July 11, 2000

NOTE: This document is a form and the blanks that were filled in are indicated in Italics and are Underlined. Any words that I am unsure are indicated with a “(?)”.

The four words that are crossed out are “all of Sullivan except”.

STATE OF MISSOURI }

COUNTY OF SULLIVAN

IN the matter of Ira Heads ________ estate, Robinson Morris

says, that to the best of his knowledge and belief, the names of the heirs of Ira

Head_ deceased, and their places of residence are, respectively, as

follows: Mary(?) Head – widow of said Ira Head, Theophilus

Head, Louiza Head John Head Joel Head

Elcana Head, Ira Head Jr. Elizabeth Head

James Head, Mary Head Margrett Head

(four words crossed out) William Head_ _ _________

That the said Ira Head died without a will; that he will faithfully

administer all the estate of the deceased, and pay the debts, as far as the assests will extend

and the law direct; and account for and pay all assets, which shall come to his possession or

knowledge.

Robinson (his) Morris

x mark

Subscribed and sworn to this seventh day of July 185 9 .

C. Mi???????????