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STATE OF NEBRASKA ) AFFIDAVIT OF DEATH
<br />) ss. OF
<br />COUNTY OF HALL ) JOINT TENANT
<br />Amelia J. McMullen, also known as Betty J. McMullen, being first duly sworn on
<br />her oath, deposes and says that she resides at 325 N. Carey, Grand Island, Hall County,
<br />Nebraska; that her husband, George Edgar McMullen, also known as Edgar G.
<br />McMullen, died June 10, 2000, in Grand Island, Hall County, Nebraska; that her
<br />husband left no property separately owned by him and that all property subject to
<br />consideration and computation for determination of any Nebraska Inheritance Tax and
<br />Federal Estate Tax was property owned by the Decedent in joint tenancy with your
<br />Affiant, his surviving spouse; that the total value of all such property, as of June 10,
<br />2000, valued at its fair market value on that date, did not equal or approach the sum of
<br />$675,000.00; that Affiant is entitled to an exemption in computation of either Nebraska
<br />Inheritance Tax and Federal Estate Tax of the total value of all such taxable property
<br />received by her by reason of the death of the Decedent or otherwise, and that there is no
<br />Nebraska Inheritance Tax nor Federal Estate Tax due or owing by this Affiant by reason
<br />of property passing to her upon the death of George Edgar McMullen on June 10, 2000.
<br />N
<br />Real estate owned by the parties in joint tenancy is described as follows:
<br />The North one -half of Lot Thirty -three (33) and all of Lot Thirty -
<br />four (34) in Belmont, an Addition to the City of Grand Island, Hall
<br />County, Nebraska
<br />Lot Four (4), in Lucas' Addition to the City of Grand Island, Hall
<br />County, Nebraska
<br />The Northerly Eight Feet (N 8') of Lot Seventy -Nine (79) and all of
<br />Lot Seventy -Eight (78) in Belmont Addition, an Addition to the
<br />City of Grand Island, Hall County, Nebraska.
<br />E W-1151"
<br />SUBSCRIBED and SWORN to before me, a Notary Public, this �l day of July,
<br />7, ,:5 0
<br />BENERAI. NOTARY -Std at Nwaska
<br />DUA,NE & BURP18
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<br />STATE OF NEBRASKA ) AFFIDAVIT OF DEATH
<br />) ss. OF
<br />COUNTY OF HALL ) JOINT TENANT
<br />Amelia J. McMullen, also known as Betty J. McMullen, being first duly sworn on
<br />her oath, deposes and says that she resides at 325 N. Carey, Grand Island, Hall County,
<br />Nebraska; that her husband, George Edgar McMullen, also known as Edgar G.
<br />McMullen, died June 10, 2000, in Grand Island, Hall County, Nebraska; that her
<br />husband left no property separately owned by him and that all property subject to
<br />consideration and computation for determination of any Nebraska Inheritance Tax and
<br />Federal Estate Tax was property owned by the Decedent in joint tenancy with your
<br />Affiant, his surviving spouse; that the total value of all such property, as of June 10,
<br />2000, valued at its fair market value on that date, did not equal or approach the sum of
<br />$675,000.00; that Affiant is entitled to an exemption in computation of either Nebraska
<br />Inheritance Tax and Federal Estate Tax of the total value of all such taxable property
<br />received by her by reason of the death of the Decedent or otherwise, and that there is no
<br />Nebraska Inheritance Tax nor Federal Estate Tax due or owing by this Affiant by reason
<br />of property passing to her upon the death of George Edgar McMullen on June 10, 2000.
<br />N
<br />Real estate owned by the parties in joint tenancy is described as follows:
<br />The North one -half of Lot Thirty -three (33) and all of Lot Thirty -
<br />four (34) in Belmont, an Addition to the City of Grand Island, Hall
<br />County, Nebraska
<br />Lot Four (4), in Lucas' Addition to the City of Grand Island, Hall
<br />County, Nebraska
<br />The Northerly Eight Feet (N 8') of Lot Seventy -Nine (79) and all of
<br />Lot Seventy -Eight (78) in Belmont Addition, an Addition to the
<br />City of Grand Island, Hall County, Nebraska.
<br />E W-1151"
<br />SUBSCRIBED and SWORN to before me, a Notary Public, this �l day of July,
<br />7, ,:5 0
<br />BENERAI. NOTARY -Std at Nwaska
<br />DUA,NE & BURP18
<br />- -- --
<br />Notary Public
<br />
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