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STATE OF NEBRASKA )
<br />) ss.
<br />COUNTY OF HALL )
<br />COMES NOW, the undersigned, being duly sworn, deposes and states
<br />c3
<br />that the undersigned is the surviving spouse of the Decedent, and that
<br />the following information is true and correct: Q
<br />1. Name of Decedent: Donald Eugene Wernke, also known as Don
<br />E. Wernke
<br />Date of Death: March 27, 2001
<br />Domicile at Date of Death: Hall County, Nebraska
<br />Date of Marriage: October 9, 1949
<br />2. The Affiant is the surviving spouse of the decedent.
<br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or
<br />Nebraska Estate Tax that arose, or can arise, by virtue of the
<br />Decedent's death.
<br />4. Title to the following described real estate was held by the
<br />Decedent and Donna S. Wernke, the Decedent's spouse, on the date of the
<br />Decedent's death, to -wit:
<br />East 68.55 Feet of Lot Seven (7) , in Block Seven (7) , in
<br />Hann's Third Addition to the City of Grand Island, Nebraska.
<br />S. As of the date of death, the real estate has a fair market
<br />value of $40,560.00.
<br />6. The Decedent and Donna S. Wernke were married as of the date
<br />of death of Donald Eugene Wernke, a /k /a Don E. Wernke. There is no
<br />Nebraska Inheritance Tax lien, and no Nebraska inheritance tax lien.
<br />AND FURTHER AFFIANT SAITH NOT.
<br />i
<br />Donna S. Wernke
<br />Subscribed and sworn to before me this day of April, 2001.
<br />GENERAL NOTARY -State of Nebraska
<br />III GALEN E. STEHLIK C�� c`
<br />My Comm. Exp. May 1, 2002 N r
<br />to v rublic
<br />ESTATES \A- MARITAL.AFF
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<br />STATE OF NEBRASKA )
<br />) ss.
<br />COUNTY OF HALL )
<br />COMES NOW, the undersigned, being duly sworn, deposes and states
<br />c3
<br />that the undersigned is the surviving spouse of the Decedent, and that
<br />the following information is true and correct: Q
<br />1. Name of Decedent: Donald Eugene Wernke, also known as Don
<br />E. Wernke
<br />Date of Death: March 27, 2001
<br />Domicile at Date of Death: Hall County, Nebraska
<br />Date of Marriage: October 9, 1949
<br />2. The Affiant is the surviving spouse of the decedent.
<br />3. There is no Federal Estate Tax, Nebraska Inheritance Tax or
<br />Nebraska Estate Tax that arose, or can arise, by virtue of the
<br />Decedent's death.
<br />4. Title to the following described real estate was held by the
<br />Decedent and Donna S. Wernke, the Decedent's spouse, on the date of the
<br />Decedent's death, to -wit:
<br />East 68.55 Feet of Lot Seven (7) , in Block Seven (7) , in
<br />Hann's Third Addition to the City of Grand Island, Nebraska.
<br />S. As of the date of death, the real estate has a fair market
<br />value of $40,560.00.
<br />6. The Decedent and Donna S. Wernke were married as of the date
<br />of death of Donald Eugene Wernke, a /k /a Don E. Wernke. There is no
<br />Nebraska Inheritance Tax lien, and no Nebraska inheritance tax lien.
<br />AND FURTHER AFFIANT SAITH NOT.
<br />i
<br />Donna S. Wernke
<br />Subscribed and sworn to before me this day of April, 2001.
<br />GENERAL NOTARY -State of Nebraska
<br />III GALEN E. STEHLIK C�� c`
<br />My Comm. Exp. May 1, 2002 N r
<br />to v rublic
<br />ESTATES \A- MARITAL.AFF
<br />
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