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'-flare on ., part to giye lald Intere8t note., or aftT or the., a. hereto proYlded.
or '0 Pl7 the I..e, or an7 ot the., when due. or to P&7 all eald '~e8 when due, or to ezero!.e
and ooap17 with lome one or mOl'e ot the alterna\lye pl'Oylslons hereot entitling me \0 a de.4
I to .ald land within the \lme herein speoltied tor oomplianoe \her"lth, shall absolutel7
J \er~inate all ., rlghts hel'8undel' and interest'1b-and to the land aboye de.orlbed, and all J
i lmproyeraents thereon, as tul17 al though this writiDg had neyer exlltec1 wi thout aD,1 noUoe \
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I me 01' to rq legal represen taUYes. noUoe beln~ hereby expu8al7 _iyed. anc1 wi thout aD;( legf
I aotlon or pl'ooeedlng on the part ot laid COMPANY. and I agl'ee to 7ield Immedlate and peaoeable
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I pos8easlon ot sald land and impl'oyelllenh and nery par' thereat; but 1 shall not thereb7 be !
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i rell.yed tl'om P67Men\ ot any ot sald Interest notes tbere\otore exeouted and dellwel'ed. the
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~ mone7s eYidenoed by 8ald note or notes, belng in that eYent dee:Md pay:nent tor the use ot
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I laid lanc1.
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I aooept and aoknowledge the agent or solioitor solioUlJIg and taking thi~ applioaU~n
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ay agent as well a8 the agent ot aaid COnAlfY and 1 understand and agree that said agent !
j a.
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lor solioltor ba8 no power or authorlt7 to bind said COIlPABY b7 anT representatlon, arrange~e~t
! or agreement, exoept euoh as are herein expres817 set torth; and 1D making thi8 applioation
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; and 8.8r..~ent. 1 am re171ng 801e17 upon ray own IntormaUon and inyesUgaUon, and upon the
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I printed litel'ature ot sald aOIlPABY I'elatlng to said land, and not upon an1 oral repre8.ntatlo~
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lor .tate~6nt ot &D7 per80n whomsoeyel'.
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i As a oondition ot and a oonsideratlon tor the aooeptanoe and approyal of this ap-
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i plioation by said COIlPJJIY I hereb7 malte the tollowing 8tatements and warrant the .ame to be
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l tl'ue:
1. 117 age 18 60 7ear8.
2. Bationalit7 ~erloan. white.
3. 000Upatl0D Superint,Repub11o Cl'esoting Co. .. Karried (Yes or NO) Ye8.
5. )(y wite'l name Anna
6. 1 haye 6 ohlldren.
7.
1 belong to St. Paull 8 Retormed Churoh.
1 belong to the tollowlng tra tel'nal orders:
X ot P - Eaglee
8.
9. I oarl'7 15000. 11te Insuranoe; in tollowing oanpanles Metropolitan.
10. I own I'eal estate as tollowl: Re.. 217 Bo. Tl'emont, Indlanapoli8 '6000.
11. Same 1s enowabered tOI' . 10, held by .~..
12. 1 OWD 11600. wol'th ot pers 00&1 prOpel't7.
13. 1 owe debts ot . none, oonsi8ting ot .~..
1.. 117 net wOl'th i8 $6500.
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16. There al"e DO 8UitS pending 01' J\ldglIlent8 again8t .. exoept lone.
16. Do you intend to settle on the land you haye applied tor? 7e..
-; 17. Gbe Bank reterenoe: Citizens Stat. - Railroad Bldg & Loan Asen. Indianapolis.
18. KT bank aooount i8 in the name ot Ilyselt.
19. I aa now in good health and 1 have not now. nor haye 1 eYer hand aDT dlaease ot
~. tollow1ng naaaed organs or an7 ot the tollowlng D&lD8d d1seas88: ApopleXl', Bl'i~ht'l
Dleease. Braln, Canoel'. Con8umption. Dlabotel. Epileps7. Heal't. Kldne7 Dlsease. Lunga 01'
Pal'a1181e, exoept aone.
II WITlESS WHERlOi', I haye hereunto 8ubsoribed ., name thie 18th da7 ot Septtlllbel',
fhi. applloatlon 1, aooepted and approYed thl.
17th 4aT ot Ootobel', 1922.
ID41an Rher Or~. la TNOk Land. Co.
B7 Jo.eph J. He1a.
He1'laaD Rut11
J.ppl1oan \.
W1 ta..l: had L. Foster
50liol tor.
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1922.
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