Aff - Singer, Phillip_1/31/2003�:_
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AFFIDAVIT OF SURVIVORSHIP
STATE OF INDIANA
COUNTY OF DUBOIS
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Carolyn F. Singer, after being duly s���orn wtder oath states as follows:
I am the o���ler in fee simple of che follo�ving described real estate located in
Gibson Councy, Indiana, more particularly described as follows:
Lot No. three (3) in Lester's Subdivision of a part of Lo� \io. one (1) of
Embree's Addition to his Enlargemenc of the Town (no��� Cit��) of
Princeton, EXCEPT the coal lying therein and chereunder.
Subjec< <o all legal easemencs, high���a��s and rights of �vay.
Phillip 1N. Singer, no��� deceased, and I acquired title, as joint tenants «�ith ribht
of survivorship, to said real estace by deed of conveyance on the 20th day of \'ovember,
19S9, �vhich deed �vas recorded on November 27, 19S9, in Deed Dra�ver 6, Card No.
4891 of che Gibson Cotulty Recorder's Office.
Phillip W. Singer and I held joint tities to said real es�ate until the deach o(
Phillip VV. Singer on the 2�th day of September, 2002, at �vhich time I acquired citle to
real estate as the su��i��ing joint cenanc.
The gross value of the esta�e of Phillip �N. Singer, as decermined for purposes of
� Federal Estate Taxes, �vas less than the value required for the filing of a Federal Es�ace
Ta�; Return. As a consequence thereof, che decedent's estate was not subject co Federal
Estate Tas nor required to file under the Federal Es�ate Tax Return.
The decedent's escate �vas not subjec� to Indiana Inheritance Taz.
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Caro yn F. Singer
STATE OF I\�DLSI�'A, COU\'TY OF DUBOIS, SS:
' Before me, the undersigned Notary Public in and for said County and Stace,
personally appeared Carolyn F. Singer �vho ackno�vledged the execucion of the foregoing
as her free and voluntary act and deed.
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,;ara 3 I 2003
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^IBSON r,�,i?i: •: �,�1'.�: �.���
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SUBSCRIBED rV�'D S�MOI2i\i co before me chis ��'�{l day of Januan�, 2003.
My Con�mission Expires:
7-3/ -�1 ov�
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This instrumenc prepared by Stevcn C. 6radlcv. Attomey at Law, 4201 \' i�iannheim Road. Der f3uro Komples,
� Jasper, Indiana 47546, at the specific request of the par[ies based solelv on informacion supplied bv one or more
parties io ehis Affidavic. Preparer assumes no responsibilitv for the correttness thereof, and has conducted no
examinacion of [ide as eo the subjea propertv, has rendered no opinion chereon and assumes no responsibilitv
therefor. Ph.312-482-6(r}4, Fas 452-6460, Email i:�snrrl;��v(�dullne�.corn. \Nebsite http:Ufinns.findla�v.com/sbradlev/
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Send tax statements [o: 219 St. Charles S�reet, Jasper, I\i 47�46
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