Aff - Sokeland, Elizabeth Marie_5/2/2002I\
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f��DA�T
STATE OF INDIANA
COUNTY OF GIBSON
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I, Donald R. Sokeland, residing at RR #3, Box SSA2, Owensville, Indiana 47655, being
fvst duly swom, state as follows:
I am the widow of Elizabeth Marie Sokeland, S.S.# 305-36-3663, (the "DecedenY') who
died in testate on Mazch 9, 2001. I attest that EliTabeth Mazie Sokeland was also known
as " tty M." Sokeland, and executed legal documents in that name.
Donald R. okeland
Subscribed and swom to before me this � day of __�, 2001.
V ,C/It �u. /'l� � C"T"' �`
Notary Public
My Commission expires on the � day of �, �.
GIBSON �UNTY DEPARTMEI�OF HEALTH
� . 800 S. Prince St.
Princeton, Indiana 47670
812-385-3831
RECORD OF DEATH
/,
THIS IS TO CERTIFY
that according to the records of the Gibson County Department of Health,
ELIZABETH MARIE SOKELAND
Died on 03/09/2001 at 11:40AM
Residence
R.R.# 3 BOx 55-A-2
Owensville IN
Age at death . 64 Years
Marital Status: Married
Sex: F
Color: White
Cause of death: Metastatic Adenocarcinoma Lung, 10 Months.
Adenocarcinoma Right Lung, 19 Months.
Signed by: Ronald Ruszkowski,M.D.
706 •N. Bur;ihadLdt icD
Evansville IN
Place of burial Clark Cemetery
or removal:
Owensville IN 47665
Date of burial: 03/12/2001
Funeral home:
S E A L '
Holders Funeral Home of
Gibson County, Inc.
P.O. BOx 518
Owensville IN 47665
Signed by G'
Gi son County Healt�i C�� oner
Princeton Indiana 03/15/O1
A ress Date
Recorded locally in Book No. 14 Page No. 5 Filed: 03/15/2001