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_- __ �� � � N � 0 � � � N �� 0 � � �� � = � � - � �� � 1'� C� �� � .Ti rv �:� C7 Cn •-'�.� � �-i � n - C� N. � n � � � rn � � G O � �_ n� O � � ' �� ^ Z P�) c� � `-- rn in --�7 3> m O � r�n � r � F� � � r a � c� f _, � s ,'', , z' � �, � �^ cn u� �D � v�', S� tn /Do.�� � � � � � � ;etum to: Denise Myers 611 N. Diers Ave., Ste. 1 Grand Island, NE 68803 STATE OF NEBRASKA COUNTY OF HALL AFFIDAVIT OF MARITAL STATUS ) ss. } COMES NOW, the undersigned, being first duly sworn upon oath, and deposes and states that the undersigned knows the Decedent and the surviving spouse of the Decedent and that the following information is true and correct. Name of Decedent: Marcellene M. Young Date of Death: November 17, 2011 Domicile at Death: Grand Island, Hall County, Nebraska Name of Surviving Spouse: Donald E. Young Date of Marriage: December 22, 1984 2. The Affiant is the attomey for the Decedent and, in that capacity, is familiar with the marital status and the death of the Decedent. 3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax due. 4. Title to the following described real estate is held by the Decedent and the surviving spouse in joint tenancy, to-wit: Lot Eighteen (18), Block Eleven (11), Parkhill Third Subdivision, and Addition to the City of Grand Island, Hall County, Nebraska. 5. As of the date of death, the real estate had a fair market value of $96,401.00. 6. The Decedent and the surviving spouse were married as of the date of death. There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute §77- 2003. FURTHER Affiant saith not. l�� ' / ��.� �- - � - / Subscribed and swom to before me this �1 �day of January, 2012. tary Public C�NFRAL �IOTARY • State of Nebraeka JEAtd M. PETER$ON My Comm. �p. 5ept.18, 2012