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Return to: Cathleen H. Allen <br />P.O. Box 790 <br />Grand Island, NE 68802 -0790 <br />Affidavit of Marital Status <br />STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF HALL ) <br />m 'X' <br />C ri y <br />en Z x <br />ri vi <br />x = <br />AFFIDAVIT OF MARITAL STATUS <br />COMES NOW, the undersigned, being first duly sworn, and deposes and says that the <br />undersigned knows the Decedent and the surviving spouse of the Decedent and the following <br />information is true and correct: <br />1. Name of Decedent: William F. Dunn <br />Date of Death: January 18, 2014 <br />Domicile at Date of Death: Grand Island, Hall County, Nebraska <br />Name of Surviving Spouse: Barbara C. Dunn <br />Date of Marriage: January 24, 1993 <br />2. The Affiant is the surviving spouse. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax. <br />4. As of the date of the death of the Decedent, title to the following real estate was <br />