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Return To: Denise D. Myers, 611 N. Diers Ave., Ste 1 <br />Grand Island, NE 68803 <br />C oPY <br />IN THE COUNTY COURT OF HALL COUNTY, NEBRASKA <br />IN THE MATTER OF THE ESTATE <br />OF <br />JERRY L. MYERS, Deceased. <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL <br />G NOTARY -State of Nebraska <br />LORI J. BOLING <br />My Comm. Exp. April 15.2018 <br />Betty L. M <br />Notary Public <br />RENUNCIATION <br />AND DISCLAIMER <br />r- <br />r 1 <br />CD <br />I. <br />c <br />-4 <br />FILED J <br />CASE NO. PR 15 -136 DEC 112015 <br />Cl ika coAS <br />The undersigned states: <br />1. The Deceased died on March 14, 2015. <br />2. The undersigned is an heir, devisee, beneficiary, grantee, or surviving joint tenant. <br />3. The undersigned declares that this Renunciation and Disclaimer is an irrevocable and unqualified <br />refusal to accept in whole or in part specific assets and interests in the property described on Exhibit A <br />attached to this document. <br />4. The undersigned has made this Renunciation under the provision of the Nebraska Probate Code <br />Section 30 -2352 and under the provisions of the Internal Revenue Code Section 2518. The undersigned has <br />not accepted any interest or benefit in, dominion over, and has not assigned, transferred nor waived the right <br />to renounce the disclaimed property nor has such property been sold or disposed of pursuant to judicial <br />process. <br />Dated: December ig , 2015. <br />The foregoing Renunciation was acknowledged before me on D .s*164, /c, , 2015, by Betty <br />L. Myers, an interested party in the Estate of Jerry L. Myers, deceased. <br />