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201706726
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Last modified
12/9/2019 6:10:30 PM
Creation date
10/4/2017 2:22:31 PM
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DEEDS
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201706726
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•■••■• <br />VI - � � P <br />"ft, <br />c> V' <br />STATE OF NEBRASKA <br />COUNTY OF HALL <br />2017, by John Ruzicka and James Ruzicka. <br />After recording, return to: <br />Glenn Van Velson <br />P O Box 1287 <br />North Platte, NE 69103 -1287 <br />) ss: <br />Ruz cka, A <br />co <br />d s�ldiagfa;z4r- <br />This document was acknowledged before me on the �`7 day of C2hier <br />AFFIDAVIT FOR TRANSFER OF REAL PROPERTY WITHOUT PROBATE <br />JOHN RUZICKA and JAMES RUZICKA, under penalty of perjury pursuant to Nebraska <br />Revised Statute §28 -915, hereby state and affirm the following to be true: <br />1. Thirty (30) days have passed since the death of THOMAS RUZICKA and I have attached <br />to this Affidavit a certified copy of his death certificate. <br />2. Decedent, THOMAS RUZICKA, is the owner of the following described real estate, to- <br />wit: <br />Lot 4, Block 4, Rollins Addition to City of Grand Island, Hall County, Nebraska <br />Street Address: 919 West 7th Street <br />Grand Island, Nebraska 68801 <br />3. Based on the assessed value of the real property through the County Assessor in the year <br />of death, less real estate taxes and interest on real estate taxes if any is due at the time of <br />death, the value of all the real property in Nebraska belonging to Decedent is $50,000.00 <br />or less and the value of the entire estate (real property value plus personal property value) <br />is $25,000.00. <br />4. There is no Personal Representative, application for appointment of Personal <br />Representative, or petition for appointment of Personal Representative either pending or <br />granted in another court. <br />5. We are brothers of the Decedent and are entitled to the real property by reason of the <br />homestead allowance, exempt property allowance, family allowance, or by intestate <br />succession pursuant to Nebraska Probate Code §30 24,129. <br />6. No other person has a right to the real property interest described above. <br />7. We will file this Affidavit and certified or authenticated copy of the death certificate with <br />the Register of Deeds of Hall County, Nebraska. <br />r-- <br />YOUR AFFIANTS SAY NOTHING FURTHER this )1 day of , 2017. <br />Affidavit for Transfer of RE.wpd <br />
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