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- �� N � e �� � �� N �� � �� W � � �� .p � �� �� �� � � � � y � � &�91 � � � I � ! 6 n : �•� e�, a d � �, � , Once recorded, please return to: Parker, Grossart, Bahensky, Beucke & Bowman, L.L.P. PO Box 1600, Kearney, NE 68848-1600 _� � r n �' �i ;o � *�' ±°R_. :� ��> � �T, � n ,, . �� :.,, r� � 0 � AFFIDAVIT OF SURVIVING SPOUSE STATE OF NEBRASKA ) ) ss: COUNTY OF �c�►10 ) r V HJ n (� �� ".� � ca � Z —� ,� --� rn � o � '�L7 � W � � o � � � = rn D � r z� r n � � � � cn � O f-+ N O w C.!'I CO .,L Affiant, Keith E. Dibbern, also known as Keith Edwin Dibbern, after being duly sworn upon oath, does depose and state as follows: 1. That affiant is the surviving spouse of Shirlee J. Dibbern, also known as Shirlee Jean Dibbern (hereinafter refened to as the "decedent"), who departed this life on April 14, 2012, as shown by the copy of the death certificate attached hereto as E�ibit "A" and by this reference incorporated herein. 2. That on the date of death, the affiant and the decedent were the sole owners as joint tenants with rights of survivorship of that real property described as follows: A tract of land comprising a part of the East Half of the Northeast Quarter (E'/iNE'/a) of Section Twenty-four (24), Township Twelve (12) North, Range Ten (10) West of the 6 P.M., Hall County, Nebraska, more particularly described as follows: Beginning at a point on the East line of said Section 24, said point being Four Hundred Ninety Eight and Siz Hundredths (498.06) Feet North of the Southeast corner of said Northeast Quarter (NEl/a); thence Northerly along the East line of said Section 24 on an assumed bearing of due North, a distance of 1,101.61 feet; thence South 69°11'06" West, a distance of 149.92 feet; thence South 18°09'35" East a distance of 143.96 feet; thence South 34°36'23" West a distance of 220.52 feet; thence South 67°04'S5" West a distance of 111.6 feet; thence South 76°40'S1" West, a distance of 86.53 feet; thence South 83°14'Ol" West a distance of 150 feet; thence due South a distance of 654.3 feet; thence North 89°27'06" East, a distance of 556.48 feet to the place of beginning. 3. That by virtue of the survivorship of affiant, affiant became the sole owner of the above-described property. 4. That this affidavit is given as evidence that pursuant to Neb. Rev. Stat. §77-2003 (Reissue 2003) no inheritance tax lien arising due to the death of the decedent can attach to the above- described real estate. 5. That no federal estate tax return has or will be filed as the gross estate of the decedent was less than that amount necessary to require the filing of such a return pursuant to Internal Revenue Code §6018. Dated: / v `0. � 2012. O eit . Dibbern SUBSCRIBED AND SWORN to before me on �.3 , 2012. �f 4L N81'� - �e of Nebragk� PATR(C�q L MqLLqM �' �. b� June 9, 2015 ' � ��- -� .' � , �c�eso