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Return to: Denise Myers <br />611 N. Diers Ave., Ste. 1 <br />Grand Island, NE 68803 <br />cti <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <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: Neil M. Mutchler <br />Date of Death: March 31, 2015 <br />Domicile at Death: Las Cruces, Dona Ana County, New Mexico <br />Name of Surviving Spouse: Bonita A. Mutchler <br />Date of Marriage: June 17, 1975 <br />2. The Affiant is the attorney for Bonita A. Mutchler 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 <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 Southerly Eighty Feet (S80') of Lot Nine (9), Block Twelve (12), H.G. <br />Clark's 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 $52,002. <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 />FURTHER Affiant saith not. <br />GENERAL. NOTARY- State of Nebraska <br />KEUJE G. HOFFART <br />l L*+ My Comm. Exp. July 17, 2018 <br />Denise D. Myers <br />Subscribed and sworn to before me this J day of July, 2015. <br />V <br />Ite 66 <br />