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� � � j r .�; a�oo3�s 90 NFr IDnVIi [�� i� u�wiii OP 3uli3i T�i3Hi3i� u�3�i�k STATE OF NEBRASKA� COUNTY aF HALG: Under oath, I declare: 1. I am the widow o£ Sam J. Becker who died on November 22, 1989, a resident of Hall County, Nebraska. 2. At the time of his death, Sam J. Becker and I, as joint tenants, were the awners of the following described real estate situated in Hall County, Nebraska: Lot 202 West Lawn, City of Grand Island, Hall County, Nebraska. 3. All of the real estate and personal property, in which my husband, Sam J. Becker, had an interest at his death� was owned by him and me as joint tenants and not as tenants in common. 4. The total fair market value of all of the joint tenancy property awned by my husband and me, as joint tenants, at the time of death of his death, was less than the sum of $600,000.00, and no Form 706 {United States Estate Tax Return) has bee� or will be filed with the Internal Revenue Service � because no United States Estate Tax was, can be ar was assessed as a result � . of the death of my husband, Sam J. Becker. ___ : 5. Since al� of the property owned by mv husband, Sam J. Becker was owned _ � `�--� by him and me as joint tenants, there is no liability for a Nebraska Estate = Tax nor is there any liabili.ty for Nebraska Inheritance Tax by reason of the death of my husband, Sam J. Becker. 6. All of the joint tenancy property owned by my husband and me passing to ��' me at his death is exempt from United States Estate Tax, Nebraska Estate Tax 't and N �raska I� e itance Tax. � i� ,.r � � (Ell Becker) Du sworn to and signed before me on December 8 , 1989. � ..P-�,� ' ' � ,�.. (Notary Publ ic) ��,�.; M Commission expires 6-24-93 �w� -- � wa..av.�»xs� ;--_-_ . ��. � . � Y � � � � , , �� .. � �