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<br /> ��� � APPIDAYIT OF MARITAI,STATUS
<br /> � (NCI.B Form Na.S35)
<br /> . �, .
<br /> ` ��TB OF NEBRASKA )
<br /> . ��s. 98— sus���
<br /> � . �� �-'0
<br />� �.�QUNTY OF MAIDISON ) `
<br /> 0
<br /> � COMBS NOW Loren A.Jofmson,bein,g duly sworn,deposes and says tbat he knows the
<br /> � pecedeat and tbat;he foUowing infomnation is true and conect:
<br /> f = 1. N�e of Decedent: Bessie A.Mellaad
<br /> ;r;
<br /> ; .� Date of Death: December 17. 1982
<br /> � � � Domiclle at Date of Death: Graud Island.Hall County.Nebraska
<br /> �
<br /> " � Naime of Survlving Spouse: Clifford L. MeUand �
<br /> � � IDate of 1�Iarrlage: Uecember 29, 1962 . _
<br /> ' 2. Tluia is no fedeaal estau tau, Nebraslc�.iWieritauce taa or Nebzaska estate tax.
<br /> � '� 3. Tifle to the following descn'bed real estate is held by We Decedent and the su�vi►ving
<br /> spouse of the Da�denY iu j4int tenancy.to wit: ,
<br /> The swuherly 33 feet of tt�e aorthsrly 66 feet of Lot 8,Block 3S.
<br /> Qtigtnal City of Grand Isl�d,.Hall County,Nebraska;aad die
<br /> noir�Iierly 33 feet of Lot 8,$la�ck 35.Origtna!City of Grand Island,
<br /> Hall County.Nebraska. ,,"
<br /> . ,� �:,� �
<br /> 4. As of the date of death,tlt�r�ostat�.�as a fait mazket value of$Il�,5�0. .. ;;��;., . � .
<br /> ;;,,,;�� 5. The Decedent aiad Clifforc�,�.;.Melland were marrted as of thc dat�,+`,a#'�r��?, '�ih�re is
<br /> ., . , ,:, . -
<br /> no Nebraska iaheritanc�ta�c liea�:by reason of N�.REv.STAT.§77 2003. 'Ther�5's�do'NebrasIsa estate: .:`=
<br /> taa lien by teason of NES.REV.$TAT.§77 2102. � �
<br /> Further af6ant sayeth not.
<br /> , W � �
<br /> Lonn A.Johnsoa,Affi�nt
<br /> Subscn'bed aad swo:n¢v before me on September a'' , 1998.
<br /> 6�l 1101AtUFqr�t M�In[o :��j��- .S. /�.�.
<br /> �lNMEII1t.10lq rtotaty��ublic
<br /> �p�o.q.fl�c�►l111
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