Aff - Shanley, Mary M_5/10/1989t
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STATE OF INDIANA
SS:
COUNTY OF GIBSON
AFFIDAVIT OF DEATH
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G185pN COUNiY �
FlIFDPoRRECOROiHp DAY
OF �.D.19_
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DULYRECOROEDIM
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JAMES G. MeDONALD, JR., being first duly sworn upon his oath
deposes and says:
1. That he was well acquainted with Mary M. Shanley, who
resided at 714 North Main Street, Princeton, Gibson County,'
Indiana, 47670, and that he knows of his own knowledge that the
said Mary M. Shanley departed this life on January 19, 1989, and
that he viewed the corpse of Mary M. Shanley at Colvin Funeral Home,
Ine., 425 North Main Street, Princeton, Indiana, 4']670, following
her death.
2. Affiant says further that he has known the decedent for
more than forty (40) years last past and attaches hereto and makes
a part hereof a copy of,her Death Certificate issued by the
Gibson County Department of Publie Health, 800 South Prince Street,
Princeton, Indiana, 47670.
AND
FURTHER
STATE OF INDIANA
SS:
COUNTY OF GIBSON
Before me, a Notary Public in and for said County and State,
personally appeared the above named signatory, who acknowledged the
execution of the same as being true and correct and the same was
signed on the 3� day of May, 1989. , /J
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� /.,.c,e,v i,�Xu�i e -?� PRINTED
NOTARY PUBLIC, AND I AM A RESIDENT
OF GIBSON COUNTY, STATE OF INDIANA
My Commission Expires:
i� a�,�e--r,.P..��. / 6 , I `19 /
This instrument prepared by:
JAMES G. b7cDONALD, JR.
Attorney at Law
