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Return to: Denise Myers <br />P.O. Box 505 <br />✓ Cairo, NE 68824 <br />AFFIDAVIT OF MARITAL STATUS <br />STATE OF NEBRASKA ) <br />) ss. <br />COUNTY OF HALL <br />FURTHER Affiant saith not. <br />JENER NOTARY-State of Nebraska <br />LORI J. BOLING <br />AL <br />My Comm. Exp. Aped 15.2019 <br />P1 z <br />=no <br />r = N <br />rr <br />=I> <br />rn <br />rts <br />r <br />C <br />Denise D. Myers <br />Notary Pub <br />1. Name of Decedent: John R. Eilts <br />Date of Death: April 16, 2017 <br />Domicile at Death: Grand Island, Hall County, Nebraska <br />Name of Surviving Spouse: Barbara L. Eilts <br />Date of Marriage: January 25, 1958 <br />C. <br />N <br />CC) <br />C) <br />H <br />Subscribed and sworn to before me this J5' day of August, 2017. <br />c <br />COMES NOW, the undersigned, being first duly sworn upon oath, and deposes and <br />states that the undersigned knows the Decedent and the surviving spouse of the Decedent <br />and that the following information is true and correct. <br />2. The Affiant is the attorney for the Decedent's spouse and, in that capacity, is <br />familiar with the marital status and the death of the Decedent. <br />3. That there is no federal estate tax, Nebraska inheritance tax or Nebraska estate <br />tax due. <br />4. Title to the following described real estate is held by the Decedent and the <br />surviving spouse in joint tenancy, to -wit: <br />Lot Three (3), Sunset Seventh Subdivision, Hall County, Nebraska. <br />5. As of the date of death, the real estate had a fair market value of $154,764. <br />6. The Decedent and the surviving spouse were married as of the date of death. <br />There is no Nebraska inheritance tax lien by reason of Nebraska Revised Statute §77- <br />2003. <br />