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201704186
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Last modified
6/23/2017 11:01:07 AM
Creation date
6/23/2017 10:57:54 AM
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DEEDS
Inst Number
201704186
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STATE OF NEBRASKA <br />COUNTY OF HALL <br />FURTHER AFFIANT SAITH NOT. <br />AFFIDAVIT OF MARITAL STATUS <br />) ss. <br />COMES NOW, the undersigned, being duly sworn, deposes and states that the undersigned <br />is the surviving spouse of the Decedent, and that the following information is true and correct: <br />1. Name of Decedent: Junior Christ Johnson <br />Date of Death: March 26, 2017 <br />Domicile at Date of Death: Grand Island, Hall County, Nebraska <br />Date of Marriage: November 8, 1974. <br />2. The Affiant is the surviving spouse of the decedent. <br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or Nebraska Estate Tax <br />that arose, or can arise, by virtue of the Decedent's death. <br />4. Title to the following described real estate was held by the Decedent and Phillis J. <br />Johnson, the Decedent's spouse, on the date of the Decedent's death, to -wit: <br />Lot Four (4), Block Two (2), University Place, to the City of Grand Island, <br />Hall County, Nebraska. <br />5. As of the date of death, the real estate has a fair market value of $111,140.60. <br />6. The Decedent and Phyllis J. Johnson were married as of the date of death of March 26, <br />2017. There is no Nebraska Inheritance Tax lien, and no Nebraska inheritance tax lien. <br />Subscribed and sworn to before me this [ : day of June 2017. <br />sh <br />Notary Public <br />MELISSA J SUTTON <br />General Notary <br />State of Nebraska <br />4 <br />My Commission Expires Oct 20, 2017 <br />201704186 <br />
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