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J Once recorded, return to: <br />Par art, Bahens <br />P.O 1600, Ke <br />STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF BUFFALO ) <br />Dated: July 6, 2015. <br />GENERAL NOTARY - State of Nebraska <br />DAMON T. 8AHENSKY <br />My Comm. Exp. Aug. 30, 2017 <br />rya <br />71 <br />i � <br />All i p1` 64- <br />ucke & Bowman, L.L.P. <br />68848 -1600 <br />/6,114„r_._ <br />Notary Public <br />rt <br />AFFIDAVIT OF <br />SURVIVING SPOUSE <br />SUBSCRIBED AND SWORN to before me on July 6, 2015. <br />-c <br />3 <br />Affiant, Larry D. Bredthauer, after being duly sworn upon oath, does depose and <br />state as follows: <br />1. That affiant is the surviving spouse of Cathy L. Bredthauer (hereinafter referred <br />to as the "decedent "), who departed this life on August 20, 2014, as shown by the copy of <br />the death certificate attached hereto as Exhibit "A" and by this reference incorporated herein. <br />2. That on the date of death, the affiant and the decedent were the sole owners as <br />joint tenants with rights of survivorship of that real property described as follows: <br />Lot Eight (8), Park Gardens Second Subdivision, City of Grand Island, <br />Hall County, Nebraska. <br />3. That by virtue of the survivorship of affiant, affiant became the sole owner of the <br />above - described property. <br />4. That this affidavit is given as evidence that pursuant to Neb. Rev. Stat. §77 -2003 <br />(Reissue 2009) no inheritance tax lien arising due to the death of the decedent can attach to <br />the above - described real estate. <br />5. That no federal estate tax return has or will be filed as the gross estate of the <br />decedent was less than that amount necessary to require the filing of such a return pursuant <br />to Internal Revenue Code §6018. <br />01 <br />3,03, W. i rK Rai <br />[Stank 6o770 1 <br />