Aff - Young, James R_5/21/2010,� AFFIDAVIT OF D• H
COMES NOW James R. Young, and being duly sworn upon his oath, states that
Jacquelyn M. Young died on or about cf`- � C�g5 , and at the time of
such death was a resident of Gibson County, State of Indiana.
mes R. Young
STATE OF INDIANA )
) SS:
COUNTY OF GIBSON )
Before me, the undersigned, a Notary Public in and for said county and state,
personally appeared the within named James R. Young and acknowledged the
execution of the foregoing instrumeni.
WITNESS my hand and notarial seal this � S�day of Apnl, 2010.
My county of residence is O_J%'�(1.,UM � S�t-�(.M
G;�� County, NotaryPublic
State of Indiana, and G1
My commission expires: �]'W i,J'� � �'P� }ty�
6� �5- I � (Printed)
L:LLI B�D0051322591PR08ATElSN50 W.DOC