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_ <br />omo ) D 2 n i � © CID <br />m� G m O <br />C7 ) co <br />U) W <br />t` 71- <br />rn P, , <br />Cil <br />A CA) <br />p N OD CD <br />41- { <br />O C/1 C.0 0 <br />V'f <br />AFFIDAVIT FOR TRANSFER OF REAL PROPERTY <br />WITHOUT PROBATE UNDER THE NEBRASKA PROBATE CODE <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL ) <br />200105839 <br />The undersigned Affiant, upon being first duly sworn, does <br />hereby depose and state: <br />1. Decedent, Dennis Roy McGee, is the owner of an undivided <br />one -fifth (1/5) interest in the real property legally described as <br />the North Eighty -Eight Feet (N88') of Lot One (1) and the North <br />Eighty -Eight Feet (N881) of Lot Two (2), Block Eighteen (18), <br />Schimmer's Addition to the City of Grand Island, Hall County, <br />Nebraska, more commonly known as 1618 N. Walnut Street, Grand <br />Island, Nebraska 68801. <br />2. The value of Decedent's interest in the real estate <br />described in Paragraph 1 above does not exceed $25,000. <br />3. Thirty (30) days have lapsed since the death of Decedent <br />as shown in the certified copy of Decedent's Certificate of Death <br />attached hereto. <br />4. No application or petition for appointment of a personal <br />representative is pending or has been granted in any jurisdiction. <br />5. Affiant is entitled to the real property pursuant to the <br />Nebraska Probate Code, Section 30- 24,129, and that Affiant's <br />entitlement is based upon Affiant's status as surviving spouse. <br />6. The value of the entire estate of the Decedent is <br />$10,500. <br />7. Affiant swears and affirms that all statements in the <br />Affidavit are true and material and further acknowledges that any <br />false statement may subject Affiant to penalties relating to <br />perjury under Section 28 -915. <br />R M. cG E, Af lant <br />621 West 13th St. <br />Grand Island, NE 68801 <br />Telephone: (308) 382 -0360 <br />SUBSCRIBED in my presence <br />day of , 2001. <br />Notary Public <br />and sworn to before me this -�� <br />NERAL NOTARY State of Nebraska <br />VICKI L. GEWECKE <br />My Conn. Exp. Jan. 24, 20 05 <br />