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U 7- W n em. _ Ss1 �� 7C = Return to: Denise Myers 611 N. Diers Ave., Ste. 1 Grand Island, NE 68803 STATE OF NEBRASKA ) ) ss. COUNTY OF HALL ) to -wit: Subscribed and sworn to before me this GENERAL NOTARY -State of Nebraska KELUE G. HOFFART My Comm. Exp. July 17, 2018 AFFIDAVIT OF MARITAL STATUS Denise D. Myers day of May, 2015. --c N N COMES NOW, the undersigned, being first duly sworn upon oath, and deposes and states that the undersigned knows the Decedent and the surviving spouse of the Decedent and that the following information is true and correct. 1. Name of Decedent: Harold E. Bilslend Date of Death: April 29, 2015 Domicile at Death: Wood River, Hall County, Nebraska Name of Surviving Spouse: Patricia L. Bilslend Date of Marriage: December 21, 1951 2. The Affiant is the attorney for the Decedent and, in that capacity, is familiar with the marital status and the death of the Decedent. 3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax due. 4. Title to the following described real estate is held by the Decedent and the surviving spouse in joint tenancy, The Southwest Quarter (SW1 /4), and the West Half of the Southeast Quarter (W1/2SE1/4), located in Section Three (3), Township Nine (9) North, Range Twelve (12), West of the 6 P.M., Hall County, Nebraska, EXCEPT a tract of land conveyed in Survivorship Warranty Deed, filed of record at Book 175, Page 584, of the records of the Hall County Register of Deeds, and EXCEPT Lot One, Bilslend Subdivision, Hall County, Nebraska, and EXCEPT that tract legally described in Document No. 92- 104169 filed with the Hall County Register of Deeds. The South Half of the South Half of the Northwest Quarter (S1/2S1/2NW1/4) of Section Ten (10), Township Nine (9) North, Range Twelve (12), West of the 6 P.M., Hall County, Nebraska. Lot One (1), Bilslend Subdivision, Hall County, Nebraska. 5. As of the date of death, the real estate had a fair market value of $1,995,163. 6. The Decedent and the surviving spouse were married as of the date of death. There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute §77 -2003. FURTHER Affiant saith not. 04 a° rn —1 rn ry rn cD C/3 Cn O cn 0