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A F F I D A V I T
Comes the Affiant and after first being duly cautioned and s~vorn
states and deposes as follo~vs:
1. That shc~ is the surviving spouse of Floyd Fuller ~vho died a
resident of Bellevue, Campbell County, KE:ntucky, on the llth day of
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' December, 197b.
; 2. That Affiant and the said Floyd Fuller were married on the
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~ ~~th day of D~ cembe r , 19 ?.9 , in tie~vport, Kentucky ;
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and remained n~arricd from said
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~ date to the date of death of the above named decedent, i. e. December 11,
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~ Further Affiant sayeth naught.
~ I~T WITNESS WHEREOF, I have hereunto set my hand at Newport,
4 Kentucky this 28th day of ~iovembe r , 1977.
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~i~ L ,
ti Ethei Fuller F~~~O ANp RECOR~Lu
~`3 ST. lUC1E COUMTY F~~ \
~ ~ ROCiF POttRtS .
' Fa( i:i•~~~ij. ~;;~14T
~ jTATE OF KENTLCKY ~ •`lri.._~___~_
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CO:;N'I'Y OF CAMPBELL QS ~H ~F.
Subscrib~d and sworn to before me by the said Ethel Fuller this
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~ ZSth day of Novembc r , 1977,
= C.~, / _
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~:r ~ _ N ry blic pbe 1 Co. , Ky. "
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= My comrziission c:cpires:
; ~ ~ Dez. 8, 1977
BGUd ~OL! PAl,E
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