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C' S <br />i <br />A' <br />Z <br />M <br />W <br />4 <br />206u0y026 <br />," <br />= D <br />M N <br />_ <br />S D <br />Z n <br />�i <br />M <br />O <br />O <br />0 <br />r <br />Q <br />� <br />AFFIDAVIT <br />STATE OF NEBRASKA ) <br />ss. <br />Box Butte County ) <br />Harold M. Anderson, being first duly sworn on oath, states: <br />1. I am the surviving spouse of Lois Louise Anderson. <br />2. Lois Louise Anderson died May 31, 1999, a resident of and domiciled in <br />Alliance, Box Butte County, Nebraska. <br />3. At the date of death of Lois Louise Anderson, she and I owned the following <br />described real estate as joint tenants and not as tenants in common: <br />In Township 11 North, Range 11 West of the 6th P.M., in Hall County, Nebraska: <br />Section 33: S' /2NE' /4 <br />4. Attached hereto is a certified copy of the death certificate issued by the State <br />of Nebraska Department of Health Bureau of Vital Statistics. <br />FURTHER AFFIANT SAYETH NOT. <br />Harold M. Anderson <br />Subscribed and sworn to before me on May 2000. <br />GENERAL NOTARY•Sbts of Ne6psw 1 <br />NATAUE A. COWNS 1 llz� MY Comm. Exp. Aug 13, 2002 <br />` ay Public <br />My commission expires:IV-13 -02 <br />O f'i't <br />N � <br />O a CD <br />O �- <br />O <br />N <br />C <br />s �- <br />0 3 <br />N <br />CD <br />O '-�- <br />z <br />LS <br />c n <br />a7 <br />�i <br />M <br />O <br />O <br />z <br />r <br />� <br />n m <br />v <br />r a <br />cn <br />►--► <br />cn <br />w <br />.1 <br />-.7 <br />N <br />Cn <br />Harold M. Anderson, being first duly sworn on oath, states: <br />1. I am the surviving spouse of Lois Louise Anderson. <br />2. Lois Louise Anderson died May 31, 1999, a resident of and domiciled in <br />Alliance, Box Butte County, Nebraska. <br />3. At the date of death of Lois Louise Anderson, she and I owned the following <br />described real estate as joint tenants and not as tenants in common: <br />In Township 11 North, Range 11 West of the 6th P.M., in Hall County, Nebraska: <br />Section 33: S' /2NE' /4 <br />4. Attached hereto is a certified copy of the death certificate issued by the State <br />of Nebraska Department of Health Bureau of Vital Statistics. <br />FURTHER AFFIANT SAYETH NOT. <br />Harold M. Anderson <br />Subscribed and sworn to before me on May 2000. <br />GENERAL NOTARY•Sbts of Ne6psw 1 <br />NATAUE A. COWNS 1 llz� MY Comm. Exp. Aug 13, 2002 <br />` ay Public <br />My commission expires:IV-13 -02 <br />O f'i't <br />N � <br />O a CD <br />O �- <br />O <br />N <br />C <br />s �- <br />0 3 <br />N <br />CD <br />O '-�- <br />z <br />LS <br />