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� ; s <br />20120627� <br />7. The Affiant claiming as successor under this Affidavit hereby swears that all <br />statements in this Affidavit are true and material. <br />8. The claiming successor has made an investigation and has been unable to determine <br />any subsequent Will of the Decedent. <br />9. No other person has a right to the interest of the Decedent in the above-described <br />property. <br />10. Affiant as the claiming successor is the Decedent's surviving spouse and the value <br />of the estate located in Nebraska. is the sum of Fifteen Thousand Eight Hundred Twenty and 00/100 r <br />Dollazs ($15,820.00). <br />1 l. 'This recorded Affidavit and copy of the Decedent's original Death Certificate will <br />be recorded in the Register of Deeds Office, Ha11 County, Nebraska. <br />DATED this �SS day of June 2012. <br />�� <br />PAUL A. LEMII�, Surviving Spouse and Affiant <br />STATE OF HAWAII ) <br />) ss: <br />COUNTY OF KAUAI ) <br />On the I�$� day of June 2012, personally appeared before me the undersigned Notary <br />Public, Pau1 A. Lemke, who being first duly sworn upon oath, deposes and states that he is the <br />Affiant and has read the above and foregoing Affidavit; that he is familiar with the contents thereof; <br />that the facts and allegations set forth therein are true as he verily believes. <br />•,�:..<<r <br />� " � � r., egJr °Jea . / . <br />.ti�� '� is /�'"�i�^+ :a, <br />•a ' ',� n. <br />�' "�o 7 ' ] ��y <br />' `� E r.., �� `� .' � � � `"�' �� r 11U�lCi <br />6 '� � c� p � o'��A� <br />� p � ; �,,,�� m`����" My Commission Expires: �� J�+.S <br />; �� �" � � n =. <br />; /°q � y ,� e> <br />:. C-,` .� `w�� iJ ����.`,� . <br />a � �'�: `� � r� "' ` � ��` � NOTARY CER'TIFICATION STATEMENT <br />��� , <br />Document Identification or Description: Sma11 Estate Affidavit for Succession of Real <br />Property <br />Document Date: G� 1�'/ � t�. <br />No. of Pages: three (3) including Death Certificate <br />Jurisdiction (in which notarial act is performed): <br />Fifth Circuit <br />Q.� 6 �� 2�� . _ <br />S' ature of Notary Date of Notarization and <br />Certification Sta.tement ,�,,n77�3���ae�:,.., <br />, �:, <br />., .^ '`W '�� � �' � `�:;� <br />��' �, G!l�Jor'a1Q.s :• ', , .>•eoa���`%�;� <br />` f , r`� ,si°e <br />Printed Name of Notary ° °'� � � �; � � '' ` ` <br />f T eE � � �� .�^ �. . <br />! "� - �� <br />' a' � 'e <br />�:���''�'�j`°000c�co,:- - <br />• ;of. � �7� - . <br />°cr;... <br />