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201604918 <br /> STATE OF NEBRASKA ) <br /> COUNTY OF fat l ) <br /> (county in which the document will be signed) <br /> Affidavit for Transfer of Real Property without Probate <br /> I, L Itt 11/1 . Tbrr s , under penalty of perjury (Nebraska Revised Statute § 28-915), <br /> (your name) <br /> affirm the following to be true: <br /> 1. Thirty days have passed since the death of sQrchILI-d MQ-If►9w Lentpke, and I have attached <br /> (deceased's name) <br /> to this affidavit a certified or authenticated copy of the death certificate; <br /> 2. The deceased is the sole owner of the real property described as <br /> I p 'Tax I& (0M PIv�, (9O fn ekt ipjj . h1 i ,Tr, 6 , <br /> l is il/ L/. 11i1 LA% AIL 1 r<< l MO AL_ _1 ik• . .[ fiD <br /> 3. Based on the assessed value of the real property through the County Assessor/Register of Deeds in <br /> the year of death, less real estate taxes and interest on the real estate taxes if any is due at the time <br /> of death, the value of all the real property in Nebraska belonging to the deceased is $50,000.00 or <br /> less and the value of the entire estate (real property value plus personal property value) is <br /> $ qi, CO, DD <br /> 4. There is no Personal Representative, application for Personal Representative, or petition for <br /> Personal Representative either pending or granted in another court; <br /> 5. Er I am the seCcfll £0 USIA of the deceased and am entitled to the real <br /> (your relationship to the deceased) <br /> property by reason of the homestead allowance, exempt property allowance, family allowance, or by <br /> intestate succession pursuant to Nebraska Probate Code §30-24,129 <br /> OR <br /> ❑ I am entitled to the real property per the will of the deceased and I have made an <br /> investigation and have been unable to determine any subsequent will; <br /> 6. No other person has a right to the real property; <br /> 7. I will file this affidavit with the Register of Deeds Office of the county in which the real property is <br /> located ( (t ti County); and <br /> 8. I will file the affidavit and certified or authenticated copy of the death certificate in any other county in <br /> Nebraska in which the deceased owns real property that is subject to this affidavit. <br /> A q st .�.:. , :....: L.., _ <br /> bates 3 A(vI Sig,'ure <br /> 140 _ M/8 I (do NOT sign UNTIL A NOTARY IS PRESENT AND WITNESSES YOU SIGNING) <br /> Address (line 1) <br /> Page 1 of 2 <br /> Affidavit for Transfer of Real Property without Probate <br /> CC 15:41 Rev.01/15 <br /> Pro Se Committee <br /> Neb.Rev,Stat.§30-24,129 <br />