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AFFIDAVIT FOR TRANSFER OF REAL AND PERSONAL PROPERTY WITHOUT PROBATE UNDER NEBRASKA PROBATE CODE IN RE: BERNELDA LEWIS, DECEASED STATE OF NEBRASKA ) )SS. COUNTY OF HALL ) 201705278 The undersigned Affiant's, upon being first duly sworn, does hereby depose and affirm that all statements in this affidavit are true and material and further acknowledge that any false statement may subject affiant to penalties relating to perjury under Neb. Rev. Stat. §28 -915. 1. The value of all of the real and personal property in the estate of Bernelda Lewis , Deceased, wherever located, less liens and encumbrances, which is subject to probate proceedings, does not exceed $50,000.00. 2. Thirty (30) days have elapsed since the death of Decedent, the Decedent having died January 5, 2017. 3. No application or petition for the appointment of a Personal Representative is pending or has been granted in any jurisdiction. 4. Affiant is entitled to payment and delivery of all property held by others in the sole name of Decedent pursuant to Nebraska Probate Code § 30- 24,125 and 30- 24,129, and that Affiants' entitlement is based upon Affiants' status as surviving daughter of the decedent. 5. Pursuant to Nebraska Probate Code §30- 24,126, the person paying, delivering, transferring or issuing personal property or the evidence thereof pursuant to this Affidavit is discharged and released to the same extent as if said person dealt with a Personal Representative of the Decedent; said person is not required to see to the application of the personal property or evidence thereof, or to inquire into the truth of any statement in this Affidavit. That the affiants have made an investigation and have been unable to locate any will or testamentary document of the decedent. 6. The decedent was the joint owner with the deceased husband of the following real estate to wit: Lots Seven (7) and Eight (8), in Block Two (2) in Fifth addition to Cairo, Hall County, Nebraska and also known as 614 Thede, Cairo, Hall County, Nebraska. Affiants are unaware of any other real estate in which the decedent had an interest The current assessed value of the property is $31,375.00, which is the value of the entire estate.