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Return to: Denise Myers <br />611 N. Diers Ave., Ste. 1 <br />Grand Island, NE 68803 <br />FURTHER Affiant saith not. <br />1,04zu <br />6EI6 RAL NOTARY • Side of NebFpk4 <br />A 0 PO <br />Wry C omm Exp Nor .16,2014 <br />• <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />Denise D. Myers <br />C) cn <br />C) <br />C: D N.) <br />CD <br />CD <br />r- <br />Cn <br />Cr) Co <br />C^ <br />1 Is <br />COMES NOW, the undersigned, being first duly sworn upon oath, and deposes and <br />states that the undersigned knows the Decedent and the surviving spouse of the Decedent <br />and that the following information is true and correct. <br />1. Name of Decedent: Mary Louise Russell <br />Date of Death: May 11, 2013 <br />Domicile at Death: Grand Island, Hall County, Nebraska <br />Name of Surviving Spouse: Robert J. Russell, Sr. <br />Date of Marriage: March 4, 1957 <br />2. The Affiant is the attorney for the Decedent and, in that capacity, is familiar with <br />the marital status and the death of the Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate <br />tax due. <br />4. Title to the following described real estate is held by the Decedent and the <br />surviving spouse in joint tenancy, to -wit: <br />The North Seventy Feet (N70') of Lot Thirteen (13), Block One (1), Pleasant <br />View Addition to the City of Grand Island, Hall County, Nebraska. <br />5. As of the date of death, the real estate had a fair market value of $65,519.00. <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- <br />2003. <br />Subscribed and sworn to before me this day of June, 2013. <br />G O <br />t77 ' <br />rro <br />z <br />