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Return to: <br />Jamie Mues Jankovitz V J <br />P.O. Box 639 <br />Grand Island, NE 68802 -0639 <br />AFFIDAVIT OF MARITAL STATUS <br />Jenni <br />Affiant <br />STATE OF NEBRASKA ) <br />)ss: <br />COUNTY OF HALL ) <br />SUBSCRIBED and sworn to before me on this day of <br />Jennifer I. Bonham aka Jennifer H. Bonham, Affiant. <br />raoraN•eoce <br />DIANNE C. ZILLER <br />NyConan. Exp.Jay 1, 201$ <br />PREPARED BY: <br />Jamie Mues Jankovitz, #20754 <br />BRADLEY, ELSBERND, ANDERSEN, <br />MUES JANKOVITZ & KEARNEY, P.C. <br />202 West Third Street <br />P.O. Box 639 <br />Grand Island, NE 68802 <br />Telephone: (308) 382 - 2128 <br />/arnie(t�braca'Ce lc a_r�tTice. corn <br />m 2y <br />C m x <br />C <br />z <br />m N `Ks X <br />X <br />Notary Public <br />Comes Now, the undersigned, being first duly sworn upon oath, deposes and states that <br />the undersigned knows the Decedent and the surviving spouse of the Decedent and that the <br />following information is true and correct. <br />1. Name of Decedent: James Lee Bonham aka J. Lee Bonham <br />Date of Death: August 28, 2013 <br />Domicile at Death: Hall County, Nebraska <br />Name of Surviving Spouse: Jennifer I. Bonham aka Jennifer H. Bonham <br />Date of Marriage: July 16, 1966 <br />2. The Affiant is the wife of the Decedent and in that capacity is familiar with the <br />marital status and the death of the Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate tax <br />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 Southern Fifty -Three and Four Tenths Feet (53 4 /10') of <br />Lot Fourteen (14), and the Northerly Six and Six Tenths Feet <br />6 6/10') of Lot Fifteen (15) all in Block Three (3), Southern <br />Acres Addition to the City of Grand Island, Hall County, <br />Nebraska <br />5. As of the date of death, the real estate had a fair market value of $107,375.00 <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 § <br />77 -2003. There is no Nebraska estate tax lien by reason of Nebraska Revised <br />Statute §77 -2102. <br />FURTHER THIS AFFIANT SAYETH NOT. <br />e I. Bonhl aka Jennifer H. Bonham, <br />ta,Litt. e „zgee.L., <br />2015 by <br />0 6 <br />