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I <br />8c9.— .10054 5 <br />AFFIDAVIT <br />STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF HALL ) <br />Affiant, Paula M. Shull, after being duly sworn upon oath, <br />does depose and state as follows: <br />1. That Affiant is the surviving spouse of Frank T. Shull <br />( "Decedent's), who departed this life on December 11, 1987, as <br />shown by the certified copy of the death certificate attached <br />hereto as Exjhibit "A" and by this reference incorporated herein. <br />2. That on the date of death, the Affiant and Decedent were <br />the sole owners as joint tenants with rights of survivorship of <br />the;real estate located at 1720 S. Spring Road, Grand Island, Hall <br />County, Nebraska, and legally described as follows: <br />The South Ten (10) Feet of Lot One Hundred Twenty -Five (125) <br />.and all of Lot One Hundred Twenty -Six (126) of Hawthorne <br />Place, being. a Subdivision.df part of the Northwest Quarter <br />INW1 /4) of Section Twenty -Two (22), in Township Eleven (11) <br />North ... Range Nine (9), West of the 6th P.M., Hall County, - <br />Nebraska. <br />3. That by virtue of thca survivorship of Affiant, Affiant ' <br />become the sole owner of the above- described property. <br />4. That this Affidavit is given as evidence that pursuant <br />to Neb. Rev. Stat. S77 -2003 (Reissue of 1986) no inheritance tax <br />lien ,arising due to the death. of Decedent can attach to the <br />above described real estate and that pursuant to Neb. Rev. Stat. <br />577 -2012 (Reissue of 1986) no Nebraska estate tax lien arising due <br />to the death of Decedent can attach to the above- described <br />property. <br />5.' That the gross estate of Decedent was less than that <br />amount exempt from federal estate.-taxes."- <br />FURTHER AFFIANT SAYETH NOT. <br />Dated this day of , 1989. <br />aula M. Shull. <br />Subscribed and. sworn to before this _6 day of , <br />19 <br />GEWAL WW,SW N ROM <br />GALEN R STEWK ar y ` c <br />wa.ac��ri.�r <br />