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201302201
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Last modified
8/19/2014 2:22:35 PM
Creation date
3/22/2013 9:05:14 AM
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DEEDS
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201302201
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AFFIDAVIT OF MARITAL STATUS <br />Return to: Jamie Mues Jankovitz <br />PO Box 639 <br />Grand Island, NE 68802 <br />Peterson, Affiant. <br />1. Name of Decedent: Cleo J. Peterson <br />Date of Death: March 28, 2012 <br />Domicile at Death: Hall County, Nebraska <br />Name of Surviving Spouse: Larry L. Peterson <br />Date of Marriage: May 19, 1962 <br />STATE OF NEBRASKA <br />COUNTY OF HALL <br />) ss: <br />Larry Peterson, Affiant <br />201302201 <br />Comes now, the undersigned, being first duly sworn upon oath, deposes and states that <br />the undersigned knows the Decedent and the surviving spouse of the Decedent and that the <br />following information is true and correct. <br />2. The Affiant is the surviving spouse of the Decedent and in that capacity is familiar <br />with the marital status and the death of the Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax due. <br />4. Title to the following described real estate is held by the Decedent and the surviving <br />spouse in joint tenancy, to wit: <br />Lot Four (4), Block One (1), Fireside Estates Subdivision, Hall County, Nebraska <br />5. As of the date of death, the real estate had a fair market value of $133,083.00. <br />6. The Decedent and the surviving spouse were married as of the date of death. <br />There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute § 77 -2003. <br />There is no Nebraska estate tax lien by reason of Nebraska Revised Statute §77 -2102. <br />FURTHER THIS AFFIANT SAYETH NOT. <br />SUBSCRIBED and sworn to before me on this 1 d y of A-(2.0 , 2013 by Larry L. <br />
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