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�R�m rv�•>•r ,t;(i . . <br /> lMlMW� .. �. • �� ... . �� �`'S[� .� <br /> � �t. '�' ��,'I il5 k <br /> . • ..___....�.._ 'u.�L�dtlML..� � <br /> �.. <br /> � . . .. , �:.�.,� l: .a.s��� _ _ _" <br /> � � ' �� _ +` YISII!�-L#SL. — <br /> .�tn t^ _ __._.�.,-_'_ ._.�. ,.y,a_a _ <br /> �. _ ._ <br /> � � � <br /> � � � � �� <br /> A � � �^ "� � y <br /> �n in ui � G �� "►� �!,' <br /> �� � •L rn G� -t p ' ti <br /> � � � � x ~ � <br /> �� -an � x W C7� M. <br /> v "� � � � � <br /> rn � � � N � � <br /> �� � � 'Q, � vv C� _ <br /> �^;;� G� � � ~ <br /> `� CJ � � � <br /> � - <br /> � � STATE OF,NEBRASKA 1 �g�VIT <br /> � � <br /> COUNTY OF H�WL 1 9'r•• 1()��f9 <br /> COkl�S NOW the undersigned, be3ng duly sworn, deposes \ <br /> and eays that the undersigned knows the Decedent and that <br /> ahe is the euzwiving spouse of the Decedent and that tihe <br /> following information is true and corrects <br /> l. Name of Decedent: George G. Booealis <br /> Date �f Deaths June '7► 1997 <br /> Domicile at i�ate of Deaths Hall Cuunty, Nebraska. <br /> 2. There ie no Federal Eatate Taac, Nebraska <br /> Inheritance Tax or Nebraska Eetate Tax owing on account of <br /> the death af George G. Boosalis. <br /> 3. Title ta the folZowing described tca2 ������ == <br /> held by the Decedent and the surviving spouse of th� <br /> Decedent, Mary G. Boosalis, in joint �enancy, to-wit: <br /> South Half (S�1 oF Lo� Eight (8) , Block <br /> Two (2) , Wiebe's Ac►diltion tu the City <br /> of Grand Island, Hall County, Nebraska. <br /> 4. `�ha Deaedent and Affiant were married as of date <br /> df death. There is no Nebraska Inhsritance Tax lien by <br /> reason of Nebraska Revised Statutes 3ection 77-2003. Thez�� <br /> is no Nebrasl�a Estate Taac lien by reaeon of Nebraska Revised <br /> Statuices Section 77-2102. . , <br /> FURTHER Af£iant sayeth not. � <br /> �� .> �d.c���='r.�'�'f <br /> �� <br /> �y . BOOSALI5, Aff ant <br /> SUB5CRZBED and SWORN to befare me this 25th day of <br /> Auqust, 1997. <br /> CENEPJ�I MOTAAI3UM�I N�� <br /> ARTHUIICMAYER otary Publ c <br /> IA�fb�.ExRtA.1,2�00 � <br />..'� <br /> �,� <br />