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Aff - Vickery, Robert_3/30/1978.: :� � STATE OF INDIANA C OUNTY OF SS: :_.; ; � . � ,� � �� .� Q ��o� � � �B The undersigned, John W. Ballard, being first duly sworn on oath deposes and says: 1. That he is the Attorney of Record for Nina M. Vickery, Executrix of the Estate of Robert H. Vickery, deceased; and, that said decedent died testate, a resident of Gibson County, Indiana on January 11, 1977; and, his estate was administered under the jurisdiction of the Gibson Circuit Court under Estate Dkt. PR 77-22. 2. That at the time of his demise said decedent was the owner in fee of the following parcels of real estate: The south half of lots eight (8) and nine (4j) in the Original Plan of the Town of Fort Branch, in Gibson County, and State of Indiana, Also, Lot Number 63 in the McCrary and Others Addition to the Town of Fort Branch, EXCEPT a strip 36 feet in width off the South end thereof. The above described real estate was sold in its entirety pursuant to a certain Contract For Conditional Sale of Real Estate dated November 6, 1971 and wherein "Carol Ann LaGrange" is designated as the purchaser. That said decedent, Robert H. Vickery and Nina M. Vickery, husband and wife, were the owners of the following described real estate as tenants by the entirety, situate in Johnson Township, Gibson County, Indiana: The east half of the Southeast 4uarter of the Northeast 4uarter of Section 31, Township 3 south, Range 11 west, containing 20 acres. 3. That decedent's estate was subject to an Indiana Inheritance Tax in the sum of Five Hundred Twenty-five Dollars and Eighty-two Cents ($525.82), which sum was paid into the Office of the Treasurer of �Gibson County, Indiana on July 19, 1977; and, decedent's estate was not liable for a Federal Estate Tax Form 706 and no return was prepared and filed in connection therewith. This affidavit is for the purpose of requesting the trans- fer to the individual name of Nina M. Vickery, surviving widow as tenancy by the entirety to the real estate hereinabove described. 1 � Further this affiant sayeth not. , � " ,-., . �on� . saiiard - affiant Subscribed and sworn to b ore me this .z�, day of March, 1978. N ��-'w� n ' `� L� Dolores L. Bammer, Notary Public, and I reside in Gibson County, State of Indiana. My Commission Expires: March 25, 1979 _ . . THIS INSTRUMENT PREPARED BY JOHN W. BALLARD, ATTORNEY AT LAW, l. � \ i+ -r � (