnora M. Sollman, were husband and wife, at the
time of the death of the said Elnora M. Sollman.
Affiant further states that he knows of his own knowledge that
the value of the estate of said Elnora M. SolLman, at the time of her
death, within the meaning of the Federal Estate Tax 1aws, was less =
than Sixty Thousand ($60,000.00) DoLlars, and that the estate of said
decedent was not subject to any Federal Estate Ta�c.
Affiant further
Subscribed and sworn to be
My Commission Expires: �
Novem6er-7, 1968
'IHIS INSTRUMENT PREPARED BY:
this 5th day of October, 1966.
,
JOHN W. BALLARD, ATTORNEY
I� / .
_ � , .. -
~�. • .
�' ��
�'�RECORD OF DEATH . - - �
GIBSOIQ COUN1'1' DEPART➢iENT OF HEALTH •
� _ � -PRINCETON, INDIANA - . '
� TfiI5 IS TO CERTIFY, that our records show�� � �--�-�-�c Q.�-� died
Q.�.o 2 9 �' ./ �i � 3 at�.'3o �;. �s.�.,,d„ �15...,-�.f !.(-��I,.�
, mon daY year _ - hour of �death � street, hospital, rural
�
Age at. Death 3�= Sex�1�� Color �� �-✓
� yeais � � ri•rite whether married or single �- �
- Primary cause of death given was ��^+"' �'�*� � � � -
, %.,1.._�-�,,L.: J dii.�w.,c �Q.�aCt�Y,.�, 'J.�.-R,.-�.,v `k— � � � � - ---
_—� . � - ' ' ' . - — '-�� --- - ;�_v-_..
_ x�_
Signed by v�n.4:,.e i�LC .i�ai..�y . 7it `ki -�iU.�..e.e:.(�>....
. � . physician or coroner _ � . , � address �
Place of burial or removal Y�- � %�`•�� '� — ���� °'^'�
. - � � � name of c metery _ - � � � addrnss . � ' --
c o ,
Date of burial �! — I — � 3 �-c�-�,e �i�,�c.-<-P �+�v,�^-.c ��� �'� - �^-� _ -
. ' �neral Director � - � address ' � -�
� SEAL t` - Signe�l- I` y Nn.�.�/fc�a...c�1 ��ii . .
_ . !. � � � Gibson County Heslth Commissioner _
- . J�'„�.,.,�.��, �--� 'S.� s =c�3
. . .. . . . address . ' f.�.C.n.d' date
�f3/.�6'�
Recorded locally in book No. j"f—Sb Page No. 3 y