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Return to: Denise Myers <br />611 N. Diers Ave., Ste. 1 <br />Grand Island, NE 68803 <br />FURTHER Affiant saith not <br />GENERAL NOTARY-State <br />BOLT Nefuaska <br />LORI J. BOLING <br />My Comm. Exp. April 15 2019 <br />f p o <br />c <br />n �. <br />m <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />1. Name of Decedent: Marvin J. Leth <br />Date of Death: March 4, 1988 <br />Domicile at Death: Cairo, Hall County, Nebraska <br />Name of Surviving Spouse: Shirley A. Leth <br />Date of Marriage: June 24, 1956 <br />Not P Ic D <br />c <br />CO <br />1 <br />Subscribed and sworn to before me this a 1 5 t day of January, 2016. <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 />2. The Affiant is the attorney for the decedent's surviving spouse and, in that <br />capacity, is familiar 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 />Lots Nine (9) and Ten (10), Block Five (5), 4 Addition to the Village of Cairo, <br />Hall County, Nebraska. <br />5. As of the date of death, the real estate had a fair market value of $68,328. <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 />11 00 <br />