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8a..; ;~ <br />STATE OF INDIANA } <br />{ss: <br />COUNTY OF MARION } AFFIDAVIT <br />The undersigned, Lorton G. Heusel, being cognizant of the pains <br />and penalties of perjury, affirms and truly states as follows: <br />1. That Joyce I. Heusel, who was a bona fide resident of <br />Wayne County, Indiana, upon the occasion of her death, died <br />intestate on the 5th day of July, 1377. <br />2. That the domiciliary administration of the Estate of <br />Joyce I. Heusel was in the Superior Caurt No. 2 of Wayne <br />County, Indiana, the State and County of her residence at <br />the time of her death, under Cause Number S2-77-650-P, and <br />in such proceeding the undersigned Affiant, wha is the surviving <br />spouse of Joyce I. Heusel, was duly appointed, and did serve <br />as Administrator of the said Estate. <br />3. That said Estate seas closed, and the said Administrator <br />discharged by Order of the aforesaid Court on the 20th day <br />of August, 1079. <br />4. What to the best of the knotiitedge, information and belief <br />of this Affiant, the sole and total assets of the Decedent, <br />and thei- fair market slue as of July 5, 1973, which were <br />or might have tzeen subject to Federal Estate taxatian i:i <br />consequence of the deans of said Decedent, Consisted of the <br />#ollo>King: <br />~a} 3eath value of iintoln ~latianal Llfe Insurance <br />Policy 64-333287 on Lorton G_ Heusel (policy <br />awned by the said Jayce I. Heusel): lO.DO <br />{b} Wayne Teathers Federal Gredit Union account <br />of Decedent 807.05 <br />{cj Second National Sank of Richmond, Indiana; <br />savings aCCOU;:t ?14.Of~ <br />~dj Undivided one-tenth {1JlOth} interest in the <br />South one-half {7J2) of the Northeast one- <br />fourth ~1~4} of Section 20, Township 10 <br />North, Range 12 West of the 6th P.M. in Hall <br />liGi:nty, Sebraska 12,800.Q0 <br />{e} Jointly head property (with rights of <br />SLlrYiYOrship3, a71 held jointly with the <br />