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AFFIDAVIT DY SURVtVING SPOUSE
REGAROING DECEASE OF OTt1ER
SPOUSE WIIERC PROPERTY WAS NEID AS
AN ESTATE DY THE ENTIR@TY
STATE OF
KENTUCKY
COUNTY OF
Before me, a Notory Public, tliis date appeared
Anne L. ~Cowan
518465
dc~oses and says as follo~vs:
1. Thot 1 am the surviving spouse of
, to me well known, who being by me first duly sworn,
Donal d t,l, Cowan
2. That my said spouse and 1, es en estote by the entirety, heretofore acq~+r~d title to the following
St. Lucie County, Florida, property, to-wit:
Lot 3, Block 190 of Port St. Lucie Subdivision Section 4, ~
a Subdi vi sion accordi ng to the Pl at thereof, recorded i n
Plat Book 12, Page 14A of the Public Records of St. Lucie
County, Florida.
1981 tl~R -2 ~~. ~. ~ 7
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3. That my soid spouse and I were lawfully married to each other prior to the acqvisition of title as
aforesaid, thot we remained morried to each other, without an intervening divorce, ~p to the time of the
demise of my said spouse.
4. That my said spouse became deceased on the 25th day of June
t 9 ~g , at Robbi ns dal e ,
. , Coumy of Hennepi n , Srare of
Minnesota
5. At the time of death, my said spouse was a resident of the State of Mi nnesota
County of Hennepi n '
6. Thot a copy of the deoth certificate of suid decedent is attached hereto and made a part hereof.
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MY ~AQ~T~ssi~ ~P~te~~, _ . l~:.-. i ), 198~
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ANNE L. COWAN
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80~01(349 ~a~Ei554
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